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How to lose weight with Type 1 diabetes
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.
Hi,
Regarding injection sites and fat deposition, I have noticed that my 4 year old son has definate enlarged pads of fat over all his injection sites. I was aware that insulin played a role in fat deposition within the body, but surprised to see local deposits where the insulin had been injected.
Some Thoughts On Weight Loss with Insulin:(These are personal thoughts drawn from life and observation.I am not offering medical advice):
Regarding weight loss, I can't see that this can easily be done by a person with Diabetes, unless they make educated reductions in their insulin along with an informed and appropriate reduction in carbohydrate intake. This is so complicated for even a doc to do on someone else's behalf, and they will always be overly cautious, as it is preferable that you are a bit overweight than sick or dead!
The fat reduction is generally a red herring(type of fat matters), and will only make you feel worse if you reduce it unduly.
As I see it, one can opt for calorie control, which will make you miserable and probably regain the weight quickly,(and this would only work if insulin was reduced aswell), or you can work along the principles of how fats and carbs are metabolised. If you take a certain amount of insulin, you must take a certain amount of carbs(feeding the insulin), and the end result will be weight maintenance or weight gain. As soon as we feed insulin with unrequired energy, it is deposited as fat.( or glycogen if you are short on the stuff.).Diabetics are regularly forced to take excess carbs to "feed" the insulin and raise the blood glucose level. Excess carbs lay down fat. Limited carbs burn body fat(but only if the insulin is appropriatly reduced).If a non-diabetic person reduces their carb intake, their insulin production is also reduced. No-one likes to suggest altering intake of insulin for fear that one might go overboard and become really sick. Ketosis could be a problem if extreme restrictions were made(Some degree of ketosis is normal if one is losing body fat). Dietary fat cannot be properly utilised in the absence or shortage of carbohydrate, and will not, therefore cause you to gain weight under these conditions.
I guess your daughter needs to work out a plan with her endo,on principles that she really understands, and that allows her to reduce insulin on a sliding scale with her proposed carb reduction and exercise plan. Increased exercise will also reduce her need for insulin, and if she exercises so much that she goes hypo, then she'll end up feeding the BG and limiting her weight loss on that day. I guess there will be some trial and error required, and it would be good to have a close buddy know what her plan is and to be there incase she overdoes things and doesn't feel well. Weight loss for people with Diabetes is tricky but it can be done.
I really sympathise with you, and hope you find a manageable and safe plan for weight control.
J J's mom
Regarding injection sites and fat deposition, I have noticed that my 4 year old son has definate enlarged pads of fat over all his injection sites. I was aware that insulin played a role in fat deposition within the body, but surprised to see local deposits where the insulin had been injected.
Some Thoughts On Weight Loss with Insulin:(These are personal thoughts drawn from life and observation.I am not offering medical advice):
Regarding weight loss, I can't see that this can easily be done by a person with Diabetes, unless they make educated reductions in their insulin along with an informed and appropriate reduction in carbohydrate intake. This is so complicated for even a doc to do on someone else's behalf, and they will always be overly cautious, as it is preferable that you are a bit overweight than sick or dead!
The fat reduction is generally a red herring(type of fat matters), and will only make you feel worse if you reduce it unduly.
As I see it, one can opt for calorie control, which will make you miserable and probably regain the weight quickly,(and this would only work if insulin was reduced aswell), or you can work along the principles of how fats and carbs are metabolised. If you take a certain amount of insulin, you must take a certain amount of carbs(feeding the insulin), and the end result will be weight maintenance or weight gain. As soon as we feed insulin with unrequired energy, it is deposited as fat.( or glycogen if you are short on the stuff.).Diabetics are regularly forced to take excess carbs to "feed" the insulin and raise the blood glucose level. Excess carbs lay down fat. Limited carbs burn body fat(but only if the insulin is appropriatly reduced).If a non-diabetic person reduces their carb intake, their insulin production is also reduced. No-one likes to suggest altering intake of insulin for fear that one might go overboard and become really sick. Ketosis could be a problem if extreme restrictions were made(Some degree of ketosis is normal if one is losing body fat). Dietary fat cannot be properly utilised in the absence or shortage of carbohydrate, and will not, therefore cause you to gain weight under these conditions.
