Saturday, March 29, 2008

u/kg or insulin sensitivity

I've read in books that a person without insulin resistance should use .5-1.0 units of insulin per kilogram of body weight per day. The Do You Know More than A Doctor About Insulin test says that a normal adult with type one diabetes uses only .5-.7 units of insulin per day.
I am a very active person. I do a hell of a lot of walking, and twice a week weight lifting (and I have to take insulin before I lift weights 'cause it consistantly raises my blood sugar). My job isn't a desk job though it doesn't involve much heavy lifting or anything. I'm not overweight. My family history includes one person with type 2 diabetes, and he developed it past the age of 60 when obese and having lost the weight he's also euglycemic now.
Nonetheless, when I'm not sick I average about .9 units of insulin per kg of body weight per day, and when I'm sick it's more like 1.2 units of insulin per kg of body weight per day. Do I have insulin resistance?
It doesn't sound right to me: for one thing, if I stop eating for a day I can get by with a mere 8-12 units of Lantus. Otherwise I take about 18 units (at least this week- it has fluctuated from 8 to 40, but in the last 18 months has probably averaged 16-17). My Novolog use for the day tends to be about twice my Lantus dose, although that's obviously not a constant.
My breakfast carb ratio is about 1:7, the first 20 carbs of lunch are covered by Lantus with the rest being about 1:20, same for a midafternoon snack. Supper is about 1:12. As far as I can tell, these are about normal for type 1 diabetics.
Question: I know that adolescents are expected to have a different insulin need- for the type one diabetics out there, what's your tdd compared to your weight? If you're over 25 and don't have significant kidney disease, did you need more insulin when you were 20 than you do now?


Lili said...

You left out a big cause of insulin resistance - hormones. Puberty is often a time of massive insulin resistance and difficult-to-control blood sugars. Did anyone discuss what might happen if you take them? I would look there, first.

I can't tell you anything about my insulin needs at 20, since I wasn't diabetic then.

Molly said...

I'm over 20 (I've had diabetes for 32 years), and do not have kidney damage. I take .6 units per kilogram.

I took more insulin in my 20s (prior to using a pump--using regular and nph, and eating more carbs) than I do now in my 30s.

Scott said...

For what its worth, the same medical books also indicate that basal insulin should comprise up to 50% of the total daily dose, which I find incredible. After 32 years with type 1 my basal insulin comprises less than 1% of my TDD, so you should probably take this information as being pretty close to worthless -- these guidelines are really meant as starting points for doctors to begin, but should not be taken as absolute.

Bad Decision Maker said...

I've heard .5 - 1.0. Maybe 0.5-0.7 is more common for active people, but I think anything under 1.0 is not considered insulin resistance. Lili is right - I wonder if T might affect it a little?

Also, obviously, it depends on how many carbs you eat. I think I remember you saying you eat a fair amount of carbs - so - more carbs, more insulin.