Varying glucose sensitivity: why?

Michel
Thu, 13 Apr 2017 19:02:26 +0000
Treatment

As you know, my 12-year-old T1D son recently (about 3 months ago) started puberty, and we have had a bit of a hard time adjusting our control practices.

Right now, based on his TDD, he is using about 0.35 insulin units/lb.day, so this indicates that, per this summary for instance, he probably still has some beta cells working (i.e. still in honeymoon but on the cusp) – since the expectation is about 0.5 unit/lb.day, going up to 0.7 while in puberty. I understand this varies a lot, which is why I am adding probably.

Since he has hit puberty, his glucose sensitivity has varied widely, which makes it challenging to deal with glucose corrections. It is more or less in one of two positions: either it is low at roughly 4-5 mg/dl.g (i.e. BG goes up by 4-5 per gram of carb), or it is high at roughly 12-15 mg/dl.g (i.e. BG goes up by 12-15 per gram of carb). We never quite now which it will be. Of course, we calculate this ratio only when he has no IOB outside of basal (his DIA is 5-5.5 hours).

My assumption is that his beta cells are sputtering widely: when they are on, his sensitivity is low; when they are off, his sensitivity is high. But, if that was the case, I would expect his TDD for the day to go widely up when his sensitivity goes up (since he stays in reasonably good control), which is not the case. So I am scratching my head.

What is your experience? If you are out of honeymoon, is your glucose sensitivity roughly stable? If you are not, do you see the same phenomenon? Is puberty a possible cause, and how?

And, most importantly, is there a way to predict better instant glucose sensitivity, since the day’s TDD trend does not seem to allow us to do so?

Also - what is your glucose sensitivity range? I would love to know what others see, and in what circumstances.

7 posts - 3 participants