Problem with Chronic Weight Loss

[probneurotic]

Hi,

I am a 23 y/o type 1 that was diagnosed a little over a year ago.  I am doing great with control, and test about 6 times a day.  My Hb A1c's are always under 5.5.  My problem, however is chronic weight loss.  I have dropped 20 pounds over the last 6 months (165 to 145) and it is starting to show.  I am sick of my doctor giving me soft answers that dont answer anything.  I eat like a horse, double servings at all meals three times a day with a large snack at bedtime.  I very rarely miss meals and clean my plate everywhere we go.  
I have a couple theories:
1.  I am really stressed out in school.  I am a medical student and and under a lot of pressure.
2.  I have diahrrea after fatty meals and am worried about malabsorption as a complication to diabetes.
3.  I just need to eat more. (What my doctor keeps telling me.

Anyone out there got any ideas?

[JDRF-Team-sgg]

I do not know your height, nor do I know if you are male or female, so I cannot tell if your weight is within normal limits or whether you are underweight.

Your suggestion number 2 seems unlikely since you are under fantastic diabetic control and have only been diagnosed as being diabetic for a year. Complications that are noticeable usually occur after years and after years of high blood sugars, which don't happen with a1c readings as low as yours.

Obviously, when under pressure, we can find our metabolisms speeding up and it is reasonable to assume that you may burn more calories when under pressure at school than at other times. It would appear that your diabetic control is excellent, and therefore the diabetes would not have anything to do with your inability to keep your weight up. However, I would like to suggest that you have two tests done:

1. Thyroid — there is a greater likelihood of a type 1 diabetic having thyroid disease than a non-diabetic person having thyroid disease. Both the thyroid and the pancreas are organs that can be affected by autoimmune disorders, and many doctors routinely check the thyroid levels when they do annual bloodwork on type 1 diabetics. An overactive thyroid could cause some of the symptoms you describe. Read about thyroid problems in the link below:http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZDMMPX77C&sub_cat=501

2. Another disorder that is more common among type 1 diabetics than the normal population is Celiac Disease. This is an inability to process gluten. Some celiacs are without noticeable symptoms, but since so much of our American diet is based on wheat, this maybe should be checked out. If a person has Celiac Disease, weight loss might happen because he or she is eating gluten and the body is not recieving the proper benefit of the foods containing gluten. The link below will take you to the web site of the Celiac Foundation, where you can find all sorts of information about this disease:
http://www.celiac.org/

Or your doctor may be right. You may just be someone who needs to eat a lot of calories. Many type 1 diabetics have tendencies to be lean and just don't put on weight. Since your diagnosis, you may be eating a healthier diet and you may not be snacking as much in between meals as you did before your diagnosis. A change of just one snack a day of about 100 calories will affect your weight over a long period of time. You may be showing the results of dietary changes since your diagnosis a year ago now.

But do get the other two issues checked out. If your tests come back normal, then you might try increasing your diet to include some in-bewtween meal snacks and see if the weight loss stops. Of course, you need to balance those snacks with appropriate insulin. Your doctor should be able to help you adjust your insulin dose.