I guess your daughter needs to work out a plan with her endo,on principles that she really understands, and that allows her to reduce insulin on a sliding scale with her proposed carb reduction and exercise plan. Increased exercise will also reduce her need for insulin, and if she exercises so much that she goes hypo, then she'll end up feeding the BG and limiting her weight loss on that day. I guess there will be some trial and error required, and it would be good to have a close buddy know what her plan is and to be there incase she overdoes things and doesn't feel well. Weight loss for people with Diabetes is tricky but it can be done.
I really sympathise with you, and hope you find a manageable and safe plan for weight control.
J J's mom
It took me so many years to understand I was feeding insulin, I can't even tell you how many. For a long-time diabetic like myself, I feel like I got a set idea in my mind of how much insulin I needed and simply stuck to it, regardless of the number of reactions, so the feeding and feeding went on. And no doctor ever mentioned cutting back on the insulin in terms of weight control.
Anyway, I now feel like I'm closer to actually taking the amount I need. But it requires a ton of testing! Wishing you much luck.
Lesley
Some background: I've been diabetic since I was 3 and am now 25. I got an insulin pump about 5 years ago and it makes a big difference in my ability to control what I eat. I have played competitive sports my entire life - all star ice hockey, soccer at the provincial, national and college level, mountain bike racing, snowboarding, XC running, tennis and volleyball. I now rock climb, run and lift weights.
Unfortunately, due to working on my grad degree, I put on about 25 pounds of unwanted weight. However, I discovered that by balancing my calories in with calories burned I was able to lose all of that weight. Through reducing my food (and my insulin pump basal rate), increasing my workout times or intensities, and keeping a journal of what I ate, I lost all of the weight I desired.
Here's the trick:
1. you need to figure out how many calories you burn (your basal metabolic rate + activity level):
For women: 661 + (4.38 x weight in pounds) + (4.38 x height in inches) - (4.7 x age)= Basal Metabolic Rate (BMR)
Then add your BMR to the calories you burn during activities: look this number up on the internet - type in something like "calories burned running" (or more generally: BMR x activity level.
Sedentary: BMR x 1.15,
for light activity-normal everyday stuff: BMR x 1.3,
moderately active-exercise 3-4 times a week BMR x 1.4,
Very active-more than 4 times a week: BMR x 1.6,
Extremely active-exercise 6 or 7 times a week: BMR x 1.8
2. You need to figure out how many calories you are eating (keep a journal and write everything down)
3. If you want to lose 1 pound of body fat in 1 week, you need to reduce the calories you need to maintain your current body weight by 500 per day for 7 days (this is equal to 3500 calories or 1lb of bodyfat). 2 pounds of bodyfat per week = 1000 calorie deficit per day. Can't lose anymore than 2 lbs of bodyfat a week, most people with their activity level can only burn 1.
4. Don't drop below 1300 calories a day or you'll lower your metabolism and gain weight.
5. Most people think just becasue they exercise they'll lose weight. If you're just starting out, working out for 20 mins is great, but consider the average female will only burn about 200-250 calories during a 20 minute run. That's 1/2 a cup of granola or less than a full bagel in most cases.
6. here's my personal example I started out weighing 160, I followed the above advice and lost 2 pounds of bodyfat per week. My schedule: Monday, Wed, Fri 5:45am - 30 min weight circuit, work 7:30-5:30, 6-7 bouldering at indoor rock gym for 1 hour (get to hang out with friends and family). Tuesday, Thursday, Saturday 5:45am - 1 hour run, work 8-6, occasional walk with the family and dogs 20 mins in the evenings. At some point in time in the evenings I also worked on my thesis - so weight loss can be done even with a very busy schedule.
7. Figure out how many calories you need to eat per day to lose your desired amount of weight in a week. Adjust your insulin according to this new eating plan. Ensure you are still getting the proper percentage of carbs, protiens, fruits, veggies and fats. Remember not to drop calories below 1300 pounds for women or you'll put on weight.
