I am 25 years old, have had diabetes for 10 years, and it is becoming increasingly difficult for me to control my sugar levels. I am reluctant to raise my insulin intake because I do not want to gain any more weight. I have started to exercise regularly and still my sugars are unstable. Could this be because of insulin resistance? If so, what can be done about it?

Don’t shortchange yourself. If you need more insulin to control blood sugars, it is more efficient to give some extra and stay on top of it than give a lot at once when the sugars get high.

There are a variety of reasons why blood sugars become more difficult to treat over time.

For people with type 1 diabetes, there may be a history of insulin resistance in the family which is causing you to require more insulin.
You may need to check your injection sites to make sure you don’t have any lipohypertrophy.
If you have an infection or other intercurrent illness it will cause you to have transient insulin resistance.

Finally, I would recommend you review your meal plan with your diabetes dietitian.

JTL

[Editor’s comment: It is more important to get your blood sugars on control than to worry about your weight right now. You might unconsciously be using these high sugars to control your weight. I would do as Dr. Lane has suggested: meet with your diabetes team, concentrate on insulin adjustments to optimize your control, and meet with your dietitian about weight loss/maintenance.

SS]