This increasing in insulin requirements is expected immediately following a type 1 diabetes diagnosis and later due to insulin resistance often occurring during growth and puberty.1,2,9 The increase in postprandial glucose excursions over the 48-month study period, alongside a decreasing proportion of bolus insulin relative to total daily dose despite adjustments to insulin-to-carbohydrate ratios, suggests that these adjustments were inadequate. The gene discussed is INS; the disease is Insulin resistance.