insulin and weight gain

[karabea]

Hi all-
I have been diabetic since 1989 (at age 11). I have never been super skinny, but never really overweight either. I have noticed that since I have switched from NPH and regular to Lantus and Humalog I have gaind approx 35lbs in the last 4 years. I stated the insulin pump two years ago and went from 178 to 202 in three months (dr said that it was water weight) and I went off the pump as I was so bloated that my shoes, rings and pants did not fit. I have worked hard the last 6 months to get that weight off (going from 194 to 171). I always took my Lantus, but was hit or miss with my Humalog (blood sugars stayed pretty good, I am not a big eater). All of my test for kidney, liver, eyes are normal, and my A1C is a little elevated- 7.1. Recently I have decided that I want to in the best health that I can be. I exercise (cardio) at least one hour a night, eat between 1100 and 1350 calories a day, and my blood sugars have been in the low 100s. However, I have gone from 173lb to 182lb in a week. My dr keeps telling me it is not weight gain,but water retention, however the numbers on the scale are all the same to me, and my clothes are not fitting right anymore. I am getting really frustrated...any suggestions?

[morrisma]

Insulin is a growth hormone.

Also if you eat your way out of hypos, that can contribute to weight gain. It's a delicate balancing act.

[xMenace]

What sex and height are you?

Best control is usually achieved with a pump when used correctly.

[notme]

I soooooo sympathize with you! I have always had the issue with weight gain and control. I have had diabetes for 21 years and also gained the 30 lbs I lost before diagnosis and 30 on top of it. I expected to gain the weight back that I lost before diagnosis, but never expected the extra 30. I have fought this for 21 years and wish I had an answer for you.

Like you, i have never been skinny. I am also not a big eater. Actually, I am a pretty picky eater. I am not to much overweight now, but enough that it makes all of my clothes feel very uncomfortable and I don't like the way I look.

Many people here do not have the weight gain issue we seem to have. There is obesity in my family. My older sister and my Mother was obese. Neither one of them have diabetes. My younger sister and I were more average size and I am the only one with type one diabetes in my family.

I know that not having the blood sugar swings does help with weight gain. Getting an A1C in the sixes would be helpful, but you have to do that without lows. If you go low you eat. Calorie counting instead of carb counting is key for me. I have to avoid fats and I do better with the weight gain. The biggest key for me is constant exercise. That being said, I have never been able to lose more than 10-15 pounds.

Let me know if you find the miraculous cure.

[karabea]

Thanks for the advice everyone. I am a female- 30 years old and am 5'5. I am taking synthroid (religiously). I don't seem to go low all that often ( maybe once or twice a month). I take 24 units of Levimir at 7 am and at 9 pm, and usually between 5-8 units of apidra a day.

[xMenace]

Thanks for the advice everyone. I am a female- 30 years old and am 5'5. I am taking synthroid (religiously). I don't seem to go low all that often ( maybe once or twice a month). I take 24 units of Levimir at 7 am and at 9 pm, and usually between 5-8 units of apidra a day.


That's a very odd ratio. Perhaps your levemir is way too high and you need better coverage of your meals with more Apidra. Too much basal insulin can create gaps in coverage that require food to keep you from going low. Do you find you need snacks to keep from going low in mid morning, late afternoon, or before bed? Right now I'd bet your insulin is forcing you to "feed the disease" Basal insulins should keep you flat when you omit food. Here's some reading.Getting Down to Basals :: Diabetes Self-Management (http://www.diabetesselfmanagement.com/articles/Insulin/Getting_Down_to_Basals)

[ant hill]

I stated the insulin pump two years ago and went from 178 to 202 in three months (dr said that it was water weight) and I went off the pump as I was so bloated that my shoes, rings and pants did not fit.
The pump did give better control and since that the better control that you have, You will gain the weight. :)

[karabea]

But even with the exercise and food management, I would think that some should be coming off. Has anyone found any meds that help with the fluid retention?

[Richard157]

I gained 57 pounds in the late 1990's when I changed from N & R insulins to NPH & Humalog. That weight gain caused me to develop insulin resistance. I was then a Type 1 with Type 2 symptoms. I was a "double diabetic". I am taking Avandia for the insulin resistance and pumping with Humalog. I have lost 26 pounds by eating only 150g of carbs per day and exercising at least 6 days per week. I am not gaining but I have leveled off and I think I will have to further reduce my carb intake and exercise more as well. I need to lose 31 more pounds. I willl always have the insulin resistance even if I get back to my ideal weight of 185 lbs. Work on that weight so you don't become a double diabetic like me. BTW the Avandia has worked very well for 9 years. The weight is my only problem now. Good luck!

Richard

[barbarac]

I was never heavy, but have gained a great deal of weight since being diagnosed. I have tried insulin, the pump twice, and do not really over eat. I don't care what anyone says, I believe diabetes and/or insulin puts on weight. Not only puts on weight, but makes you "out of proportion" if you know what I mean. It seems to all go to the middle. I was never heavy before diabetes. Also, it would be nice if I could get the pump to work right. Have tried. Doesn't seem to want to work right for me.

