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Hello everyone! I am a 26 year old active and seemingly healthy woman who was recently diagnosed (about 2 months ago) as a LADA Type 1. My numbers were in the upper 200's, low 300's on average and had an A1C of 9.2 upon diagnosis (up from 6.1 only 10 months prior). I have been on 7 units of Lantus a day and Humalog 2-4 units per meal. Since starting insulin, my sugar levels have come way down and I feel a lot better (more energy, not so thirsty all the time, etc). I have also gained back a few of the pounds I lost - I was told this is normal? Partially due to rehydrating my body? Has anyone else recently been diagnosed with Type 1 or LADA, started insulin and gained weight? Does it taper off eventually? Also, I have caught myself being scared to eat many carbs. I have been limiting myself to around 30 per meal because I am so afraid of spiking my sugar. I know this is not good and I met with a nutritionist last week who told me I should be eating around 150 carbs a day. Can anyone share their experience with carbs when they were new to this?
I gained weight for 20 years after I was dx'ed w/ T1 but I didn't keep track of things. I started losing weight and then got a pump which made it a lot easier however the main thing I learned from pumping is that insulin is strong stuff and if you have even a whiff "extra", it will knock your BG down, you eat, get the munchies, etc. I agree with everyone's suggestion to do what's sometimes referred to as "eat to your meter." I'm not a dietitian/ nutritionist but I agree that eating 30G is very reasonable and my suspicion is that it would be a lot easier to control your BG with a moderate amount of carbs like that. To me, BG control is "good". No one has ever yelled at me for not eating enough and, as long as my A1C is cool, they will let me do pretty much whatever I want.
Thank you for your feedback! Do you think that diabetes/insulin treatment is accountable for weight gain or do you think it is more related to one's lifestyle? Diet, exercise, carb count.. etc?
I think that it's a combination of factors. I don't seem to melt off weight when I run negative calories (e.g. running 20 miles or whatever...) so I don't think exercise is as much of a component of that. I think exercise is more mental health for me. I think a lot of it is the timing of food which people with diabetes naturally get a feel for. My friend who is really into P90X (straight, no D...) is very precise in his eating habits, controls calories, fat, types of food, pretty much says "I don't eat anything that comes in a box..." and has had great results with it. Some of it is working out like a beast but he's said 90% of his results are from diet.
(he "peaked" at 266 lbs. I saw 275 on the scale once and that got me going in a new direction...)
We're all different. I was dx'd as type 1 as an adult about 4 years ago. Yes, you will put on weight (compared to how it was during your pre diagnosis stage). Especially if you don't watch what you eat. I'm fairly active (heavy exercise 4 times a week and daily workouts) and I still have issues with weight gain on insulin. The key to keeping it down (which it sounds like you are doing) is to count your carbs and watch the intake. I'm 6'1 and around 210 and 150 is a heavy day for me carb wise. Most days I try not to hit 120 if I can. As said though, different strokes/different folks. Certainly there are days where I will hit more, and others less, but I usually strive to keep it lower. Almonds, egg whites, yogurt (sugar/fat free), lean protein and veggies will all become good friends :D
Also, a few things to read up on are the glycemic index (how different types of carbs effect your body) and also how to adjust insulin for fat/protein.
Thank you! I'm 5'9" and as an adult have usually weighed anywhere between 130-135 pounds. At the time I was diagnosed I was around 125-130 pounds, which may not seem like a big change, but for an already thin person to lose 8-10 pounds was quite noticeable. My eyes were so sunken in and my wrists, ankles and neck looked like twigs. It was pretty scary. I've been on insulin for almost 2 months and am back between 130-135, though I did notice last week when my nutritionist told me to eat more carbs and give myself more insulin that it was easy to creep up to almost 140 pounds, which is still a healthy weight for my height, but not a number I am use to seeing. I will keep my carb count low and thus use less insulin to keep my BG where it needs to be.. this has seemed to work for me so far. I just miss being able to eat as many carbs as I wanted.. :(
I was two months before my 30th birthday on diagnosis, 499 b.s. 13.9 A1C, was LADA as well. I was about 12-15 lbs below my normail weight since high school, around 123 lbs as opposed to 135-140 lbs. I didn't start insulin right away as I went to an emergency care clinic and got prescribed oral meds to start until I got my endo appointment. Did a follow-up three days later and had already gained 6 lbs. The weight gain back to your normal range probably happened within two weeks based off my experience and as long as you stay in that range there should be no fear of your insulin/diet contributing to the weight gain as much as your body being able to process nutrients better rather than expelling them through your urine.
I was also diagnosed as a T1 as a young adult, age 30. I am probably LADA as well but back in 1984 they didn't do antibody tests to confirm.
You received lots of good advice here. Eating too many carbs is trouble for many T1's. The medical establishment and dietitians are so indoctrinated with fear of dietary fat that they reflexively, almost without question, push a high carb low fat diet.
After 28 years with T1, I finally tried a low carb approach (about 50-70 grams per day). I dropped 20 pounds, took only half as much insulin, and my number of hypos went from two or three per day to two or three per week. In addition, my overall control and A1c dropped. Bernstein's law of small numbers means that taking lower doses of insulin leads smaller mistakes.
