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Diabetes

Question
Posted by: Nashmia | 2020/06/22

Q.

Can Insulin resistance be reversed in Type 1 diabetics?

I have been told that due to poor control in my childhood I have developed severe insulin resistance in my teens, I am 16 years old currently taking 42 units of long acting, with 1 unit fast acting for every 5gms of carbs and 1 unit fast acting correction for every 15 mg/dl above 90. even with this dosage Im struggling to keep my A1c under 6.5 I have read that with exercise and dietary changes I may be able to reduce this high level of dependancy on insulin, is there any truth to that? If so How long should it take for someone in my position to see some changes? Also potentially how much would I be able to reverse it?

Expert's Reply

A.

Diabetes expert
- 2020/06/25

Hi

Currently you are using higher than normal doses for a type 1, although you haven't mentioned your weight. Reasons for higher doses include 1) higher weight 2) lipohypertrophy...lumps from injection sites due to over usage of certain sites 3) poor injection technique 4)puberty(not sure where you are in this regard). If weight is an issue, then losing weight will help. Exercise will also help, but the benefit is short lived, and therefore it needs to be regular. Metformin has been tried, but the benefit is not greatly significant. The newer class of drugs called SGLT2 inhibitors would potentially help, but need to be used under an Endocrinologist's supervision, as they need to be carefully monitored in Type 1's due to a higher risk of ketoacidosis. Victoza/Saxenda as a weight loss drug(if needed) would also potentially help. You would need to discuss these options with your doctor. Diet is harder to manipulate, as the main benefits would be from weight loss(reduced calorie intake), as opposed to adjusting the individual components, although eating a Mediterranean based diet with lower carbs could potentially help

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