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Uff Da

Dilemma of a Skinny Diabetic

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Uff Da

First a bit of background. I'm 5'5". I've been underweight most of my life. Only briefly did I ever got out of my 103-107 pound range until I had a hysterectomy in my 40s, nor over 118 pounds until I retired. After I left stress behind me at retirement, my weight reached a low normal range of 120-130. I was at 122 when I was diagnosed diabetic in October 2011 at age 70 with a first A1c of 11.5. My doctor treated me as a type 2 and put me on an 1800 calorie ADA diet plus Januvia and Metformin.

 

That diet was a disaster! My BG shot up to the 400s and 500s! No way could I handle all those carbs as a diabetic. My doctor added glimepiride and over the next year, increased it to maximum dose. But still the only way I could keep my numbers from reaching the stratosphere was to limit carbs and calories. I lost weight until I was down to 105 pounds.

 

My PCP finally referred me to an endocrinologist this March who diagnosed me as a type 1.5 and put me on insulin. My problem now is that I'm so skinny there is almost nowhere left to give an injection. Injections are supposed to go into fat, but I have just skin stretched over a miniscule amount of muscle. Initially I started giving myself only basal doses and luckily the amount the endo started me on, 8 units of Lantus, was enough to cover some carbs as well as basal needs. I did have to be careful not to sleep through the night, though, as my BG could have gone too low. But with one injection a day, I still used up what little area I have on my abdomen with fat and had to start going very close to the old spots again. But I was still getting after-meal spikes to 250-275, though it would usually come down to high normal by the next meal. So a week ago I finally decided to add the Humalog the endo had originally prescribed. (In a phone conversation after the original consult, he had approved my staying on just the Lantus for a while if I wished, but said I'd need to move to the combination sooner or later.) With three shots a day, what little part of my abdomen isn't within the no-no area around my navel is now totally bruised and full of marks from the injections.

 

I need to gain weight again so I have more areas with a little fat in which I can inject. But how do I gain weight unless I can inject often enough to allow me to eat the 2100 daily calories or so I need? (Previous records showed that I maintained 110 pounds on 1600 calories.) Woe is me! LOL!

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jwags

I am also a thin diabetic, anout 117 pounds. But I am not on insulin, yet. I need to eat around 1800-2000 calories not to lose weight. I also exercise alot. Since I have to eat very low carb to keep bgs in a good range, when I increase calories I add fat. I aim for 2-3 tablespoons each meal. I use organic butter, cheese, coconut oil and nuts.

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Uff Da

Wow, jwags, an 1800-2000 calorie diet with just 20-30 carbs a day! I don't think I could ever do it! Looking back on my record for the past couple of days on FitDay, I had 103 and 133 carbs on those days. And that was with 53 and 56% of calories from fats. Perhaps I've just been too indoctrinated by ADA and USDA recommendations all these years. (I was a home economics educator in a past life.) But such a high percent of calories from fat just seems "sinful."

 

I guess it would help if I liked meat more so I could increase the protein level. Unfortunately, I've never been a big eater of meat. A serving of just two or three ounces per meal is plenty for me. Maybe it would help if I'd look for new ways to serve meat or fish. I did try a new way to serve eggs last week, crustless quiche. Duh - I'd never even considered making a quiche crustless, but that's at least one new recipe to help with the meal planning.

 

But oh, how I hope I can put those 17 pounds I lost after being diagnosed back on again! I was at what I felt was my ideal weight before all this started and had just enough extra padding that I might dare to inject in my arms or thighs.

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patricia52

Have you considered injecting in your thighs and your behind. By the way. Don't inject Humalog near the sie where you inject Lantus. I use my thighs for Lantus. The rest of my body (back of arms, stomach, midriff, and behind) is where I inject my fast acting insulins.

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Uff Da

Why not inject Humalog near the site where I inject Lantus? That's the only place I can conveniently reach where I have enough fat to dare inject at this weight. I kid you not. So that's where I've been doing all my injections and that small area is getting covered with injection spots fast. I'm not like a lot of women who put fat on their hips and thighs. My fat goes first to my abdomen, and at this weight there is precious little of that there, either. I recall that back when I weighed between 125 and 130, I had a little more padding elsewhere and would have more areas I'd feel comfortable injecting.

 

I did approach my domestic partner and will now be able to get one of my injections daily in my posterior, where I can't easily reach. Of course, I didn't initially approach him with "Would you be willing to give me an injection?" Oh no, it was "Would you be willing to pinch me in the butt once a day?" What red-blooded American senior "boy" would answer no to that request?

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patricia52

They will not work as well if you inject them too close together. I don't really understand why. I was just passing along what I was taught. U can inject one on the right and the other on the left. U can reuse an area in a few weeks. My 5'5" mother got down to 79 pounds when she had thyroid issues so I understand about the lack of body fat. Ask the pharmacy if they have a shorter needle. I think there is a very short needle for children. Good luck.

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Tribbles

I have similar problems and I use 4mm needles. If you pinch up when you inject you can use quite a wide area. It's odd but you have more fat than you think - you really know if you hit muscle!

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jwags

I don't use insulin yet but I am sure in the near future I will have to. although I am thin I still have flab on my belly. maybe I shouldn't work so hard to get rid of it. I am not a huge meat eater either. But I choose red meat when I eat it. I eat a lot of organic butter and coconut oil. Even when I eat a vegetsrian stir fry I add several tsblespoons of CO to the skillet. I also eat tons of chia seeds, flax seeds and nuts which are high fat.

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Chaseg08

I had a similar problem for the first 8 months I was injecting. I'm not as lean as you are, though. The VA was sending me 12.7 mm length needles as thats all they carry. I ended up paying for 6mm needles out of my own pocket until I started pumping. I think a box of 100 was about 20 bucks from Walgreens. The shorter needles made all the difference in the world for me. I wasn't bleeding and bruising with every injection and I didn't crash as often. Good luck.

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Uff Da

Actually, I'm already using the 4mm needles. But even that requires more than just skin and bones. In the past, I had been cussing that little bit of fat on my abdomen that wouldn't go away even at this weight, but now I'm thankful that I have it. But even there, I get horrible bruises from the injections. I currently have one about 1.25 inches in diameter. I had one about the same size on the other side a couple of weeks ago, but it is down to about half an inch now.

 

I've never put weight on easily. When I weighed 122 pounds, I held my weight steady on almost exactly the same food and same quantity as did my partner who weighs 180! But I've never been more anxious to gain weight as I am now!

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patricia52

Insulin tells your muscles to burn sugar and tells your liver to store fat. Maybe you will gain weight now that you are Using insulin.

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