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Type 1 and insulin resistant?

Discussion in 'Parents of Children with Type 1' started by Brandi's mom, Apr 19, 2010.

  1. Brandi's mom

    Brandi's mom Approved members

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    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?
     
  2. Flutterby

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    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?
     
  3. 22jules

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    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.
     
  4. maryellen816

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    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?
     
  5. BrokenPancreas

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    Is there a chance that Brandi is actually type 2?
     
  6. Lee

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    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.
     
  7. Amy C.

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    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.
     
  8. sarahspins

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    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.
     
  9. sisterbeth43

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    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.
     
  10. TheFormerLantusFiend

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    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.
     
  11. Brandi's mom

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    She was positive for the antibodies that proved she was Type 1. I took the new endo her blood test results from the hospital at diagnosis.
     
  12. Brandi's mom

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    Metformin is the meds he prescribed. They are horsepills! Brandi and I decided to give it two weeks and if we dont see any change I am going to call and let them know we dont wish to pursue that option anylonger.
     
  13. Brandi's mom

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    She is 5'7" and weighs 144-lbs.
     
  14. Lee

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    What kind of change specifically is the endo looking for? I would be very, ok, extremely hesitant to give my child medication that has known side effects with no good reason.

    Your child's blood sugar is damn near perfect, she is not overweight, and she is on a normal, if not a little lowish, amount of insulin. I would have to go back to the endo and ask exactly - spell it out - why!
     
    Last edited: Apr 20, 2010
  15. MissEmi

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    Just for comparison, she's using about the same amount of insulin that I was using when I was on MDI when I was barely 15, about 110 lbs and 5' 0". YDMV, but that doesn't seem like a whole lot of insulin. I would want some very specific reasoning before I tried anything like that.
     
  16. Brandi's mom

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    He seemed to think that she had acanthosis nigricans on her neck, but I think what he was seeing was the weird reaction her skin has when she wears necklaces which she wears every day except yesterday cuz she forgot to put them back on. She wears her diabetes necklace on a ball chain and a necklace from Claire's that has a key with reinstones on it. Neither of them are high quality jewelry.
     
  17. mmgirls

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    well if this "symptom" is bothersome to her AND metiform IS shown to help releave this, then ok, try it.
     
  18. danismom79

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    I agree! And actually, I wouldn't give my child the Metformin at all. The last highest number you posted that I can remember was 178. She's not high in the morning, when you would probably notice the insulin resistance, and she's using less insulin than my 11-year-old.
     
  19. danismom79

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    Brandi is biracial, yes? I have family members with that kind of discoloration on the back of the neck, and sometimes around the cheekbone, and they don't have diabetes at all. I know they look for that as a sign of type 2, especially in people of color. I think the endo is making false assumptions.
     
  20. frizzyrazzy

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    I'd be watching for seizure inducing lows if you decide to use Met, given her nearly perfect BGs and A1C. Just saying. You need a 2nd opinion before giving this.
     

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