"Around this age," the endocrinologist said at our last visit, "you can expect a growth spurt.  She'll likely grow up to a few inches in a year.  And you can imagine," he went on, "what that will do to her blood sugars."

I imagine no more.

She's been growing quickly for the past couple of months.  The official 'pencil mark on the door jamb' measurement shows a gain of a solid half an inch in March alone.  Last spring, she wore a size 7 Easter dress.  This year's is a 10. 

The growing part is a great.  The blood sugar part is not.  The predawn hours until late morning are the worst, not unlike when she grew quickly as a toddler.

"You'll find you're needing to increase basal rates and bolus ratios much more often," the (here paraphrased) doctor continued.  "Sometimes it will only be a couple of weeks before everything is off again."  The wry smile softened the news a bit. 

My recollection is that my daughter's 9 a.m.blood sugar was over 200 for her entire toddlerhood, though that may be a bit exaggerated.   With better tools including an insulin pump and years of experience at our disposal for her tween years, it's my hope we can do a bit better for this growth spurt.  No matter the tools, though, what really matters is the persistence of the person using them.

Therefore, there's one tool we'll need to borrow from those years: the theme song from Bob The Builder: "Can We Fix It? Yes We Can!" 

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