[Gary_W]

How are you actually testing your needs for basal insulin?

The reason I ask is that when I first went on Lantus, the advice given by the clinic was to keep ramping it up until my morning BG was good. Result was awful control and nearly 4 stone in weight (around 55lbs). No fun.

I was essentially taking twice as much Lantus as I needed. When I got the dose right, the weight fell off.

The 'Eureka' moment for me was having it pointed out that the vast majority of people are within a little of a 50/50 split between basal and bolus each day. I was on far more Lantus than ever I was Novo, and consequently had to feed the Lantus.

If I've got it right here, you are taking 48u of Levemir each day and then only 5-8u of Apidra. This ratio just does not sound right.

Have you done fasting tests to check your Levemir dose is actually correct?

Gary

[kgm0612]

Kara............I truly believe a lot has to do with genetics as to whether or not you gain weight from being on insulin.

One suggestion would be to add 500-mg of Metformin twice a day. I'm a type 1 pumper and take Metformin with breakfast & dinner. My endo believes (and there have been articles written on this) that it helps to keep the weight off. I've been the same weight (give or take a pound or two) for the last 5 years. I walk almost every night, 3 to 3-1/2 miles, and I limit my carb intake to under 100g a day.

Karen

[notme]

I tried Metformin and it did NOTHING for me. My endo finally suggested that I stop taking it. My blood sugar did not improve and my weight didn't change at all.

I am not obese, but I did gain weight after diagnosis that has never budged no matter how hard I tried. I often eat less than 1200 calories a day and I do exercise. My blood sugar does better, my muscles are much better, but I don't lose weight. The only time I lost any significant weight was when I all but deleted fat from my diet. You can only do that for so long. I gained it all back.

[Alice]

One thing I've started is tracking the calories (not just carbs) of the foods/glucose that I eat for lows. I find that on some days those carbs easily can add a few hundred calories to my daily total. I can remain the same weight at 1500 calories...and need to reduce to 1200 to lose weight slowly. Doesn't sound like a lot, but at 5 foot 2 inches, those pounds jump on quickly.

Also, I found I was concentrating on carbs to match with my insulin. Have that talent down pretty well! But, I was losing sight of the calories and have gone back to tracking calories.

Even though I attend Weight Watchers, I still count the calories instead of the points. I think after watching several segments on TV about true calories in restaurant food (Blooming Onion at Outback is over 2000 calories...)...I find I can eat through my 1200 calories very easily if I don't track them.

[aperfectbass]

I thought I'd share my experience. I don't think it will help you, Karabea, but maybe someone else who is reading this might benefit.

In addition to lowering b/s, insulin makes fat. Its really the only thing that makes fat accumulate. This is what makes the Atkins diet work. I had some weight issues in the past year or so and read this somewhere and has really helped me. So ask yourself, are you eating for you or for the diabetes?

For me, I was feeding the diabetes (when I'd go low, I'd eat for that reason) So I backed down my insulin to match my eating habits. I've lost a little bit so far. The extra 10 units or so of humalog and 5 of lantus i would give myself each day would essentially turn my excess eating directly to fat.

[notme]

One thing I've started is tracking the calories (not just carbs) of the foods/glucose that I eat for lows. I find that on some days those carbs easily can add a few hundred calories to my daily total. I can remain the same weight at 1500 calories...and need to reduce to 1200 to lose weight slowly. Doesn't sound like a lot, but at 5 foot 2 inches, those pounds jump on quickly.

Also, I found I was concentrating on carbs to match with my insulin. Have that talent down pretty well! But, I was losing sight of the calories and have gone back to tracking calories.

Even though I attend Weight Watchers, I still count the calories instead of the points. I think after watching several segments on TV about true calories in restaurant food (Blooming Onion at Outback is over 2000 calories...)...I find I can eat through my 1200 calories very easily if I don't track them.


I couldn't agree more Alice. We have lost sight of counting calories, calories from fat and calories from carbs. I honestly think counting calories is the way to go and eating whole foods rather than processed foods. Hard to accomplish this day and age of fast eating. I think it is why Europeans do so much better than we do. They still believe in the art of cooking and the art of eating. We eat on the run.

[Lloyd]

I've lost lots of weight on insulin, by limiting my carbs to 75 or 80 per day.

-Lloyd

[notme]

That is awsome Lloyd. Congratulations on your weight loss. I hope you keep up the good work!

Being women, I think it is naturally harder for us to lose weight. Type one diabetes requires a larger amount of basal and bolus insulin to control blood sugar and there is no natural insulin being produced.

I have tried limiting carbs, exercise and limiting fat with a negligable result. I am not a lot over weight, but enough that it makes me uncomfortable. I was always on the thinner side until I started taking insulin.

I wish I could lose weight, but I am about to give up. I am going to talk to my doctor again about hypothyroidism. It runs in my family with both my Mother and my sister taking medication. My tests have always been borderline normal. We will see.

