How to lose weight with Type 1 diabetes

[magkenmare]

My daughter has had diabetes for 10 years and has experienced significant weight gain.  She has tried over the years to lose with diet and exercise but to no avail.  She has recently done Weight Watchers for one month and followed it religiously.  She lost practically no weight.  She also exercise at least five times a week for an hour and a half.  She is very frustrated and I don't have any answers.  Unfortunately, her doctors over the years don't seem to be able to help.  Should we be looking at type of insulin?  She presently talkes Lantus and Humalog.  Does high protein help?  Her weight is in her back across her shoulders, in her middle and thighs.  She usually injects in her stomach and sometimes her thighs.  Does site matter?  Any suggestions would be so appreciated.  Thank you.

[JDRF-Team-SS]

Hello magkenmare,



First I want to tell you that I am not a medical professional, so the input that I give you is not to be taken in place of medical advice.



I am a mother of a 9 1/2 yr. old boy who was diagnosed with Type I diabetes at the age of 3.  Also, my sister was diagnosed (2 yrs. prior to my son) at the age of 24.  She is now 32.



My sis takes lantus and humalog, just like your daughter does. I do not have diabetes, however, I do understand that the weight issue is frustrating and sometimes even depressing.  My sister has had a very similar situation to your daughter's.  It wasn't until recently that she lost some weight.  Like your daughter, she tried everything she could think of.  Although this is unhealthy and I am not at all suggesting this, but she told me there were days she barely ate anything and no matter what she did she could NOT lose weight.



I have a question for you....is your daughter on any other medication in addition to insulin?  The reason I ask is that there are certain meds, like antidepressants that can cause weight gain and / or make it very hard to lose weight while on them.  I know this from personal experience.



magkenmare, I am going to talk to my sister as soon as I can and then post again.  I know that my mother is doing the South Beach diet, but my sis, because she has diabetes cannot follow it to a "t".  She mentioned something like she is doing a variation of it.  Please do not perceive me as saying your daughter should do that diet.  I do really need to talk to my sister and find out exactly what has helped her to lose some lbs.  It has been over the past month to month and a half that she has noticed some weight loss.  I believe she is really watching her fat intake and carb intake, however, she is not doing anything like Atkins.  When someone with diabetes is low, we all know they need carbs and in general need a certain amt. to balance out the blood sugars when insulin is taken.  We know this disease called diabetes is a balancing act.



Every time I have seen my sis take a shot, it has been in her arm.  Honestly, I am unsure if the injection site has any bearing on weight gain or where an individual gains weight.  I am sorry.  I am certain that you will get a lot of great responses to your questions.



I am definitely going to talk to my sister, as I mentioned previously.  I do believe she is wathcing carb intake, as well as fat intake.  I do know that her weight loss has not been dur to exercise because she is not on a regular exercise routine since she has fibramialga and her legs sometimes really hurt.



I will post again ASAP.  



Although I am not a person living with diabetes, I can relate to the frustration when you do not know what to do when your weight is not where you would like to to be.  



Warm Regards,

SS

[vprrchk]

You know what magkenmare?  I would also love to know how to lose weight.  For two months now I have cut back on my fat intake to about 20 grams per day, I am exercising every day (20 minutes per day) and the whole nine yards.  Over two months guess how much weight I lost.  I didn't, I gained a pound.  Anyway, I will be waiting for a response, because I am anxious to get rid of the "junk in the trunk" :)

[JDRF-Team-LRS]

I have a few thoughts on this subject.  I'm also not a physician, but a long-time DMer.  



Two things come to mind (1) "feeding" our insulin and (2) sluggish thyroid.



I'll talk about #2 first cuz it'll be short ;-)  Many DMers also have issues with our thyroid, so I'd recommend anyone with "junk in the trunk" issues (Great phrase!) be sure to have your endo check your thyroid functioning.  Thyroid is another endocrine gland and when it's not producing all it's supposed to, I think that our metabolism is slowed.  That can lead to weight gain.



