Insuln & weight gain

[JMT]

I have been insulin dependant for 47 years and always overweight. Over the last 2 years have managed to lose 4 stone and still wanting to lose another 2 (sorry still in old weight measures) but have now started to gain weight even though I am eating the same as I did when loosing it. Exercise has increased and BMI levels down to lowest ever.

In my opinion my weight loss slowed and I started to gain when Monotard & Actrapid stopped being available and I then had a short time withHumalog 25.

Due to control going from 6 to 8.4 I was advised to go onto 4 a day and in February this year was put on Novorapid and Levemir. Pre meal dosage amounts of Novorapid vary from 10 - 16 depending on severity of early morning hypos but the Levemir stays at 50 units per evening.

Are these insulins helping to prevent weight loss :?: Are there other insulins which can maintain my control and be more condusive to helping with weight loss. :?:

 

[hanadr]

Insulin is the hormone that causes you to store fat. there may he differences between the different analogues. If you reduce your carbs and your insulin, you should be able to shift some weight. I'm trying too and stuck

 

[janabelle]

Hi JMT,
don't know if this helps, but I have had problems losing weight over past few years-bit overweight too. I was on Lantus, a long-acting insulin analogue like Levemir, for nearly 4 years, and throughout this time was unable to lose weight. I felt constantly hungry and had really lousy, unpredictable BS control from one day to the next,felt like shxxx and suffered indescribable exhaustion and other horrible side effects. I moved onto Hypurin Pork Isophane in May this year,and continued with my Humalog. Since then my Humalog works really well, and doesnt do anything unexpected. I believe Lantus was the problem, and the change has proved that. I like the action of Humalog, and I only need bout 3 units to cover a meal, and I split my Isophane 22 units AM & 12 units PM.
I've been diabetic for 19 years and now have the best contol I have ever had. Like jokes, the old insulins are the best!!- Humalog being the exception.
I also feel like a normal human being, and the best I've felt in years-these new long-acting analogues aren't all there cracked up to be- I've lost half a stone as well!
When I was dianosed I was put on NPH "human" insulins and my control has always been yo-yo like, I so wish I had started on animal insulins-but was not given the option in 1989. The only prob I have with animal short acting is they're not short-acting enough, actrapid, resulted in a night coma for me a few years ago,and I'm nervous about changing to a similar acting animal insulin. I love that Humalog is in and out within bout 5 hours- b gr8 if they could produce a rapid-acting animal insulin!
Why did you go on Levemir? I assume as you've been IDD for so long you must have been on animal insulins for some time. Would be very interested to hear your experience of changing to "human" insulin. Did you not have good control on them? Did you develop any side effects or symptoms, suchas tiredness when you changed? I have to say that having been on a few "human" long-acting insulins over the years and the devil-drug Lantus, Pork Isophane works best for me and I have fabulous control, it's effortless.
I must thank Sarah on this forum for her input, having been on animal insulin for many years with no probs, no loss of hypo-awareness. That is what all us type-1s strive for, so there's a lot to be said for Pork and Beef insulins, tried and tested for many years! My question is why are they not been offered to newly diagnosed patients and why are the new "analogues" being pushed onto patients,as if there is no other option??
Maybe you should consider switching back.
Jus

 

[LadyJ]

Levemir is usually better for weight loss than Lantus. In fact, in many people it seems to promote weight loss.

Why are you having such severe morning hypos, I wonder?

Many people split the dose of Levemir and find that lasts them better throughout the day, and certainly keeps them more "steady" than before. If you are having severe hypos which you keep having to treat with sugar/biscuits, this may not help the weight loss!

 

[JMT]

I ask myself and diabetic clinic the very same question. Up until this week have been having 16 units Novorapid before each meal of which I have 3 a day and 50 units Levermir in evening as basal base.

In my quest to lose weight I am now able to walk - something which gave so much discomfort when 4 stone heavier - and so walk friends dogs in the early morning for 40 minutes before setting off for work. To avoid the hypos was advised to reduce evening meal dose of Novorapid only. That I have done and now down to 10 units but still continue to have hypos. I am at diabetic clinic now on a weekly basis it seems trying to match insulin with exercise and food intake. My saviour is a well known chemist (am I allowed to mention names) if not - you wear them on your feet for walkings !!!
own brand of glucose. Two of them and I'm compose mentus, followed by fruit.

I'm convinced that one or more of the ingredients in the insulins I have been on since February 2008 is causing my particular problem as I consistenly lost weight when on human Actrapid and Monotard and since being firstly on Humalog and then changed to Novorapid and Levermir my weight lose has stopped and I have gained 10 lbs yet still have the same, carb intake.

 

[LadyJ]

Hi - I would advise sticking with them for a while yet. I know many many other diabetics who have reported no such problems with weight gain on these insulins - although of course everyone is different.

The other thing to bear in mind is that after such a substantial weight loss (well done!) things do eventually start to slow down on that front and you might find you have to do more to lose...

