I started gaining weight as soon as I went on the pump. Before the pump, I had been usign a strategy of 65% Lantus and 35% Humalog. With the pump, I went to 50%basal, 50% bolus. I'm wondering if returning to the prior strategy will help me lose weight.

Any thoughts to share?

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I started gaining weight with a pump too. My situation was more due to increased food "freedom"..

Lowering my carb intake has helped me drop 16lbs in the last month without increasing the amount of exercise I'm already doing. I am by no means a strict low-carb eater, but I try to stay between 75 and 100g a day.

I had lost weight before I had the pump and my A1C had gone up, very disorganized, long story...but I kept at it on the pump. I think the way to lose weight is to get your BG stable, by getting your basal rate and bolus ratios set close to correct, and then cutting out carbs here and there. Maybe it's easier said than done but I've done ok at it.

Don't translate 65% Lantus/35% Humalog to mean 65/35 was your basal/bolus ratio. In all likeliness, some of that Lantus was covering your meal bolus and you didn't know it (did you go hypo if you were late for a meal? That would be a good indication that this may have been the case). If you were to try to achieve that ratio now, it could be done only by cutting back your bolus, which in turn means reducing your food intake.

I think I have to agree with Red here... I found that, if pressing a few buttons on my pump would allow me to eat a cookie, then I'd do it. Freedom is good, but it makes it harder to exercise restraint. That was the case for me, anyway. (And, BTW, my basal/bolus ratio is closer to 35/65, just the opposite of the goal you're contemplating, and it works for me.)

I also gained weight when I began pumping. As my control has improved, my weight has gone up. I have heard from the mouth of my endo that this is very common. Improved control often does this to people.

I don't know about how your control was/is, but for me it's very true. When I had an A1c in the double digits I weighed 105-115lbs. When my A1c went down to around 7 I gained about 10lbs. Now that it's been below 6% for over a year, I've gained another 20lbs.

I'm eating better than I ever did back then, and eating a lot less, so it's not about my food choices. I believe it has a lot to do with improved control (and maybe, birth control)

I think that the ratio of basal to bolus is often misunderstood. "If" you follow the ADA diet of 45-65 percent of calories from carbs, on average your basal/bolus ratio should be expected to be 50/50. But you are not average. And you may not be following a high carb diet.

You need as much insulin as you need. I think you should try to use only the minimum insulin that you need. Any extra insulin will promote weight gain. And I firmly believe that a good formula for weight loss is to set up good metabolic conditions for fat burning. And in my view, the perfect way to burn fat is to have a normalized blood sugar (80-90 mg/dl), low fasting insulin and to have your body demand energy in a measured and constant manner (like walking around all day). I know that everyone says not eat like 5-6 times a day, but I really like Intermittent Fasting (and a proper basal lets you do that)

So my recommendation is to do basal and bolus testing to establish your proper basal and ICR and don't worry about the ratio.




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