Hi, I'm currently on the omnipod system (pump system) and i've noticed that I've been using a lot more insulin in the past year compared to a few years ago. I've also gained about 10-15 pounds which I know now means I need even more insulin,,,the more insulin I take it seems the more weight I gain. I use around 60-65 units a day total. How many daily do you guys use on average? Is this too much? Also my insulin to carb ratio is around 1:6 sometimes 1:7. I'm thinking if I aim around 30 units a day I should see some weight loss and more insulin sensitivity?

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Comment by Terry on August 11, 2013 at 3:25pm

If you use less insulin, you should gain less or stop gaining weight. Weight loss is sometimes a complicated thing.

A little over a year ago, I decided that I wanted to gain much better control over my blood glucose levels. I wanted to drop my BG average and A1c while also reducing the BG roller coaster. Weight loss was not my goal.

I adopted a "lower carb" diet, about 50-70 grams/day. I lost 23 pounds, about 15% of my body weight in 90 days. Surprisingly to me, I used very little willpower to do it. My average BG and A1c did drop and my glucose variability as measured by standard deviation dropped as well. My total daily dose of insulin dropped from 60-80 units per day down to 30-35 units. I weigh 160 pounds now.

Prior to that I had gained about 20 pounds over a 15 year period. My total daily dose of insulin went up from about 40 to about 60-80. So for me, more insulin meant more weight. From what I've read, insulin is known for putting on fat.

Looking back, with that 20+ pound weight gain, I became resistant to insulin. Insulin would not act in predictable ways. Sometimes a correction, for instance, would have no effect at all. I've read more recently that insulin resistance is not unusual with T1Ds, a fact that I was unaware of when it happened to me.

Lower carb was the magic bullet for me. One thing that I tried prior to lower carb was to inject a set amount, a lower amount, of insulin and try to only eat a smaller portion of food that would hopefully counteract the insulin. I couldn't make that work with the usual carb portions.

Whatever you do, I recommend that you keep a written record. It will help you make adjustments, mark your progress, and help you see some longer term trends.

Good luck -- losing a few pounds is a great goal!

Comment by Holger Schmeken on August 11, 2013 at 6:19pm

The important thing is to reduce the carb intake to need less insulin. So the reduction of the insulin follows your carbs. Do not try to eat the same amount of carbs with just less insulin. This kind of neglecting insulin is just another form of diabulimia - with all the serious health consequences it will have. Try to find a diet assistant that will follow your goals of carb reduction. Dr. Bernstein's Book "Diabetes Solution" might be of great help to reduce your carb intake. I personally do not recommend to lower carbs below 100g per day. But still his tipps might be more valuable than trying anything unfounded.

Comment by Kathy on August 11, 2013 at 7:34pm

Insulin is "lipogenic", meaning it creates fat.
I was diagnosed in 1974 and at that time the standard treatment was one shot of NPH in the morning. A few years later they were talking about the dawn phenomenon, where your bg goes up at dawn, and suggested adding a dose of regular insulin to the NPH.
So I added 10 units each day, and gained 40 pounds in 3 months. Yikes!!!
I agree with Terry and Holger - do not take less insulin without readjusting your diet. Good luck.

Comment by swisschocolate on August 11, 2013 at 10:52pm
There are anorexic girls who use that method. Plese just make sure your bg is ok, as that is the most important for your health.
Comment by beechbeard on August 12, 2013 at 6:30am

My experience is very similar to Terry's. I cut carbs to Dr. Bernsteins levels and abstain from flour, sugars and high fructose corn syrup in foods. My basal has been stable but my bolus dropped from 75 units/day to 35. during the adjustment I tested my bg more frequently just being careful. Also dropped 35 lbs so far.

Comment by Piscesyin on August 13, 2013 at 5:34pm

You would think after 39 years we might be the expert huh?
About 7 years ago or so, I started to gain weight and had no idea why. As an ex-gymnast, I've always been pretty tiny so the weight was a huge issue. Took me 7 YEARS to find the reason and the solution.
1. Fired several Endocrinologists who did not provide ADEQUATE care.
2. Tried several types of diets (name it = I tried it)
3. Interviewed others, chatted, blogged, etc.
FINALLY, 7 years later.....
1. Started going to Valley Medical Weight Loss for weekly shots (October, 2012)
2. Found a decent Endo who suggested a) Insulin resistance and b) Symlin (April, 2013)
The Symlin was the primary "kicker". In conclusion, I had to come to terms with accepting that NO, I do NOT know it all and almost every diet fad out there will NOT work for a type 1.

Since last October, I'm down 60 lbs with another 30 to go. I also just had Laser Liposuction done (ya okay....I'm vain) which should take care of another 10 or more. I seem to lose between 8 to 10 lbs a month so another 3 months and all will be right with my closet.

I'm not a depressive kind of person and am usually going 100 miles an hour at all times. I am the primary bread winner, financial manager and household caretaker so the weight was a HUGE issue.

In summary, for each and every person the secret is going to be personal to you. Low carb, extra water, more exercise....whatever. The only commonality I have found so far with many many type 1s is insulin, be that pump or not. In 1974, they didn't know insulin had a best friend called Amylin but they sure as hell knew about it 10 years ago (probably could have saved me 7 years).

Find your secret! :)

Comment by Clare on August 17, 2013 at 11:36am

I didn't start out trying to come up with a number for my TDD. Basically my stupid endo had me on a sliding scale of Humalog for meals with a single dose of 30 units of lantus at night. What happened with that scenario is I was constantly feeding the insulin. The lantus didn't last 24 hours for me it was more like 16. Mornings and during the day I was invariably low and then sky high before dinner. At the time my total daily dose was somewhere around 57-60. My weight had increased every single year and my A1C's were 7-8 I stepped on the scale 1 pound shy of 200. The final straw for me was a severe hypo that necessitated a glucagon injection from my husband. I had just had enough. That was December 2011. Since then I have read and researched and joined tuD and myglu and other D sites. I learned how to carb count and started matching my insulin dose to what I was planning on eating instead of matching it to a blood sugar number on the chart on the fridge. I fired my endo and found a new one who is not still stuck in the dark ages. We developed a plan to get my blood sugars in line and with the help of the CDE at the clinic and a whole lot of hard work I feel as though I have finally turned the corner. Since then I have gotten a Dexcom CGMS to help me keep out of they hypo range as much as possible. Since I no longer have any awareness. I started working out at the gym playing tennis, racquetball, and swimming as often as I can. I have cut out a lot of junk food, but I am not by any stretch of the imagination low carbing it. On average I have 100 grams of carbs a day which is plenty for me. I have dropped about 50 pounds and it has come off inexorably slowly, but it has stayed off so I'm ok with it. My average TDD is now ~ 30-34 units. I got an omnipod pump a few months ago and that too has helped with the control.
I guess my point is there are no quick fixes especially not with D. If you're a gym rat, then make the gym your refuge. If you're a foodie try inventing lower carb versions or your favorites. The secret is no matter what you choose to do, stick with it, because nothing happens overnight.

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