I guess I would rather carry a few extra pounds than have long term complications.

[ant hill]

In addition to lowering b/s, insulin makes fat. Its really the only thing that makes fat accumulate. This is what makes the Atkins diet work. I had some weight issues in the past year or so and read this somewhere and has really helped me. So ask yourself, are you eating for you or for the diabetes?
Yes this to me makes a lot of sense as I get some lows in my day so if I were to discount my insulin and look at listen to your body and say I have had enough. I find that the more insulin that you take the more food to cover for it.

For me, I was feeding the diabetes (when I'd go low, I'd eat for that reason) So I backed down my insulin to match my eating habits. I've lost a little bit so far. The extra 10 units or so of humalog and 5 of lantus i would give myself each day would essentially turn my excess eating directly to fat.
I do the same Alice for the lows and that gives me some indication to back off the insulin. Sure you will see the BG's start climbing up and so go walking or something that will bring that BG down.

I think it is why Europeans do so much better than we do. They still believe in the art of cooking and the art of eating. We eat on the run.

:) Now that made me smile Nancy as I think that the food they eat is so enticing and it's much better for you.
In France they don't eat a plate full as you look at a 10" Plate and they just use half of it! So there is some merit in eating small. ;)

I've lost lots of weight on insulin, by limiting my carbs to 75 or 80 per day.

-Lloyd

That's awesome Lloyd!! :D

I guess I would rather carry a few extra pounds than have long term complications.

As for me I can afford to loose some Kg's (in your case Pounds :))
So buy looking at just cutting back the insulin little by little and keep looking at my plate and eat small. If I dwell on that I may loose some Kg's. :)

[karabea]

Oh....I am soooo frustrated. I have been really watching my BS ( have been in low 100s) my carb intake- eating less than 85 grams per day and only taking 5-6 units af Apidra and I have still gained an additional 3lbs in the past 3 days (that makes 15lbs since really watching it the past few weeks). ANY OTHER SUGGESTIONS- I am DESPERATE!!

[notme]

Have you had your thyroid checked karabea?

[karabea]

yes I have and my levels were off. I am currently takin 0.50 a day, at first it helps, and then seems to quit working. This is the 4th time that I have been placed on synthroid. At this point, I do not think that the drs know what they are doing. So frustrated!

[Sarah Black]

Hi Everyone, especially Karabea

My story is sooo similar to yours (and I'm having the exact same difficulties) and this prompted me to join the site. Hopefully together we'll eventually find a solution...

In December I was hospitalized with ketoacidosis, and was placed on an insulin pump while I was unconscious so that the doctors could better monitor what was going on. I gained 15 kilos (that's 33 lbs) in 2 weeks - the gain was so incredible that they actually brought in a different scale because they thought that the first one was broken! Since I'm very athletic (about 2 hours of sport per day) they had me on a 200 g carb, 1900 calorie diet.. since then we've been gradually reducing the calories and the carbs (and thus the insulin doses) as well as augmenting my daily exercise to 4+ hours per day. Despite all of this I weigh in at 70 kilos (154 lbs) at xxx (5'1), whereas my normal weight before, with diabetes well-regulated, was 50 kilos (110 lbs).

On to a possible solution : my mum has been doing loads of research to help me out with this, and there seems to be a lot of disagreement on how to eat, etc. Something I'm going to try is limiting not only the number of carbs but the type of carbs as well, avoiding stuff like pasta, bread, rice, basically the starchy stuff, and instead having vegetables and a little fruit to go with it (apparently though if you do this, to not lose muscle mass one must get enough animal protein). So, instead of having a small bowl of pasta to get my 30g of carb per meal, I'll have loads of veggies (1 giant can of green beans only has 6g of carb!). So, if anyone has tried something like this, let me know - and of course I'll share everything I know about this with you guys :)

[BrianSCohen]

Insulin is a very powerful hormone. We all hear about how insulin is the key hormone controlling how glucose is absorbed by our muscles. What we don't hear much about is that insulin is also a fat storage hormone. When we eat excess carbs, insulin also signals to our bodies to store those excess carbs as body fat. If you start insulin therapy and you are starting to gain fat, you should look at your carb intake. Reducing your carbs can really address this issue. Lloyd says that he has lost dramatic weight in this way limiting his carbs to just below 100g/day. You might think about trying this and see if it works.

[Sarah Black]

Hi again!

Well, it's only been a week, but I'm already seeing some results (and, most importantly, feeling sooo much better!). I've been really careful about limiting my carbs to about 30g per day (a nice big salad every lunch and dinner with at least 4oz of protein), and I've lost 5 kilos (about 10 lbs)! Hurrah! I've also got more energy AND my highest blood sugar (after meal test) has been 1,21 (about 6.0 I think); normal before meal & during the day & night has been 0,65-0,85 :D

Everyone who's been saying that fewer carbs = less insulin = less excess weight/fat seems to be absolutely right! And it's nice to read stories from those who have had success (nice work!).