Pènice de Résistance


Scale created by British pediatrician and portrait artist James Tanner.

I never was a teenage boy. Even so, I’m certain I would not have wanted my mom to think about my—um. So, without postulating anything about anybody’s unit, I can safely say I was happy to find this article which begins to explain what I’ve been wanting to know about insulin resistance and puberty, i.e. when will this end?

Recently, I’ve been remembering the time my 8-year-old’s (eight at that time, that is) first endo told us about teenage boys who use a 1:1 insulin to carb ratio. I remember thinking that was terrifying, and also so remote and futuristic as to be irrelevant. And the endo added something like, yeah, and since they’re teenage boys, they want to eat a whole pizza. That’s like 200 grams, 200 units, ha! I was remembering that conversation again today as I (hubris) programmed a pump to use a 1:3 (one to three) I:C ratio, up from last week’s 1:5, which was—last week—unthinkably huge, up from the previous week’s 1:7. Which was, in its day, also unthinkably huge.

Speaking of unthinkably huge, the article I linked to above clued me in to the Tanner scale. (Here’s Wikipedia on that.)

So I gather if your person is in Tanner 3 or 4, insulin resistance is at its peak. When a person reaches Tanner 5, celebrate! Their insulin requirement can be expected to return to something closer to what it was before puberty.

How long are these phases? Does each phase last a year? A month? Any chance someone could blast through stage 4 in a day or two? I don’t know the details re how anyone’s bathing suit area is hanging these days, so the Tanner information is practically useless to me. Even so, it is reassuring to know that the end is in sight. Or not in sight, as the clues are (considerately) hidden from view. But the end exists. And that, for a weary T1d puberty parent looking at a not-even-very-big dish of ice cream and a suggested bolus of 17 units, is a huge relief.



  1. Rick Phillips · November 21, 2016

    I was 17 when Dx’d so I do not know the answers even for me. I can say that insulin resistance dropped during college and started to rise again around 30. I hope your son finds his way thru as quickly as possible.

    This item has been referred to the TUDiabetes Blog page for the week of November 7, 2016

    Liked by 1 person

  2. mumoftype1 · November 22, 2016

    Oh la la, I’m still giggling from the title! Too funny! My son was diagnosed at 13 and has grown approx 20cm and gone through puberty at the same time as coming out of the lovely ‘honeymoon’ period post dx. We have seen huge rises in his insulin in the last year. We have learnt to just roll with the crazy thing that it is! Those links you shared are fab too! Merci beaucoup! Xx

    Liked by 1 person

  3. Reyna · November 22, 2016

    I’m feeling your pain. Joe is now 5’9″. He is using 60-90 units/ day… I thought that was a lot. I’m glad to read we r “normal”.

    Liked by 2 people

  4. skchrisman · November 22, 2016


    An education, as always. And, I’m sorry. If there is any silver lining here it is you are not spending a fortune on tampons, pads, pain relief at the same time. < – – *-*

    Yet, still. Wowzers.

    Liked by 2 people

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