Learning to carb count will definitely help! Novo rapid is not designed to be taken in a fixed dose - you are supposed to match it with the carbs that you eat. Taking fixed doses of it doesn't really make sense and you will find control AND weight loss easier when you have tackled that. Constantly having to have glucose tablets (almost pure sugar) will certainly not be helping the weightloss.

Also, what have your levels been like? Of course if you were previously running quite high levels this would have contributed to your weight loss!

 

[Jenny]

I had thought that insulin only stores fat when it hits more glucose than the body needs to function, the excess is therefore stored. Should it not be that if the intake is reduced sufficiently, and the right amount of insulin is applied, there should be no glucose left to be removed from the bloodstream and stored?

 

[fergus]

Jenny, you're partly right, but there are many hormonal processes at work when glucose and insulin get to work.
Fat cells are continually active,with an ebb and flow of stored energy taking place pretty much constantly. When insulin levels are elevated, as they are following a high carbohydrate meal, the body shifts into fat storage mode and finds it impossible to metabolise stored fat until insulin levels are much lower. With a high carb diet, the risk is that insulin levels become permanently elevated so that fat is stored, not burned. I think I'm right in saying that all overweight or obese people have elevated insulin levels.
The fat building is an ongoing process with insulin, even at low levels, but the important point is that fat burning is disabled when levels are raised.
You're certainly right to say that reducing insulin levels is key to weight loss.

All the best,

fergus

 

[LadyJ]

Levels of insulin are elevated by the increased consumption of carbohydrate because the more you eat, the more insulin is required to process it.

I don't think there is any evidence whatsoever to suggest that insulin of itself causes weight gain! It's a complex hormone related to the metabolic system and it's a misnomer to say that it causes weight gain.

 

[fergus]

Hi LadyJ. In fact, there is abundant evidence that insulin is the primary hormone responsible for fat metabolism. Actually, throughout the field of biochemistry it's commonly known as 'the fat building hormone'.
Clinicians since the 20's and 30's have used insulin to assist underweight patients to gain weight. It does this by stimulating appetite and fat storage. Joslin's Diabetes Mellitus, the stadard textbook on the condition discusses the direct connection between insulin and weight gain.
Erich Grafe's 'Metabolic Diseases and their Treatment' describes insulin as "an excellent fattening substance".
George Cahill, former professor at Harvard Medical School who studied insulin and fat metabolism since the 60's summed it up thus "carbohydrate is driving insulin is driving fat."
It's something that the world's farmers seem to have understood more clearly than it's physicians - the fact that animals fatten on carbohydrates.
Myself, I have lost 4 stones, not by eating fewer calories, but by using much less insulin. The fat building hormone indeed!

All the best,

fergus

 

[LadyJ]

Fergusc, I would agree that carbohydrate causes weight gain, but not the insulin itself.

George Cahill, former professor at Harvard Medical School who studied insulin and fat metabolism since the 60's summed it up thus "carbohydrate is driving insulin is driving fat."
It's something that the world's farmers seem to have understood more clearly than it's physicians - the fact that animals fatten on carbohydrates.

What you say here supports that. The insulin is only produced to deal with excessive carb consumption. Therefore it is the carbs, not the insulin to blame.

I would say your weight loss is due to the reduced carbs, rather than reduced insulin (all non-diabetics have loads of the stuff and they're not all fat, unless they stuff their faces with cakes and crisps!)

 

[fergus]

Well, it's certainly the carbs which cause the greatest demand for insulin, of that there's no doubt. But it is insulin which acts upon the glucose released, turning it into triglycerides which, in turn, are stored in the adipose tissue.
I'm type 1 and know from bitter personal experience that, without any insulin, weight is quickly lost regardless of the amount of carbohydrates consumed. In that sense, it is insulin that is crucial to fat metabolism, and one of the main reasons why diets low in carbohydrate appear to be much more successful in assisting weight loss.
I think we actually agree with one another - it's the carbohydrate / insulin mechanism which drives weight gain. Yes, non-diabetics have the potential to produce a lot of insulin, but only gain weight when they over-use that potential. It's also true that perhaps all sufferers of overweight and obesity have hperinsulinemia too.
The fact that I now use 25% of the insulin I once needed is the critical factor in my weight loss. It's the reduction in carbohydrates which has enabled me to make that reduction.

