Losing Weight With Type1

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Permalink Reply by Jen on February 28, 2008 at 7:45pm

I want to do is lose about 10-15 lbs. (I think I've gained about 5 lbs in the past year.) I need to get motivated to go back to the gym, which I have not been doing. I'm also trying to get a better grasp of my insulin:carbs ratio. (When I was first diagnosed, it was all about "exchanges." I saw a nutritionist a few months ago for the first time in 10+ years, and she told me I was behind the times and had to figure out my ratio.)

Although I've only started doing this over the past couple of weeks, I've been trying to write down everything I eat (specifically to figure out my ratio). I'll tell you, having to write it all down does make me much more aware of everything I'm putting in my mouth. I don't want to have to write about the potato chips and the brownies/cookies -- it adds up before you know it.

So, basically I'm in the same boat. But if you come up with any ideas, please let me know! If I have any revelations, I'll keep you posted.

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Permalink Reply by Maureen on February 28, 2008 at 8:20pm

I keep my weight in check, or lose it by using John Walsh's Ex-Carbs idea. He writes about it at http://www.diabetesnet.com/diabetes_control_tips/excarbs.php

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Permalink Reply by Sara on February 28, 2008 at 10:11pm

It sounds like your body is happy right at the weight where it is. Maybe you should accept that and stop dieting, which only leads to more weight gain in the long run. Be happy that your diabetes is in good control, and be happy with your body, regardless of what the scale reads.

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Permalink Reply by Allison Blass on February 29, 2008 at 6:47am

Sometimes people gain weight just because their body's metabolism changes or some other factors that you can't necessarily control. As long as you eat well, exercise often and aren't gaining weight quickly, I'm sure you're find. If the 10 lbs. has pushed you into the overweight category, then I would be concerned. But people have a window of acceptable weight range, so if you're still in there I wouldn't worry too much about trying to manipulate it. Focus on maintaining health, not a weight.

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Permalink Reply by Joe on February 29, 2008 at 9:17am

hi Danielle,

your basal is 1.4 the whole day through? I am 155 lb, my rates change from 1.0 to 0.55 during the day and my total basal is just under 18 units. my am carb ratio is 4:1 but by night I am using 9:1 (i take an avg of 50 units a day) my weight dropped at first from 160 but has been flat for a year. Sorry you are having probs losing - it can be frustrating.

there's a scale for temp basal depending on how hard you work out. I use it and it's great because the calories I need to get back from a low... well let's say kinda erases the workout! If I am working hard I can set a temp basal for 20% and go work out and nothing happens. then I wait for bs to climb before setting it back to normal, sometimes it's 6 hours later.

did you ever get a thyroid test? if it's low there's no way you're losing weight. hey hope you are okay and don't get frustrated - you are doin all the right stuff - it goes like this - it takes time and it's easier to put it on than take it off lol, cheers!

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Permalink Reply by Danielle on February 29, 2008 at 12:21pm

thank you lol..its not 1.4 the whole day..when I'm sleeping and up until around 9am it's .85, and then for a few hours it's 1.1 or something like that..but the majority of the day is 1.4, and that's after I lowered it because my sugar keeps going low. When I see my endo, she tells me that I'm not on a lot of insulin, and thinks I should be taking more because of my highs, when really I probably should just be bolusing better for my meals and taking less in the basal. It's VERY frustrating, but Im going to try and do the percent thing, and thanks again for the help.

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Permalink Reply by Joe on February 29, 2008 at 4:06pm

it took me a year to get me basal right, and I have to change it in the spring and fall for the weather. I think Allison has a good point - it aint the total because it's based on mass and diet and lifestyle.

but I think you have a good idea where to start - if your basals are too high your bs will drop, then you will eat and overshoot (I did this exact thing for 29 yes TWENTY NINE years) and put on an ugly gut from the extra calories. (I wasn't a pumper I took long acting insulin)

First thing is not to over eat a low. 4 grams of glucose (one of those chewey pills) brings me up 20 points and that's it, no more s-fisting the chocolates for me when I am 55!

next thing is the basal protocols - if you don't have them I can send them to you, essentially you skip a meal and check every hour, you tune your basals until there's no change in bs over the test time. you can do them alone or with your doctor but I bet it's what is making you miserable. good luck Danielle!

