I am 22 years old, have had type�1 diabetes for eight years now, and I have an inactive thyroid gland. I am taking 22 units of Protaphane with 30 units of Humalog per day (this is what my doctor prescribed) and following my meal plan, but my blood sugars are constantly too high. I then have to do the necessary adjustments which increases my daily insulin dose by nearly 15 units. It seems that my insulin sensitivity is reducing by the week. Why might this be happening? Is it normal? When do they use an insulin pump? Would it help?

It is not abnormal to see an increase in insulin requirements over time. Remember, your activity, diet, and insulin dose have the greatest impact on your sugars. If you require the most insulin and have the highest sugars during the week, could this be from decreased activity?

It is important to increase your maintenance insulin so that you are not taking supplemental insulin all the time, after the sugar has already gone high because it takes more insulin to bring down a high sugar than it does to keep it down.

An insulin pump is another way of delivering insulin. I believe it provides the most flexibility of all the ways to administer insulin. There are also additional aspects of pump therapy that allow pump users better control. If your hemoglobin A1c is not where it should be (more than 1% above normal), talk with your physician about an insulin pump and the local expertise needed to utilize this form of treatment.

JTL