Insulin needs of an 11 year old

My almost 12 year old daughter is going through 200 units in 2 days. She is pretty active too. Is this normal? That used to last her about 3 days. 

My insulin requirements were pretty high when I was that age. It dropped dramatically when I was out of my teens. Right now between growth and hormones insulin resistance or requirements change a lot and sometimes quite dramatically. All you can do is test a lot and try to keep up. Don't forget that this is an emotional time too and that can affect your blood sugar levels also. It's a touch time. We get through it though.


There's no normal amount of insulin.  Insulin is one of the only drugs that has no maximum dose because different people have different sensitivities to it.  

It's such a difference in insulin requirements than before. She is pretty active too.

She has been getting a bit of a tummy on her now and it is causing her worry. She had three terrible highs over the last few days and I'm afraid she is cheating on insulin to lose her tummy. We caught her lying about a BG too. She said it was 130 when it was 330.

Sounds like you may have a couple issues.  

It's not unusual to lie about a high or low because it feels like a failure and something you don't need to mention because you can easily fix it.  Reassure her that highs happen and she shouldn't lie about them, just treat them.  

Sounds like you're also concerned about diabulemia.  What do you mean by "go through" insulin?  Do you see her inject or bolus with her pump?

When I was about 10 I started skipping shots and would draw up insulin and then squirt it down the bathroom sink.  Ask her specifically if she's pretending to do shots or under dosing.  I think a lot of teenage girls with diabetes experiment with this, but it usually doesn't become anything long lasting.  

Probably best to talk to her honestly about your concerns and ask her to shoot up in front of you.  Eating disorders are secretive and can't stand up to honest discussion.  

Your daughter is at that difficult pre-teen/early-teen age when girls tend to get highly emotional and highly irrational.  Know that no matter what her response to what you say, she is listening and she needs your guidance.  

SHe has a pump so I think it would be a little more difficult to pump insulin down the drain. I am more worried that she is becoming insulin resistant.

She is starting to worry about her tummy but so far it has meant that she is more interested in healthy food that anything else. She is eating salads more and not looking for cookies or ice cream every day.

That makes sense.  She might just have highs because of forgetting to bolus.  

Ask her if she's changing the infusion sets every 3 days too.  Any longer than that and it causes high blood sugars because the skin doesn't absorb insulin well.  

Like Cora orginally said, growth hormones may be causing the highs and the insulin resistance.  Growth hormones, reproductive hormones, and steroids are all in the same family.  They all cause noticable insulin resistance.  The fact that she has a little tummy probably means she's getting close to puberty and/or a growth spurt.  

I don't remember having a big insulin increase at that age, but frankly I was in terrible control and it could have happened without me noticing.  

Sorry if I was confusing with the eating disorder reference.  What I meant is that diabulemia (withholding insulin so carbs eaten aren't utilized) is considered and eating disorder.  If your daughter will allow you to do so, ask to see her basal rates and recent boluses with her pump.  

200u a day is a lot, but I don't know if there are other pre-teens with similar levels.   I'm an adult and take about 45u a day.  When I was 9 months pregnant and had severe insulin resistance (caused by reproductive hormones that increase in 3rd trimester) my insulin needs were 100u a day.  But we're all different so it's not a sign that anything is wrong.

If this is the start of ongoing insulin resistance, some people with type 1 diabetes take metformin or other oral meds and some use u500 insulin instead of the standard u100.  They are more potent and also stay active longer.    

Not to repeat what has already been said but, talking to your daughter will go farther than anything. i was 14 when I was diagnosed and although I am not a girl ;) my parents yelling, screaming, and accusations of cheating, went a long way to makeing me "not care" one way or the other. The meals that were served were not healthy diabetic meals plus I wasn't cheating so when my test results showed high sugar levels my parents would commence to accusations. It was a rough time for me then and now my 9 year old is dealing with the same thing. I've tryed to talk to my wife about the whole "accusations" thing but she says I don't know what I'm talking about. Then I get angry, we fight, and it all makes things worse. I just don't want my daughter to experiance the same things I did. Things are better now. treatment is better, home testing is better. i don't know how to get through to my wife but I do know, honest conversation with a person with diabetes goes a lot further than the way my wife is doing things right now. I will get through to her, eventually. But, for now, it's a loseing battle. best of luck to you.

You're right on Brad.  Most people rebel when they are accused or attacked.  That's human nature and people with diabetes are not immune from it.

This article is great and I hope you can get your wife to read it because it captures how people with and without diabetes have good intentions, but often fall short of doing what's ideal.

As you know, when you have diabetes your pancreas doesn't work and so you have highs and lows.  With good control you can lessen the severity and the number you have, but highs and lows still happen.  It's especially hard for kids since they are more active and during growth spurts have insulin insensitivity.  

That's cool that you've just hit your 30th anniversary with diabetes.  I recently had my 35th diabetes anniversary and have been so encouraged by people who've lived with D for 50+ years and are still doing great.  Take care.   -Jenna