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Permalink Reply by Erin on February 29, 2008 at 10:21am

Having extra insulin in your system can effect weight. Try to reduce the number of lows that you are having.
Also I think your basal rate is a little high. I would really talk to your doctor. I have 7 basal rates that range from 0.45 to 0.75 for a total basal of 14.4. Additionally my carbohydrate ratio varies during the day. Your doctor hopefully will guide you to better rates and ratios.

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Permalink Reply by Danielle on February 29, 2008 at 12:23pm

hey..thanks again..i also think my basal rate is high, but like I replied above, my doctor sees the highs and targets the basal rates when I could probably just bolus more for a meal. Plus it's hard to have a set basal when no two days are the same, which I'm sure you know. Anyway thanks again for all the feedback from you and everyone else! =)

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Permalink Reply by Allison Blass on February 29, 2008 at 2:39pm

It honestly does NOT matter how much insulin someone else takes. How much insulin you take is not just determined by how much you eat, but also by how big you are - height AND weight. Your insulin is also factored into how active you are - I take more insulin because I have a desk job versus someone who, say, is a teacher and is on their feet all day.

I really hate when I hear people say "How much insulin do you take?" because it's such a personal question. You need to take the amount of insulin that keeps your blood sugars as close to normal as possible *and* matches a healthy eating plan - which means you shouldn't cut food to take less insulin but you also shouldn't take extra insulin so you can eat more.

High blood sugars will do way more damage in the long run than ten pounds.

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Permalink Reply by Danielle on February 29, 2008 at 4:02pm

I definitely agree with you here..today was a normal day for me- school then work, and my sugar went low twice. I've been thinking about speaking to my doctor anyway about lowering my basal.. I'm just tired of having to drink a juice or eat a snack when I am not hungry. And of course I'd rather be 10lbs heavier than have out of control blood sugars..but thats part of why I'm trying to eat healthy and exercise..

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Permalink Reply by Scott Strumello on February 29, 2008 at 6:44pm

I totally agree with Allison. I hear the same thing about total daily dose (TDD) as I do about what percentage of your TDD should be basal vs. bolus -- the fact is that general guidelines mean nothing to you as a patient, nor should they. I have even read in some medical textbooks which make such a bold (and inaccurate) claim as 40-50% of the TDD should be basal, and think to myself, I would be hypoglycemic all day long if that much of my TDD was basal. For me, 95% of my TDD is bolus only, and that varies based on what I eat and what kind of activity I have during the day. My basals are next to nothing (I went back to MDI because my pump basals didn't go low enough, so while the precision of dosing for meals was great, the underlying assumption of basal rates being at least 0.5 units per hour nearly killed me with hypos!)

Regarding the high blood sugars thing, I do differ from Allison in that hyperglycemia has not been proven to cause complications, it is merely a correlation. However, new research suggests that hyperglycemia is not nearly as dangerous as glycemic variability is! This means that dosages of insulin to cover carbs which cause large swings in glucose levels may be as dangerous as steady numbers slightly above normal. But the 10 lbs. have a huge impact on our perception of ourselves, not to mention impacting how well our clothes fit and motivation to keep managing this stupid disease. I do not believe it is appropriate to reduce insulin dosages in an effort to lose weight, but I also think that the single best rule is one from Dr. Bernstein, which is the law of small numbers. In short, he argues that minimizing your dosage of insulin reduces the likelihood for errors and therefore makes things easier to manage. Using this rule, one could make an argument that minimizing carb consumption therefore helps us to stick with the law of small numbers.

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