Hope this helps, good luck to all of you.
Unfortunately, due to working on my grad degree, I put on about 25 pounds of unwanted weight. However, I discovered that by balancing my calories in with calories burned I was able to lose all of that weight. Through reducing my food (and my insulin pump basal rate), increasing my workout times or intensities, and keeping a journal of what I ate, I lost all of the weight I desired.
Here's the trick:
1. you need to figure out how many calories you burn (your basal metabolic rate + activity level):
For women: 661 + (4.38 x weight in pounds) + (4.38 x height in inches) - (4.7 x age)= Basal Metabolic Rate (BMR)
Then add your BMR to the calories you burn during activities: look this number up on the internet - type in something like "calories burned running" (or more generally: BMR x activity level.
Sedentary: BMR x 1.15,
for light activity-normal everyday stuff: BMR x 1.3,
moderately active-exercise 3-4 times a week BMR x 1.4,
Very active-more than 4 times a week: BMR x 1.6,
Extremely active-exercise 6 or 7 times a week: BMR x 1.8
2. You need to figure out how many calories you are eating (keep a journal and write everything down)
3. If you want to lose 1 pound of body fat in 1 week, you need to reduce the calories you need to maintain your current body weight by 500 per day for 7 days (this is equal to 3500 calories or 1lb of bodyfat). 2 pounds of bodyfat per week = 1000 calorie deficit per day. Can't lose anymore than 2 lbs of bodyfat a week, most people with their activity level can only burn 1.
4. Don't drop below 1300 calories a day or you'll lower your metabolism and gain weight.
5. Most people think just becasue they exercise they'll lose weight. If you're just starting out, working out for 20 mins is great, but consider the average female will only burn about 200-250 calories during a 20 minute run. That's 1/2 a cup of granola or less than a full bagel in most cases.
6. here's my personal example I started out weighing 160, I followed the above advice and lost 2 pounds of bodyfat per week. My schedule: Monday, Wed, Fri 5:45am - 30 min weight circuit, work 7:30-5:30, 6-7 bouldering at indoor rock gym for 1 hour (get to hang out with friends and family). Tuesday, Thursday, Saturday 5:45am - 1 hour run, work 8-6, occasional walk with the family and dogs 20 mins in the evenings. At some point in time in the evenings I also worked on my thesis - so weight loss can be done even with a very busy schedule.
7. Figure out how many calories you need to eat per day to lose your desired amount of weight in a week. Adjust your insulin according to this new eating plan. Ensure you are still getting the proper percentage of carbs, protiens, fruits, veggies and fats. Remember not to drop calories below 1300 pounds for women or you'll put on weight.
Hope this helps, good luck to all of you.
I've been type 1 diabetic for 17 yrs, on tight control therapy for 16, I'm a woman and I'm a professional dancer. So the weight issue has always been a big one in my life.
You've got some good info already. However, I didn't read through everything, there were some rather long posts...so if I'm repeating anything I apologize but here's my two cents ;)
First off, insulin is a growth hormone, if you are taking more then you need, you will gain weight. So number 1 it's important to work closely with your physician to make sure your basal or base insulin is the right amount for you. (body type, lifestyle, diet and exercise all affect this)
Secondly, cutting back on unhealthy fats is good, especially since its important for diabetics to have really good cholesterol numbers. But the biggest diet change that will help to lose weight is carbohydrates. If you eat a piece of cheese or some almonds do you take a shot? no, why? because there is no carb content and what you ate will not significantly alter your BG.
Carbs are important for giving us energy, so I don't think it's healthy to cut them out completely as in the Atkins diet, but just being mindful of your carb intake can make a huge difference.
Another factor is low blood sugars. The more hypoglycemic episodes a person has, the more excess calories and carbs one is taking into their body. It also means that the body is receiving more insulin then needed. So really that's a double whammy.
For women we have a wonderful hormones called estrogen and progesterone which affects the bodies response to insulin. Now this is the tricky part, because it's different for each woman. Take me for example, I use an insulin pump and my Dr. and I recently figured out that I need 3 different patterns to go with my cycle. I have my base pattern, then I have another pattern for the week before my period and a third for the week of and after, then it's back the my base pattern.
