Hormones, Teens and T1D: The Ultimate Balancing Act

If you’re the parent of a teenager with T1D, you may have noticed something alarming: their once (relatively) stable blood sugar levels have turned into a chaotic mess.

One minute, everything seems fine. The next, their numbers are sky high, insulin doesn’t seem to work and you’re left wondering if their pancreas has somehow gotten even lazier than before.

The culprit? Hormones.

Yep, puberty is here and it’s bringing along some extra challenges for diabetes management. But don’t panic! Understanding how hormones impact blood sugar and how to adjust can help you and your teen navigate this unpredictable phase.

Why Hormones Wreak Havoc on Blood Sugars

Puberty triggers an increase in several hormones that make managing T1D a whole lot trickier. Let’s break it down:

1. Growth Hormone = Higher Blood Sugars

During puberty, the body releases growth hormone to fuel all the rapid development. Unfortunately, this also makes the body more resistant to insulin, meaning higher blood sugars- especially overnight and in the morning.

2. Cortisol = Stress + Blood Sugar Spikes

Puberty can be stressful (for both teens and parents!) and stress triggers cortisol, another hormone that raises blood sugar levels. Arguments over curfews, school pressures and even excitement over a big game can all lead to unexpected highs.

3. Adrenaline = Surprise Spikes and Drops

Adrenaline, the “fight or flight” hormone, increases with emotional highs and lows. That means everything from a scary movie to a big test can spike blood sugar, while intense exercise might cause a sudden drop.

4. Menstrual Cycle Fluctuations

For girls, blood sugars often run higher in the days leading up to their period due to rising progesterone levels. Once their period starts, levels may drop again. Tracking these patterns can help adjust insulin doses accordingly.

How to Adjust for Hormonal Changes

So, how can you keep up with these hormonal shifts? Here are a few strategies:

1. Increase Basal Insulin (With Your Diabetic Care Teams Guidance)

Since puberty increases insulin resistance, many teens need higher basal (long-acting) insulin doses- sometimes up to 50-100% more than before. But don’t make drastic changes alone- work with your teen’s diabetes care team to adjust safely.

2. Tackle the Dawn Phenomenon

Many teens experience higher blood sugars in the early morning due to growth hormone surges. Some possible fixes:

• Adjusting overnight basal rates (for pump users)

• Taking long-acting insulin earlier in the evening

• Using a Continuous Glucose Monitor (CGM) to catch trends

3. Track Menstrual Cycle Patterns

If your teen is experiencing blood sugar fluctuations due to their cycle, try tracking patterns with a diabetes app or journal. Once you spot a trend, insulin doses can be adjusted proactively to prevent extreme highs.

4. Prepare for Stress and Adrenaline Spikes

Since stress and excitement can cause blood sugar swings, it helps to:

• Check levels before and after big events (exams, sports, performances)

• Have a plan for treating highs and lows in advance

• Teach coping strategies like deep breathing or mindfulness to manage stress

The Emotional Side of Hormonal Changes

It’s not just blood sugars that go haywire during puberty- moods do too. Hormonal shifts can make teens:

• Easily frustrated

• More emotional than usual

• Resistant to diabetes management

This can be tough for parents, but patience is key. Instead of nagging, try:

• Giving them more independence in diabetes management

• Encouraging peer support (teens often listen to other teens more than parents!)

• Reminding them that mood swings are normal, but keeping blood sugars in check can help lessen them

Lean on Your Teen’s Diabetes Care Team

Hormonal changes aren’t permanent, but they do require constant adjustments. Your teen’s diabetes care team can:

• Help fine tune insulin doses

• Provide emotional support for both you and your teen

• Recommend tools like CGMs and insulin pumps to make adjustments easier

Regular check-ins with the care team can make a huge difference in staying ahead of puberty’s surprises.

Final Thoughts: This Won’t Last Forever

Puberty and hormones might make blood sugars feel unpredictable, but this phase doesn’t last forever. By staying flexible, tracking patterns and working closely with your teen’s care team, you’ll both get through this roller coaster in one piece.