I would like to know if a child with type 1 diabetes can become resistant to insulin? What tests can determine this? What would be the treatment?

The reason I am asking is that my seven year old son, who was diagnosed with type 1 at the age of 4, is experiencing higher blood sugar levels. He follows his diet and exercises. His blood sugar levels’ average per day is over 250 mg/dl [13.9 mmol/L]. At present, his doctors have reduced his NPH from 16 units to eight units in the morning and from 20 units to eight units in the evening. Humalog is given according to a scale.

At a first glance, your child’s story reminds me once more that, in a child with type 1 diabetes with high blood sugar levels, before thinking of insulin resistance or of idiopathic brittle diabetes, a better and more physiological insulin regimen with proper education of the child and his/her family might be the most right answers. In your child’s case, I’d discuss with your diabetes team switching to an intensified insulin regimen based on glargine insulin as the basal insulin with lispro (Humalog) or aspart (NovoLog) before each meal. This regimen, if correctly applied with the help of a pediatric diabetes team, may solve your child’s high blood sugar levels in almost all cases.

MS