Will the pancreas or insulin sensitivity get worse with age?

Hey there,
I’ve been diabetic for 5 years now and i’m pretty insulin sensitive and in good shape despite my eh a1cs (usually in the 7s). I was wondering if as i get older i will become less sensitive to insulin or if insulin sensitivity is related to other things such as fitness. Thanks!

I wonder about this sometimes too, and also about my ability to feel symptomatic when I’m low. My uncle is T1 and he says he can no longer feel his lows. Scary.

I am 60 and exercise still helps quite a bit. Weight gain is undesirable as it makes you require more insulin.

I’ve been T1 for 36 years. Shortly after becoming T1 I started college. I rowed varsity crew there on a team that took it very seriously (Nationals etc). I got a lot of exercise every day - rowing plus running or weights or stadiums. Clearly I was in the best shape I’ll ever be then; also this was in the days of a single injection of NPH insulin. I don’t remember my exact TDD (total daily dose) then, but it was very small because of all the exercise. (One of these days I’ll pull out my old records to check on it). After my exercise routine became more sane/reasonable my TDD increased, but it also continued to very gradually increase over the next 30-some years. Over these years I continued to exercise (running, rowing, squash, etc.) but the frequency decreased. And I gained some weight - about 15 pounds. BTW, there was no such thing as A1c’s back then, but I’ve been in the 7’s (occasionally 8’s or high 6’s) since I started being tested.

Last year I noticed that my TDD seemed to have increased a lot and my BG got very hard to predict, so I tightened my control and exercised more predictably (last A1c 6.5). The improved control caused me to lose weight - I am now the same weight I was in college. Along with the weight loss my TDD went down a bit, but my TDD is still much higher than it was when I was rowing in college, and significantly higher than it was after I left college and was in grad school etc.

Although increased weight and reduced exercise cause less insulin sensitivity and an increase in TDD, my conclusion is that for me, at least, the increase in TDD is not simply due to less exercise (since I am exercising now about as much as I was in grad school and later), and is not simply due to increased weight (since I now weigh the same as I did then). I believe it is simply because I am older. It could be in part because my control wasn’t great (average probably in the 7’s) - but I haven’t seen anything to indicate that loose control is a known cause of higher TDD - except when it leads to weight loss.

BTW, I am just as symptomatic as I’ve ever been; I feel my lows and treat them, so that has not been an issue for me. And having a higher TDD than expected isn’t really an issue since it isn’t really a negative (except for the cost of the insulin).

Ah i’m glad to hear you’re still in good shape! It would make sense if things change with age.
Lately i can’t feel when I’m high or when i’m beginning to get low. However when i’m rising from being low i get the usual “low” symptoms.

I think that’s a very individual thing. Some people develop increasing insulin resistance with age, regardless of whether they’re diabetic or not (in many people, it’s genetic). If you want to retain your college weight, you will have to work increasingly hard at it, because metabolism slows down with age. Increased weight usually means increased insulin resistance.

But I think that if you’re motivated, you can do a lot to maintain your fitness, and if insulin usage goes up a bit, then so be it – it’s not a catastrophe!

I agree that exercise and activity can increase insulin sensitivity levels,. Like Jag,I am a long -time insulin user and do not even remember how many units I took in the one time daily shot back in the 70’s. I know that when I am active and bicycling, walking and hiking in the summers, even now at 56, my need for insulin goes down and my sensitivities go up ( need less basal, bolus, and correction insulin). In the cold Ohio winters, i need more insulin, as I do not move around as much and I am inside, snacking on low-carb.However, low-carb homemade hot chocolate ( YUM), cheese, and nuts have a lot of calories and I tend to gain 5-8 pounds over the winter months. I lose them with the return of more activity in the spring. I cannot say that I am truly more insulin resistant when it is cold just more sendentary
AND greedy(LOL).

