Adolescent with DT1 with insulin resistance problems

Hello,

My son is 14 years old, 1 with DT1, he uses 24 of Lantus at night and novorapid before meals with ch, and the free Style CGM free the problem is mornings, wakes up very well between 90 and 140 depending on how muchHe went to bed.

It is click as a fast IU for about 50 CH, about 15 or 20 minutes before breakfast.

But in the same way the GLUC is uploaded to 250 or 300 in a terrible peak and at 3 hours it descends.I don't know what to do.It is growing and I can't give break breakfast.

As you can see it double the fast and it does not work.I wonder if someone went through this issue in their adolescence when hormones cause that insulin resistance?

Or would I have worked for the lantus in the morning instead of the moche?

Thank you!

@"Maxiro", that resistance of adolescence is like that, they need to increase the dose of insulin and then in a few years will play again.The slow seems well adjusted.How about the rest of the day?The other meals also cause that beak or is it basically at breakfast?Look to see, with the Free, until there is low later.Or it needs faster or, as is usually very common, it has resistance in the morning and you have to try to space the insulin of breakfast to give time to insulin to cover the intake.All with great prudence and relying on Free readings.The sport will also help him a lot.Encouragement and a hug.

I do not see any insulin resistance there if it always happens, there may be resistance if you have taken fat, hormones in specific periods and others but if it is always that is not resistance.There the basal fails, the breakfast bolus ratio or fails what is taken at breakfast, that is, the type of food it takes for breakfast.
You had to comment with the endo you see what happens.

If it serves as comfort, my son is the same (although the peak does not usually pass from 220).Until 2h45-3h, fast insulin as it is not so fast.
I corrected it a season raising myself before and clicking 30 to 45 minutes before breakfast.Although it worked, it did not seem to be worth it for the risk of some setback (which had less breakfast, or act the insulin before, or had sport early, or ...).So we have let it be.It is not a tremendous peak.As @"jconegar" tells you, he tries to have breakfast has a more appropriate glycemic index (I would tell you more fatty so that the glycemia rises slower and becomes better to the action of rapid insulin).

I think that if you change in the morning it will be worse, because it will still act less the slow one at breakfast
You have to try other breakfasts .. that have more solids and some fat and protein .., do not discuss it ..

The first thing that would advise you is that you do not overwhelm if the rest of the day is in normal values, and you look little by little alternative until the body changes routine.The first measure you can do as the classmates tell you (although you do not tell us what kind of breakfast does) is to change breakfast for slower absorption hydrates and some fat, if you see that it does not work, and after consulting with the endocrine, change slow insulin, for example the toujeo, or later the fast insulin until seeing if the body reacts.I also think that if you change the Lantus in the morning it will be worse because many people do not last 24 hours and take effect 1 hour since it is injected.
I had a somewhat similar season, after breakfast I put peaks over 200, and I solved it exercising after breakfast (even soft), although it is not always possible because I imagine that I will have to go to school, but it canTry when you take the holidays if you have not been corrected until then.

My daughter is now 15 years old.Our problem was the same, breakfast, Lantus was also put at night.After asking for the change to Tresiba and getting to anticipate the 50 min insulin at breakfast, we have managed to avoid the peak of breakfast almost every day, and if it has it it can reach 200 but there are no longer 300 or 350.

@"Rociollinares" that is, the only way to avoid those peaks in my opinion is to space enough and breakfast (checking trends with the MCG or free if it is available to not have scares).With the pump you can also increase the basal in that section so that the basal also helps the rapid to cover breakfast.

@"Ainhoa" totally agree.
I have the same problem and I am not a teenager.

On weekends I put the insulin and I hope to see the trend;It does not effect until almost 1: 30h later;Total that during the week I do not get up at 5:30 I take my peak in tow ... and I don't care because I have tried to upload the rapid and what I get is a hypo at 3 hours when finally when finallyThe rapid acts.
Always breakfast the same at 7:00 (during the week), 4 HC rations of slow absorption with 2 ud of Rapida.I have the maximum peak at 9:00 (250-280) and at 11:00 I am around 100 or even hypos if I upload the slow night.

File X? Insulin resistance?Alba effect?No idea .... I live with it and I only overwhelm if it seems to be more than 299 :)

Thank you all for your suggestions, I will take them into account.THANK YOU !!

@"Maxiro" The morning is one of the most complicated moments for almost all of us.The solution may be, indeed, in space more insulin and start eating breakfast.In my case, the wait is between 20 and half an hour, depending on the departure glucose.You can also add some fat to try to soften that peak, such as butter, or something that slows down the absorption of HC.If you upload the fast insulin a lot but you do not change anything more likely it will have a very pronounced fall of glucose in mid -morning and can cost you to overcome on occasion.