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.