God bless,


My sensitivity to insulin has not changed in more than 20 years. I started with 16 units of NPH (basal) per day and with Levemir it is the same. The fast acting NovoRapid was the biggest surprise for me. No waiting time anymore and the spike I had with regular insulin is also gone. With more physical activity I could reduce my insulin needs further. My weight was pretty stable over the years - these school reunions are quite shocking to me.

I have to agree that sensitivity hasn’t changed with age for me either, although my lifestyle has changed quite a bit a few times active, less active, more active, WAAAY more active and now pretty active and that seems to still be pushing my insulin needs down. The part of me that likes it when my BG is lower all the time seems to be up against a wall of diminishing returns these days and is always reluctant to turn any ratios down. Damn the torpedos and full speed ahead.

I think to improve, I will need to figure out a way to make myself keep records. I’m amazed at you guys having records going back 20 years!! My first endo died last year so I dunno if there’s even any way I could track that stuff down but I am hard pressed to say what I ate yesterday, much less in 1992 or 1987!!

It’s difficult for me to determine, as a general rule, if my sensitivity has decreased over the 25+ years I’ve been a T1. Since leaving my honeymoon period, I know that my sensitivity has fluctuated but it seems to depend a lot on how consistent I am with my exercise program. My weight does not fluctate a lot and my sensitivity does not seem to track very closely with weight gain or loss.

That being said, I think I have been able to maintain a fair bit of insulin sensitivity just through exercise and if I didn’t maintain my exercise program, I have no doubt that I’d require a significantly greater amount of both basal and bolus insulin.

I was diagnosed at age 11 and around age 16-17 started to gain weight unexpectedly and started having insulin resistance (and at this time was a starter for the Varsity Soccer team). This got worse and continued until my mid 20’s when I drastically changed my diet and began exercising a lot again. Then my insulin sensitivity came back to what it was when I was diagnosed. Turns out, I personally, can’t eat anything white. So I stick with unprocessed, whole foods-mostly, meat, chicken, (all organic), vegetables, fruits, and nuts. The only grain I do well with is Ezekial toast. It’s been 16 years for me now with type 1 and luckily, still feel my lows. I’m not overweight but, I could lose a few pounds. (5’3, 135 pounds) I use less insulin when I weigh less so that’s why I’ve got a goal to lose the last 20 pounds)

If you stay thin and active and eating a healthy diet, I personally, think you can keep your insulin sensitivity (at least for a long long time)

After 10 years on MDI, I still have the same insulin sensitivity as when I started.
The only way to retain hypo awareness is to keep that average above 80-90, set it higher for a while to regain awareness if necessary. Do not tolerate lows. Prevent them. You can get awareness back.

I don’t record what I eat unless I am actively trying to figure out carb ratios, etc. It takes too much time. The only records I would look for are the ones my Doctors have kept of the amount of insulin I’m taking. That’s always the first they ask me so I know its in my medical records. All you have to do is ask your doctors for a copy of your medical records to see that history. I got a copy of my records when my first doctor retired - if yours died you may still be able to get the records if you contact the remains of his practice.

I was diagnosed as a teenager and over time the amount of insulin I’ve needed has actually dropped a lot.

e.g. shortly after diagnosis at age 14 I was taking circa 70 units a day.

Today (age 43) I am taking circa 35 units a day.

So obviously there are a lot of factors that can come in.

Yeah that’s what i understand i have to do (Keep my sugars up) the only thing is that my blood sugars have been up and down lately but mostly high and occasional lows, i think my body is tired of dealing with the fluctuations. I hope that when my sugars get more stable that my awareness comes back more.

They’re the same thing. Just depends on where a person lives what it’s called.

It’s called NovoRapid in Canada.

70’s are fine. People raise the bar when they start losing hypo awareness. Sometimes it’s not so much the actual number as it is how quickly BG is coming down that accounts for that shakey feeling when you’re not that low. Yea, when BG has been high for a while, it takes an adjustment period to acclimate to more normal BG.

I agree; varying exercise is by far the easiest way to increase or decrease insulin sensitivity. It doesn’t take long to make a difference - only a couple weeks before basal rates change noticeably.