Help! I was diagnosed A LADA diabetic in July. Upon diagnosis I was 107 pounds. For the past five years I have steadily been between 115-120 pounds. I Understand that my elevated blood sugars were causing me to be underweight at 107 but now that I am on insulin I am up to 125 pounds. Every Dr's visit has been an incremental gain of 3-5 pounds. Now my clothes are not fitting. I have started to excercise more, 6 days a week running a total of 20 miles, 1 day of Yoga and two days on an elyptical. I eat less than 1500 calories a day yet the pounds keep rapidly coming on. I am so frustrated. It is bad enough to find out that you have diabetes but to have to gain weight too? My Endo put me on Symlin to help suppress my appetite and it seems to be helping a little. Did any of you experience this? If so, any suggestions on how I can help to control it?
I've heard of quite a few people having success in lowering their morning fasting levels after experimenting with different amounts of protein/carb snacks before bedtime. (For example multigrain crackers with peanutbutter.)
Excellent points and some thoughts:
Liver (working) is supposed to do a dump when BG goes sub 70. The amount of glucose dumped on system is dependent upon the insulin level in blood. Liver works off of inverse of Insulin level. Liver assumes - lower the insulin level means to liver add tons of glucose ; hgher insulin means reduce amount of glucose dumped.
The human body is an interesting sample of cost effective engineering.
As the pancreas ages and goes wonky dropping insulin level, the liver oblidges by adding more glucose. This is not an ideal form of signalling from a failsafe model.
When one is young and system working correctly, skipping meals is quite OK as liver adds correct amounts of glucose when blood glucose goes too low - sub 70.
When one gets older and things become loose and wonkey, low carb diets while desireable may cause the liver to dump sooner and more often. If liver is caught overadding glucose, one may have to add a few more carbs to diet to reduce amount of liver dumps that occur. That is why vancouver sailor quite correctly mentioned the eating meals on regular schedule and no skipping meals.
The liver actually has a couple of streams of glucose namely the low level feed that is on all the time providing the necessary amounts ( slightly more) that keeps body alive, brain functioning etc. Basil pulses from pancreas chip away at the liver low level glucose output to regulate BG to 100 - typical.
The liver also has a high level dump mode for when glucose level of blood system goes sub-70. The only time I ever saw the blood system glucose level jump fast was when the liver was doing the liver dump mode from its resivoirs.
The other flow is when the intestines are cranking out glucose from digested food being passed to liver and is used to fill back up the liver resivoir and also sent to external blood system. This mode was always slow , smooth and cgms followed easily.
The problem one has is that when analyzing the troubles and problems of the body, assumptions are made that the complex system is mostly working and all issues and problems rotate around insulin and the pancreas and the complex powerfull actions of the liver and its glucose buffering actions and role quickly get overlooked.
The reason that the liver can be big pain is the possible result of broken liver insulin signalling and liver adding excess glucose during fasting by mistake.
Here is latest findings form Scienc News/Nature on how metformin signals directly to cut off excess liver glucose release:
... from universities, journals, and other research organizations
Most-Used Diabetes Drug Works in Different Way Than Previously Thought
Jan. 6, 2013 — A team, led by senior author Morris J. Birnbaum, MD, PhD, the Willard and Rhoda Ware Professor of Medicine, with the Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, found that the diabetes drug metformin works in a different way than previously understood. Their research in mice found that metformin suppresses the liver hormone glucagon's ability to generate an important signaling molecule, pointing to new drug targets. The findings were published online this week in Nature.
For fifty years, one of the few classes of therapeutics effective in reducing the overactive glucose production associated with diabetes has been the biguanides, which includes metformin, the most frequently prescribed drug for type 2 diabetes. The inability of insulin to keep liver glucose output in check is a major factor in the high blood sugar of type 2 diabetes and other diseases of insulin resistance.
"Overall, metformin lowers blood glucose by decreasing liver production of glucose," says Birnbaum. "But we didn't really know how the drug accomplished that."
Despite metformin's success, its mechanism of action remained imperfectly understood. About a decade ago, researchers suggested that metformin reduces glucose synthesis by activating the enzyme AMPK. But this understanding was challenged by genetic experiments in 2010 by collaborators on the present Nature study. Coauthors Marc Foretz and Benoit Viollet from Inserm, CNRS, and Université Paris Descartes, Paris, found that the livers of mice without AMPK still responded to metformin, indicating that blood glucose levels were being controlled outside of the AMPK pathway.
Taking another look at how glucose is regulated normally, the team knew that when there is no food intake and glucose decreases, glucagon is secreted from the pancreas to signal the liver to produce glucose. They then asked if metformin works by stopping the glucagon cascade.
The Nature study describes a novel mechanism by which metformin antagonizes the action of glucagon, thus reducing fasting glucose levels. The team showed that metformin leads to the accumulation of AMP in mice, which inhibits an enzyme called adenylate cyclase, thereby reducing levels of cyclic AMP and protein kinase activity, eventually blocking glucagon-dependent glucose output from liver cells.
From this new understanding of metformin's action, Birnbaum and colleagues surmise that adenylate cyclase could be a new drug target by mimicking the way in which it is inhibited by metformin. This strategy would bypass metformin's affect on a cell's mitochondria to make energy, and possibility avoid the adverse side effects experienced by many people who take metformin, perhaps even working for those patients resistant to metformin.
ditto this reply from Shawnmarie and Jag1. I count everything. Also do get the thyroid checked, Roberta. And you may need to revise your insulin dose and schedule.
Roberta, more Lantus = more weight gain. It's normal to gain after you get diabetes under control.
I agree with the thyroid check recommendation but also do a basal check round the clock. Your low carb diet, and knowing an exact I:C ratio should make you lean/know the least needed lantus. Absolutely what the body needs and no more. Any extra lantus, and voila! Pounds are up.
Weight gain is absolutely NORMAL after diagnosis of T1/Lada. For a long time your body had to consume his fatty deposits to survive. One big source of energy coming from the carbohydrates could not be processed because of the limited insulin production you had. Now think about it. Let us assume you are on a survival trip. Now you come to this magic place with enough food. You will eat as much as you can because you will think that tomorrow this dream will come to an end. Your body is doing the same. He has experienced that his fatty deposits were very important for survival. Thus he accumulates as much deposits as possible. After some months your body will have learned that the processing of carbohydrates is reliable again. Then he will slowly start to reduce the deposits and to rely more on a balance of carbohydrates and fat. So please relax, do sports and allow your body to demilitarize from DEFCON1 to normal. It will take 1/2 to 1 year to get there...
Yes, it is the insulin. This is why some teenage girls stop using insulin so they can loose weight (they are dying too). One of the functions of insulin is to store fat. Have you checked your thyroid? This might be the problem. Also, age and gender influence how we respond to insulin. Women are more prone to weight gain.
Keep in mind that many people who go on low calorie diets (1600 or less per day) gain weight because the body goes into 'starvation' mode and becomes super efficient at storing any surplus energy as fat. Generally, a 1800 calorie a day diet, supplemented with exercise, will work well for most adults.
Also, it is common to gain weight after starting to inject insulin as that's one of the primary functions of insulin: to store excess blood sugars as body fat. The only two ways of avoiding that is to lower the intake of carbohydrates, and/or to increase the amount of daily energy burning activity.
First of all, you have been given a lot of good ideas but what is your height. I would consult with your doctor and see how many pounds you should weigh for your height and build. Another thing to consider is allergy. I am allergic to corn and corn is on everything. Once I stopped ingesting corn in any form I started losing weight. Yes it has been hard to avoid corn but it has been worth it. It is just another thing to consider in possibilities