Type 1 and insulin resistant?

Brandi's mom · #1 04-19-2010, 05:02 PM

We went to the new endo today. He feels that Brandi might be insulin resitant and wants her to take an oral Type 2 drug for a month to see if it can lower the amount of insulin she needs. She is on 9 units of lantus 2x a day and an average of 2-7 units of Humalog for each meal depending on how carby the meal is.

He is going to approve the insulin pump but does not want me to order it yet because he wants her to try the oral meds first.

I think it sounds a little odd. What about you guys?

Flutterby · #2 04-19-2010, 05:16 PM

Doesn't she have really good numbers though? If I remember correctly, you posted numbers last week that were AWESOME!

Reguardless of whether or not there is insulin resistance, she should be able to pump.. why does he want to see what the type 2 med does first?

22jules · #3 04-19-2010, 05:29 PM

I am not an expert by any means and my daughter is only 11--no teen years yet--but I do know that you can be a type 1 and be insulin resistant.

I do though think it is odd that he thinks your daughter is since she is relatively newly dx and is on such little amounts of insulin.

My dx for over 3 years 68 lb daughter has a TDD of 18-21 units a day. Even if your daughter is getting 7 units every meal/ 3 meals a day her TDD is 39 and that is probably in the middle of puberty.

Why does he think she's insulin resistant?

Oh and I know a type 1 adult who has been dx for over 30 years who takes a type 2 drug along with pumping so it CAN be done.

maryellen816 · #4 04-19-2010, 05:48 PM

Yes, it sounds odd. The dose that your daughter is taking does not really indicate insulin resistance to me at all. If your control is good, then there is no reason to introduce a medicine that is not without risks or potential side effects. Not to mention the annoyance of having to worry about pills being taken each day.

I would ask your doctor to explain why he feels that your daughter is insulin resistant. Does he realize that your daughter is Type 1?

BrokenPancreas · #5 04-19-2010, 05:59 PM

Is there a chance that Brandi is actually type 2?

Lee · #6 04-19-2010, 06:09 PM

18 units of Lantus for a teenage girl is not to much Lantus - plus, you guys have REALLY great #'s...if her insulin needs were climbing drastically and her #'s were super high, then Type 2 meds might be called for.

Amy C. · #7 04-19-2010, 06:40 PM

This is odd. Your daughter shows no signs of being insulin resistant. Her A1c is great. She has in range readings -- she responds to insulin.

She takes at most 50 units a day -- some teens who are resistant take up to 100 units.

sarahspins · #8 04-19-2010, 06:42 PM

Is he wanting her to try Metformin? I am currently on it... my goal was to help eliminate the IR I experience after ovulation (due to higher progesterone levels - it basically acts like a steroid) and to hopefully help me lose a little weight (from using less insulin). It seems like it's been helping, however I haven't exactly had a "normal" cycle since I started it sicne my thryoid is also way out of whack at the moment (I am still over medicated) so it's too soon to tell for sure.

That said, I need to check EZManager, but I might be using 10% less insulin overall compared to what I was using in November and December (January doesn't count since the Cedar got me really bad) it hasn't been a very significant change. I've been on it nearly 3 months now.

It's one of those "can't hurt, might help" things, but honestly it doesn't seem like she's using a lot of insulin... not for a 15 year old anyways. If she was using more than twice what she's using and you were having tons of difficulties with her #'s then I could see adding metformin but it doesn't seem necessary right now.

Using more than 1u per Kg of body weight usually signifies IR.. I would suspect that you're not anywhere close to that yet.

sisterbeth43 · #9 04-19-2010, 06:45 PM

Reann was on type 2 meds for awhile, but they bothered her stomach. Many teens even those without D are insulin resistant. But Reann had really bad numbers and was on massive doses of insulin at the time. She can still pump and take the type 2 meds (altho I don't see why they are necessary). I am type 2 on a pump and still take metformin.

LantusFiend · #10 04-19-2010, 07:23 PM

So I figure that's not more than 40 units per day (18 lantus plus 21 humalog), and she's 15- I don't see the insulin resistance. In general, a person whose insulin needs are less than 1 u/kg/day is not considered insulin resistant. 40 kg = 88 lb. Most 15 year olds weigh more than 88 pounds, so I figure your daughter is not insulin resistant.

You can have type 1 and be insulin resistant, and the oral medication metformin (glucophage) has been shown to be good for heart health as well as blood sugar, and the side effects are all in the short term - but it does give people stomach aches, and it also makes alcohol consumption very dangerous, plus it's just another thing to throw into the already complicated mix.