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Discussion Starter · #1 ·
Hi,
My name is Kay my oldest son who is 15 is type 1 and was diagnosed in Jan of 09. Neither myself or my husband are diabetic, but we learned quickly about the disease. We've been threw the honeymoon phase within the first 6 months which was a great break. When He was first diagnosed he's medication was 20 units of Lantus at night and we used the sliding scale with the Novalog. Since we have increased to 32 units of Lantus, correction factor of 38 and carb ratio of 1:10 with the Novalog. In which we've been having to use the correction factor quiet often just to try and keep it controlled. Which at a days end was ending up to a total of 80-100 units of insulin per day. In the past week we started seeing BGL from 400 to almost 600. I assumed he was eating things he shouldn't have or that his insulin was bad so we changed pens.

Last Wed. he gets up for school like usual his BGL was what we consider normal 120, he had his breakfast took his insulin and went to school. I get a call that morning that he passed out in Math class and the nurse rushed to him checked his BGL it was almost 600 she admediatly gave him insulin and we rushed him to the ER. Once at the ER they administored EKG, CT scan, X-ray and blood cultures. In which they couldn't find any infections or anything wrong and sent him home (which I found out the next day he should have been admitted, his Dr was highly upset to find out they sent him home).

Anyhow the next day at his Dr. appt we discussed the situation and reviewed his insulin dosages and BGL. He gives him a check up and talks with him. I tell the Dr. how over the past week he started complaining about his feet being cold at night. After our discussion and his check up he proceeds to tell me he believes he has become insulin resistant. That the amount of insulin he was having to take was not normal for his age and weight (he's 6 ft and 180 lbs). That he's experiencing complications usually seen way later on. He added Metformin to his insulin twice a day had me increase his lantus to 36 units at night his correction factor to 30 and ratio to 1:9.

He's sending us to a new Indo Dr. because he's other one is over 3 hrs away, he wants us to have one closer. The first day of introducing Metformin to his insulin we saw dramatic changes and no spikes after meals. But we've started seeing high BGL again when he gets up in the morning of 250-300, so I called this morning and they want me to increase his Metformin at night.

I'm just at my wits end and I just wonder "REALLY" how much more can this child take it's bad enough to be insulin dependant but now your telling me he's insulin dependant and he's insulin resistant. If this is what he's got to deal with only 2 1/2 yrs in what else is coming at him. It's just a little much right now. I've accepted the fact that he's diabetic and it's just our way of life, but really when your doing all you can and it doesn't seem to be working. I've got to the point where I don't even want him going to school and about came to the conclusion if I see anymore spikes I'm going have home schooled until it's all straightened out. I know a 15 yr old boy dosen't want to spend all their time with their moma.

Well that's my story, sorry for the length but thanks for taking the time to read it.

Kay
 

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Hello, Kay, wow, that does sound unusual! Hopefully the metformin will help control the IR. I do not have any kids 15 yet, but I can imagine his -- and your -- frustration!

Something my Endo has commented on, I am on Levemir not Lantus, but both have been modified to slow their usage by the body. If you use a pump, you use only rapid (okay it too is modified) and that might change the liver's response to what you are putting in.

I have no clue, but a pump might be worth considering, if it is a problem with the basal insulin ...
 

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Discussion Starter · #3 ·
Hello, Kay, wow, that does sound unusual! Hopefully the metformin will help control the IR. I do not have any kids 15 yet, but I can imagine his -- and your -- frustration!

Something my Endo has commented on, I am on Levemir not Lantus, but both have been modified to slow their usage by the body. If you use a pump, you use only rapid (okay it too is modified) and that might change the liver's response to what you are putting in.

I have no clue, but a pump might be worth considering, if it is a problem with the basal insulin ...
Thank you very much....We discussed the pump and my son was against it at first. I believe we have finally agreed on getting a pump. I explained how much it would be a benefit rather than what he thinks a hederance.
 

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Wow. I am so sorry to hear this has been so difficult. I hope we can offer you some emotional and support if nothing else. Please let us know how this goes.

I am currently on 24 units of lantus per day and kind of a slidding scale. Tell me, what kind of diet does he tend to follow? Does he eat low carb even though he's on insulin? This will be extra important if he is, in fact, insulin resistant.
 

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Discussion Starter · #6 ·
Well, let us know if it helps!
Will do....thanks for listening feels good to have someone listen:) I will defiently keep update post. This site seems to have a lot of good suggestions and very friendly people who uderstand.:)
 

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"thanks for listening feels good to have someone listen" Especially if you have a teen!

My daughter is just starting to get mean -- she is TEN!
 

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I am not convinced that he is all that insulin resistant. First of all metfomin would not have made much of an effect until he had been taking for 3 or 4 weeks. I do think that his basal needs are not being met with lantus. I too went through this and doctors told me I wasn't trying hard enough blaaaa blaaaa blaaa. When I got my pump it got a little better but not real good. First year my A1C's were in the 7 to 7.5 range. I t was when I added a CGMS to my treatment toolbox that I was able to see the whole picture. Now my basal rates change 9 times throughout a 24 hour period to give me more when I need more and less when I need less. I also discovered that one I:C ratio was not going to work good for me. I need more or a higher rate in the morning, the least at lunch and my middle ground is at dinner time. It became quite clear to me why MDI were not working for me and why they may never work for me again.
 

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Discussion Starter · #9 ·
Thank you very much for your concern.

Yes, we follow a diet and count all carbs. Thankfully he's always liked green vegetables so he eats plenty of those and very few starchy high carb things. We make sure he has plenty healthy choices. But ofcourse like most kids he's gotta calculate in a brownie or donut here and there. :D
 

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Discussion Starter · #10 ·
I am not convinced that he is all that insulin resistant. First of all metfomin would not have made much of an effect until he had been taking for 3 or 4 weeks. I do think that his basal needs are not being met with lantus. I too went through this and doctors told me I wasn't trying hard enough blaaaa blaaaa blaaa. When I got my pump it got a little better but not real good. First year my A1C's were in the 7 to 7.5 range. I t was when I added a CGMS to my treatment toolbox that I was able to see the whole picture. Now my basal rates change 9 times throughout a 24 hour period to give me more when I need more and less when I need less. I also discovered that one I:C ratio was not going to work good for me. I need more or a higher rate in the morning, the least at lunch and my middle ground is at dinner time. It became quite clear to me why MDI were not working for me and why they may never work for me again.

Thanks you for your response. We hope to find out more when go to his specialist. He's Dr.'s main concern is the amount of insulin at such an young it's taking to try and control it doesn't seem to be working. He says at the most for age and weight he should be only require 50 units total of his Novalog and Lantus a day. Then again that's why we're going to the specialist to seek futher options and other medication options. Alls we know is that we can't have him passing out from it being to high. And what he is experiencing is not normal for him.

But thank you so much for sharing your advice.:)
 

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Hello Kym, welcome. I am a type 1 with insulin resistance and use Metformin in the morning and evening, just like your son. It is working very well for me, but it took a few weeks for things to settle down with the Metformin. With good control we type 1 diabetics can have long, healthy lives. I was diagnosed in 1945, when I was 6, but I did not have insulin resistance until the mid 1990s. I hope the new doctor will give good advice.

My insulin pump has made a big difference. After starting to pump in 2007 my control was the best it had ever been. I hope you have insurance to cover the pump and supplies, it is very expensive. Good luck to both of you!

Richard
 

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I would honsetly say that you won't get any negative reaction from me for a brownie or donut here and there. I think people, especially young kids, probably do much better in the long run with a splurge here and there. Occasionally. Not very often. ;) I have been known to splurge, too.
 
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