Type 1 Need help with insulin-diet-weight equation

tvnerd

Well-Known Member
Messages
73
Type of diabetes
Type 1
Treatment type
Insulin
Hello, my name is Royina, I’m 24 years old, and I’ve had T1D for 3 years now. For my first 1.5 years as a diabetic I lived in India, had a low carb,low fat, high fibre diet, and needed very small amounts of insulin (about 15-20 units total a day). Last Feb I moved to Australia and since then the amount of insulin I need to take keeps increasing. At first I thought it was the honeymoon period ending, or a need for protein blousing however my ICR keeps getting worse (it’s at 1:3 now). The total amount of insulin I need now is 70u.
During this same time, the number of calories I’ve been able to eat keeps reducing. I was on a steady diet of 1100 cals/ day but now I’m at about 600-700 cals/ day. This is largely because I have prolonged spikes after eating and I have to correct for a few hours before I come down, in which case I often tend to go too low, then rebound etc. Thus most of the time I’m eating to correct and I only eat a small breakfast and dinner now.
My exercise has stayed consistent- HIIT about 3-5 days a week. However my weight has increased from 50kgs to 54kgs. I’m unable to bring that down too.
I’m really worried about how my insulin requirements keep increasing about the amount of food I get to eat is decreasing. I’m concerned that I can’t eat more without risking putting on weight and becoming even more insulin resistant.
Has anyone had this problem before? What am I doing wrong?
 

ert

Well-Known Member
Messages
2,588
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
diabetes
fasting
Unlike normal insulin, injected insulin has a fixed 4-hour curve, so you would have to wait for four hours to see if your blood sugars returned to where they were before eating to see if you needed a correction (note: corrections should be taken with your next meal, otherwise your insulin stacks which causes the danger of a hypo, which you are experiencing.) If you are eating normally, you should ignore the peak over the four hours.

I've had to intermittent fast to lose weight on insulin. I don't eat until 3 pm when I'm a lot less insulin resistant, which means I need less insulin over the whole day. Are you still on LCHF? I am, which means less insulin also.

I hope you find something that works for you.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. It sounds like you are really trying. First, carbs are almost always the problem for higher BS and weight. You should be having a higher level of fat to help keep you feeling full and not be tempted by the carbs. Roughly how many carbs do you have per day? What foods are you eating to give you that high fibre diet? I'm suspecting but may be wrong that you have gained a bit of insulin resistance needing more insulin to overcome it. I can only suggest lower carbs. BTW don't think calories but think carbs.
 

tvnerd

Well-Known Member
Messages
73
Type of diabetes
Type 1
Treatment type
Insulin
Unlike normal insulin, injected insulin has a fixed 4-hour curve, so you would have to wait for four hours to see if your blood sugars returned to where they were before eating to see if you needed a correction (note: corrections should be taken with your next meal, otherwise your insulin stacks which causes the danger of a hypo, which you are experiencing.) If you are eating normally, you should ignore the peak over the four hours.

I've had to intermittent fast to lose weight on insulin. I don't eat until 3 pm when I'm a lot less insulin resistant, which means I need less insulin over the whole day. Are you still on LCHF? I am, which means less insulin also.

I hope you find something that works for you.

I am still on LCHF (36c; 35f; 11fibre). Though I’ve found I need to correct twice after the 4 hour curve.
 

tvnerd

Well-Known Member
Messages
73
Type of diabetes
Type 1
Treatment type
Insulin
Hi. It sounds like you are really trying. First, carbs are almost always the problem for higher BS and weight. You should be having a higher level of fat to help keep you feeling full and not be tempted by the carbs. Roughly how many carbs do you have per day? What foods are you eating to give you that high fibre diet? I'm suspecting but may be wrong that you have gained a bit of insulin resistance needing more insulin to overcome it. I can only suggest lower carbs. BTW don't think calories but think carbs.

I’m on 35 carbs, 35 fat, 11 fibre, and 94 protein. I have gained insulin resistance but I don’t know why!
 

Rokaab

Well-Known Member
Messages
2,159
Type of diabetes
Type 1
Treatment type
Pump
Have you done any basal testing? Cos if that's wrong then maybe you're needing more bolus to cover the basal you're missing.
 

tvnerd

Well-Known Member
Messages
73
Type of diabetes
Type 1
Treatment type
Insulin
Have you done any basal testing? Cos if that's wrong then maybe you're needing more bolus to cover the basal you're missing.

I did! Over the last year, I’ve increased my Basal from 20u to 31u but it seems to keep increasing (as does my bolus)
 

MarkMunday

Well-Known Member
Messages
421
Type of diabetes
Type 1
Treatment type
Insulin
... I need to correct twice after the 4 hour curve.
That sounds like inadequate basal insulin action. Do basal testing again. Volatile blood glucose and having to do lots of corrections could explain the weight gain. Closing the basal action gaps makes bolusing much easier and more predictable.
 

tvnerd

Well-Known Member
Messages
73
Type of diabetes
Type 1
Treatment type
Insulin
That sounds like inadequate basal insulin action. Do basal testing again. Volatile blood glucose and having to do lots of corrections could explain the weight gain. Closing the basal action gaps makes bolusing much easier and more predictable.

I think perhaps I do need to increase my basal again. Is increasing insulin resistance normal? I feel like my condition keeps getting worse
 

MarkMunday

Well-Known Member
Messages
421
Type of diabetes
Type 1
Treatment type
Insulin
... Is increasing insulin resistance normal? I feel like my condition keeps getting worse
Declining insulin sensitivity as endogenous insulin production fades is normal. Using 70 units of insulin for a 54 kg body sounds like a lot, but until blood glucose is stabilised and corrections are no longer required, the actual insulin requirement is uncertain. My suggestion is to do the basal testing, fill the basal insulin gaps, get bolusing to where it needs to to be, and then consider the insulin requirement. The sequence is important. Trying to fix bolusing while basal is out of whack puts one on a hiding to nothing.
 
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tvnerd

Well-Known Member
Messages
73
Type of diabetes
Type 1
Treatment type
Insulin
Declining insulin sensitivity as endogenous insulin production fades is normal. Using 70 units of insulin for a 54 kg body sounds like a lot, but until blood glucose is stabilised and corrections are no longer required, the actual insulin requirement is uncertain. My suggestion is to do the basal testing, fill the basal insulin gaps, get bolusing to where it needs to to be, and then consider the insulin requirement. The sequence is important. Trying to fix bolusing while basal is out of whack puts one on a hiding to nothing.

Thank you Mark! I will try the basal testing and hopefully things get better.
 

DCUKMod

Master
Staff Member
Messages
14,298
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
@tvnerd - have you mentioned this to your Doctor, or diabetes team? If so, have they done any additional tests for you?

I'm wondering if it could be an idea to have other things, like your thyroid function checked. Sluggish thyroids are very common, and when you have one auto-immune condition, it's good to be mindful of others.

It's tested by a simple blood test, and treatment is usually very simple, so if nothing else, could be worthwhile discounting it.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
I’m on 35 carbs, 35 fat, 11 fibre, and 94 protein. I have gained insulin resistance but I don’t know why!
Thanks. That sounds a very sensible diet. I think you may need to discuss possibilities with the GP that are causing the need for increased insulin