Each pattern has a different daily base rate, low, middle, and higher, to follow my hormone cycle. Until we set this up, I was constantly up and down with my BG. One week everything would be text book perfect numbers, the next I'd be getting low more then once/day, another week my numbers would sky rocket.
Diabetes is a very complex disease, but the medical industry is learning more and more all the time and new technology is changing the face of diabetes for the better.
The important thing is to keep on truckin! Work closely with a good Dr. and a diabetes educator (can't recommend that one enough) and hopefully you can stay on top of it.
You've got some good info already. However, I didn't read through everything, there were some rather long posts...so if I'm repeating anything I apologize but here's my two cents ;)
First off, insulin is a growth hormone, if you are taking more then you need, you will gain weight. So number 1 it's important to work closely with your physician to make sure your basal or base insulin is the right amount for you. (body type, lifestyle, diet and exercise all affect this)
Secondly, cutting back on unhealthy fats is good, especially since its important for diabetics to have really good cholesterol numbers. But the biggest diet change that will help to lose weight is carbohydrates. If you eat a piece of cheese or some almonds do you take a shot? no, why? because there is no carb content and what you ate will not significantly alter your BG.
Carbs are important for giving us energy, so I don't think it's healthy to cut them out completely as in the Atkins diet, but just being mindful of your carb intake can make a huge difference.
Another factor is low blood sugars. The more hypoglycemic episodes a person has, the more excess calories and carbs one is taking into their body. It also means that the body is receiving more insulin then needed. So really that's a double whammy.
For women we have a wonderful hormones called estrogen and progesterone which affects the bodies response to insulin. Now this is the tricky part, because it's different for each woman. Take me for example, I use an insulin pump and my Dr. and I recently figured out that I need 3 different patterns to go with my cycle. I have my base pattern, then I have another pattern for the week before my period and a third for the week of and after, then it's back the my base pattern.
Each pattern has a different daily base rate, low, middle, and higher, to follow my hormone cycle. Until we set this up, I was constantly up and down with my BG. One week everything would be text book perfect numbers, the next I'd be getting low more then once/day, another week my numbers would sky rocket.
Diabetes is a very complex disease, but the medical industry is learning more and more all the time and new technology is changing the face of diabetes for the better.
The important thing is to keep on truckin! Work closely with a good Dr. and a diabetes educator (can't recommend that one enough) and hopefully you can stay on top of it.
Hello :)
Im 14 and i have had type 1 diabetes for nearly 10 years and i recently got an insulin pump about 5 months ago and have noticed that where I used to give myself injections has flattened out a bit....i also used to have about 5 injections a day and was taking novo rapid actrapid protophane and lantus.
Im pretty sure ive lost about 2 kg without trying so yeah :)
Im 14 and i have had type 1 diabetes for nearly 10 years and i recently got an insulin pump about 5 months ago and have noticed that where I used to give myself injections has flattened out a bit....i also used to have about 5 injections a day and was taking novo rapid actrapid protophane and lantus.
Im pretty sure ive lost about 2 kg without trying so yeah :)
I have had type 1 diabetes for 42 years and over that period of time I have seen many changes in diabetic therapy due to the changes in technology. I am 6'1" at 220 lbs, and I worked as a stuntman in Hollywood for many years, so, there was a lot of stress on my body. I am not a doctor nor claim to know everything but I have found things that work for my diabetes and don’t work. All diabetics are a little different due to our DNA make up so what works for one diabetic may not work for another. The first step to losing weight is to get into a target range of your A1C hemoglobin if that is high it will be hard to lose weight. The second step once A1C is controlled, then lower insulin doses and decrease carbs until you find a good balance. There are so many diet plans on the market and really none of them will work better then a diabetic diet set up by a diabetic nutritionist, most professional athletes follow a made to plan diabetic diet. Exercising is the key ( something that I don’t do but need to). There are so many complications with diabetes over the long term and I am sure most of you with diabetes know the complications. The key to the whole equation is the A1C or blood testing, lower the insulin, lower the carbs and calories and increase activity and you should lose weight
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