Counting carbs and dosing accordingly is a good practice. Unfortunately, your body's sensitivity can fluctuate day to day and from morning to night. Even very accurate carb counting, using a scale, will still produce out of range BG's. So, the less insulin you take will mean milder lows and highs.
Congratulations for your aggressive curiosity about diabetes. Even back in 1984 the doctors told me that they noticed that education and knowledge about diabetes made a big difference in the long-term outcomes.
And yes, insulin can make you fat! You are smart to keep an eye on the number of carbs, the amount of insulin, and the trend of your weight.
I'm sorry you got this diagnosis but you seem to be a smart and practical young woman. Good luck to you!
I was also diagnosed as a T1 LADA only 7 months ago and have been a patient of Dr. Bernstein's since Sept. Eating 30g of carbs per meal is perfectly fine. I eat about 30g a day and went from an A1c of 8.8% in May to 5.1% in Nov and am in the best shape I've ever been in my life. In fact, any nutritionist who is pushing 150g of fast acting carbs on a diabetic should have their head checked.
If you were diagnosed with an A1c of 6.1% 10 months ago, you were unfortunately already solidly in the "pre-diabetic" range and well on your way to Diabetes. Are you certain about your LADA diagnosis? If you're T2, you might have the good fortune of being able to manage this insidious condition through diet changes and oral meds alone.
As others have posted, the reason you're gaining weight is that your body is finally able to absorb the nutrients you're eating due to your stabilization of your BG through injected insulin. Your weight will reach an equilibrium based on the level of carbs you decide to consume. The fewer you eat, the less insulin you'll need, and the less weight you will gain. Had you gone untreated, you would have continued to lose weight to the point of eventual death.
How many carbs you eat is really matter of choice. You can find comfort in the fact that you can cover all of your nutritional needs for carbs through the consumption of the healthy veggies alone that our mothers always told us to eat (broccoli, spinach, Brussels sprouts, asparagus, etc.). There is no nutritional need for breads, rice, potato products, pasta or any other fast acting carbs (and don't fall for the "whole grain" agribusiness spin either, it's about as credible as the "low-fat" labeling you see on so many products). Having said that, let's face it, fast acting carbs taste good, and when consumed in reasonable quantities by non-diabetics these foods will have no detrimental effects whatsoever. The challenge as a diabetic is trying to match insulin dosage to the dramatic effects fast acting carbs can have on our blood sugar. This is the crux of Dr. Bernstein's "law of small numbers" approach.
You will see there are members who can maintain good control eating much higher carb levels than others. My preference is 30g/day allowing me to cover my meals with negligible insulin doses and keep my BG in the same target range before and after meals. It's also allowed me to completely rid myself of the carb cravings I used to have during my non-diabetic days. You might achieve your desired BG control with higher carb consumption. It's all a matter of trial and error.
Good luck. You've come to a good community with a wealth of good advice.
Christopher, it is your personal choice to eat just 30g of carbs per day. However your body will turn down its metabolic rate as a reaction to this. This is to preserve energy for more important tasks like maintaining muscles and the brain. This is actually the last thing a T1 needs in my opinion. The metabolic rate and muscle mass are key elements for good control. With good I mean the ability to consume carbs WITHOUT severe spiking afterwards. Your path will lead to high carb sensitivity making it nearly impossible to cope with higher loads of carbs. I highly recommend moderate carb intake - no doubt about that. However the radical Bernstein approach is far too low in my opinion. Especially for young women there is a high risk of developing eating disorders like Diabulimia. Thus I think we as a community should take this into account too. We have enough statistical evidence that normal carb intake with correct insulin dosing can be done without complications. We also know that an A1c up to 6.0 is statistically sufficient to prevent complications. There is little value in bringing the A1c lower than 5.5 - at least for fully insulin dependend T1 diabetics.
The high carb sensitivity is a tricky thing to balance. Too few and you'll have yourself on a diet that won't be able to handle eating out anywhere. You'll feel like you're wearing a space suit.
But, too many carbs and the variance in your insulin effectiveness (as much as 30% I've heard - can anybody give me tested numbers?) can cause your BG to go all over the place. Your I:C ratios will change and you'll need more Insulin for each meal as well, which escalates the issue.
This is where logging your BG, carbs and insulin help out because you'll be able to find a happy medium (I have a slice of toast with breakfast, 1-2 with lunch and then a 30-50g carb portion with dinner) that will work for you.
Bernstein is brilliant, but his level of dietary control is far too intense for my liking.
Either way, it sounds like you're doing really well so far and are on the (sometimes bumpy) road to a long and healthy lifestyle.
Hi Holger, I am curious about your statements, but I certainly don't want to attack your ideas in any way. In fact, I think conventional wisdom concerning diet in large part agrees with what you wrote above. However, I was wondering if you based your thoughts on scholarly research or perhaps something else. If you do have scholarly references, would you be willing to share them for (1) low carb intake lowers metabolic rate, (2) low carb diets lead to carb sensitivity, and (3) low carb dieters, especially young women have an increased risk for developing eating disorders? I appreciate anything you can offer.
It's a bit of a "side note," but I have to completely agree with Holger about developing eating disorders. I would go so far as to say that Type 1 diabetes is a recipe for disaster for women, leading often to eating disorders. It is a complex thing. Thankfully, there are lots of great groups and support here on TuD and elsewhere (Diabulimia Helpline, for example).