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June 8, 2005

Insulin, Other

Question from Oakville, Ontario, Canada:

My 12 year old son has had type 1 for 4 years. My concern is the large amounts of insulin he seems to require relative to other people we know with diabetes. He weights 105 pounds and his blood sugars are in relatively good control. His last A1c, before switching to Lantus, was 7.6. He now takes 42 units of Lantus at bedtime and 1.5 units of Humalog for every 15 grams of carbohydrates. I don't know of anyone his size or age that requires more than 25 units of long-acting insulin per day. Will his requirements increase as he gets older? Is it possible that he will become insulin intolerant if he has such high requirements?

Answer:

It sounds as though there may be some insulin resistance. Some with type 1 diabetes do have it and puberty makes it worse. It is unlikely he will stop responding to insulin; it just may take more.

Also, who is giving the insulin? Sometimes children do not take all the prescribed insulin. It sounds harsh, but it happens. Be sure all the correct dose of insulin is being taken.

LD