"Feeding insulin" results when we're unwittingly taking too much insulin adn therefore have to eat to cover it.  Sometimes, it shows up as going low; other times it shows up as simply eating too much all day.  When I first started pumping, I actually LOST weight ... I wasn't trying to.  In figuring out why I lost, I realized that I am no longer waking up 2-3 nights a week to drink a juice box cuz I'm low; or eating an extra snack at night to prevent going low.  Each juice box and extra snack (that I didn't otherwise want) were examples of feeding my insulin.  I think this is most common with long-acting insulins that have a peak, like Lente or NPH.  My suspicion is that Lantus, which has little, if any peak, is less likely to require feeding.



Do either of these suggestions seem like fruitful paths to look into?



As a final note, does this "junk in the trunk" look at all like similar body characteristics in adult family members?  Parents?  Siblings? Aunts, uncles or cousins?  If so, there may be some genetic component of body shape that'll be really tough to overcome.



Well, I suppose I have one more "final note" ... It may be worth while to check your BMI or your weight/height ratios.  In the US especially, there is a diseased perception of what a good weight is.  Often, folks at a healthy weight want to loose to a point where they'd be underweight.  Young women are more prone to that misperception of good health, but it's not uncommon among men.  I know a fellow who suffered that way.  I'm not suggesting that either of you are "off" in your self-perception, but I wanted to add this note for the many others who may be reading and who may not have a healthy self-perception.



I wish you well and hope that this has been of some help.

[JDRF-Team-SS]

What was posted (above) by JDRF-Team-LRS:

"I realized that I am no longer waking up 2-3 nights a week to drink a juice box cuz I'm low; or eating an extra snack at night to prevent going low. Each juice box and extra snack (that I didn't otherwise want)" makes a lot of sense!



My sister did switch from NPH to Lantus...not sure exactly when, however, I know there were and might still be times that she wakes up low during the night and munches and doesn't always even remember it until she finds something half eaten near her bed.  LOL....I am not laughing at the "night low," or diabetes, but my sis and I always laugh about the time she woke up and there were a few squashed grapes on the floor that she must have stepped on during her grape eating and the time she found a cookie in her bed.



I do know that ea. person living with diabetes is different and responds differently.  My son has never done the waking up and eating bit during the night...even before the pump when he was son humalog & NPH.  I have tested him during the night and he was (on occasion ) low and I squirted the gel frosting I keep on his night table and had him take a few sips of juice and then he went back to sleep (he was already half asleep) and I waited to re-test him.



I am going to ask my sister when she changed from NPH to Lantus and if she is still having then night lows and doing the night eating.  To be honest, I believe that she is been on Lantus for several months now and that it was hard on lantus to lose the weight that she thought she needed to. (you know...it is the "I need to get back into my normal or usual size" thing)



One thin gI do have to add about my sis who an adult living with Type 1 is that, as I mentioned, like magkenmare's daughter she is on Lantus and Humalog, but I believe that an antidpressent or similar med. may have caused some weight gain and kept her from losing even when desperately trying to.  I believe her other doc either cut back on that particular med or took her off of it.



I agree with and relate to our perceptions of ourselevs are sometimes off.



Here is a link where you can enter your current weight, height, whether you are male or female and your age range and click calculate and see what it tells you.



http://www.halls.md/body-mass-index/av.htm



and another that is a chart



http://www.med.umich.edu/1libr/primry/life15.htm



I definitely agree with LRS about your daughter having her thyroid tested if that has not been done in a while.  While searching this morning, I found the same advice.



I do understand that when you are trying to lose and nothing is happening , it can be depressing and very frustrating.  



I am on the Internet a lot and I will see my sister tomorrow to ask her what she changed in the last 2 months to help her lose some lbs. and then I will post again in hopes that it will help your daughter:)

[jdrf team dm]

Dear magkenmare and vprrchk,



SS and LRS have both given you great information. Weight gain and type 1 diabetes is a very serious problem. I would like to suggest that if it is at all possible to bring in a type 1 diabetes nutritional specialist that may help out with information that can help with weight loss.



There is another website that I would recommend dealing with this subject. It is www.childrenwithdiabetes.com/dteam/indexweight_2002.htm. This is a well known and very much respected site.



None of us here are physicians, but volunteers that can give our life experience and knowledge in dealing with type 1.



Please keep in touch and let us know how things are going.



Best to you,

dm