All the best,

fergus

 

[janabelle]

In theory prob a lot of what is said is true. But what if the insulin or Insulin "analogue" doesn't act in the way it's supposed to? My experience of nearly 4 years on Lantus and subsequent change to a purified pork long-acting proved that Lantus wasn't working as it should, for me at least. One day was never the same as the next, even though I was taking same dose, and eating the same amount of carbs with my meals My blood-sugar levels were so unpredictable and I totally lost confidence in my ability to control my diabetes-I couldn't control it! I would wake up with blood sugars of 12 one day, and 3.7 the next. It was crazy, and I thought there was something wrong with me or my hormones. Since changing insulins, my control is predictable- the difference is like night and day. There is no other explanation for this, hormonal, dietry or otherwise. The Lantus did not work as it claimed to.
I don't have an overwhelming exhaustion (prob due to better control), and I feel better generally.
I am very angry with the clinic that recommended I change to Lantus, and even angrier that when I asked for help and described the problems I was having and how bad I was feeling, I was ignored for nearly 4 years. Thank God for the IDDT for their advice.
I make no apologies for sounding like a stuck record-If telling my experience can help just 1 person on this forum, it's worth it!
Jus

 

[fergus]

Your experience sounds dreadful, Jus. I do read of many peoples bad experiences with Lantus, whether it's weight gain, poor coverage, variability of action etc. Forums like this are a good opportunity to see that such experiences are shared, not isolated.
Personally, Lantus hasn't caused me obvious problems, once I split the dose that is.
Did you try Levemir at all? How do you use your porcine insulin? Do have to use a vial and a syringe, or is it available in cartridges for pen systems?

All the best,

fergus

 

[janabelle]

Hi Fergus,
I am using vials and syringes for both my Pork and my Humalog at the moment. The pork is available in pens, as is the Humalog- haven't decided what to do long term, but do plan to change to pen for one of them to avoid disasterous confusion, been there before!
I split the dose of my Pork Isophane 22 units in morn and 12 units in eve. Humalog, I only need 3-4units with meal.
I have had a really horrible experience on Lantus, and I know I go on about it, but if I had an inkling that changing insulins would change my life, it would have saved me so much misery. I only relay my experience in the hope that I may be returning the favour. I feel like I've had those years stolen from me. I'm losing my sight to RP and I love cycling, didn't cycle much after I lost confidence due to severe tiredness and other weird symptoms, and I feel bitter I suppose.
Jus

 

[fergus]

Hi Jus,

I'm a bit of a road cyclist myself. What a thrill to see our boys givin them hell in Beijing today. Our local lad, Chris Hoy, will get himself another gold this weekend, and I'm not even going to start on what Mark Cavendish will do to the lesser mortals. Brilliant stuff.

Oh, sorry, diabetes forum.

All the best,

fergus

 

[martinbuchan]

Levemir is slightly less weight inducing than lantus. Levemir needs 20-30% more than lantus for a similar effect. I have been on both, Changed from Lantus, increased my dose from 60 Lantus to 100 units levemir per day and [put on 2 stones in weight by having to lay up due to my foot problem and having a huge apetite. Now on 82 units once per day. Losing weight by going low carb and apetite now under control.


Did try twice daily levemir, but swithed to once daily- got better control very quickly. Interestingly, the current thought on levemir's length of action seems to be related to its dose (so to get 24 hours action, take a bigger dose).

Rocks and hard places. I might go back to Lantus , really as each syringe will last longer and thus will be cheaper for the NHS. If anyones control was not optimal, it would always be worth thinking about changing to the other as a wee experiment. If control is good, why change. My A1c was 6.0% on Lantus, its 5.9% on levemir.

 

[LittleSue]

Levemir needs 20-30% more than lantus for a similar effect.

I found the opposite to you - needed 14 of Lantus, but 8 Levemir in a single dose was too much. Much more stable control on split Levemir approx 4 + 3.5). I'm not doubting your experience, this may be a common finding, just pointing out its best to be cautious with the dose when changing insulin.

 

[sugarybibs]

Hi all im new to this site and when i got diagnosed when i was only 17 many years ago!!!i went like a skeleton to about 5stone.no one in our family had heard of diabetes in the 1970s.I was in hospital for two weeks only just started work as well Had to use big glass syringes which had to boiled and rub surgical spirits on my legs before each injection.Cant believe how lucky we are these days.anyway i have been on loads of different types of insulin,and am now on novorapid before each meal which i adjust according to carbs i am eating and 10 units of lantus in evening.i went to 11stone and only ate very small meals anyway so i was very upset when i got weighed in diabetes clinic so i went on a strict diet on top of my diet!!!Cut out nearly all fats lowered my carb intake and have lost 1stone in 8months.I suppose if i was non diabetic i would have lost about 4stone but you cannot do this on insulin.i dont mind staying at 10 stone because i am 5'5inches tall and look healthy.i do get a very tired feeling in afternoon times and feel i am going to fall asleep wherever i am but dont know if it could be the lantus.Also i have aches in my shoulders knees which i have never had before so i was wondering if this could be the lantus but dont know how i would find out.does anyone else have pains or aches anywhere.My eyes are good kidneys liver etc i am lucky i dont have any diabetic complications so far and dont want any.

 

[Dennis]

i do get a very tired feeling in afternoon times and feel i am going to fall asleep wherever i am but dont know if it could be the lantus.

Hi sugarybibs,
When you get this feeling of tiredness in the afternoon have you tested your blood sugar? What you are experiencing is often a symptom of high blood sugar levels.