Gaining/maintain weight as T1D.

[checshorts]

Hello Everyone,

I hope you are all doing well. This is my first post here, and I’m reaching out to share my experiences and hopefully gain some insights from this knowledgeable community. I have been living with diabetes for over 12 years. I’m currently using NovoRapid and have recently switched to Tresiba from Lantus. I’m a very active person, exercise regularly, maintain low body fat, and consider myself to be in generally excellent fitness levels.

About three months ago, I started using the Libre system to monitor my glucose levels more closely. I was devastated to see all of the spikes in my glucose levels, even though I was diligent about cooking and weighing every single meal. This led me to seek more information on how I could achieve better results.

Two months ago, I read "Diabetes Solutions" by Dr. Bernstein and decided to try a low-carb diet. I saw phenomenal results with my glucose levels, sometimes even going a week without a reading higher than 10mmol/L. However, I ran into a different problem. Despite consuming around 3200-3300 kcal (roughly 36g carbs, 220g protein, 250g fat), my weight dropped from 82kg/180lbs to 78.5kg/173lbs. For reference, I am 187cm/6’2” and already have a very lean build.

This weight loss discouraged me from continuing the low-carb diet, prompting me to return to a moderate amount of carbs (around 180-210g per day). Unfortunately, this reintroduced glucose spikes, with my Libre often showing readings of 10, 11, or 12mmol/L, 1-3 times a day. My time in range is around 68%, but this doesn’t seem good enough for me.

I’m reaching out to ask if anyone has encountered similar issues and has found solutions. Do I just need to consume more calories, despite already feeling satisfied with my current intake? The goal is to maintain my weight and not lose the gains I’ve achieved through years of exercise, while also maintaining optimal glucose levels.

I value any advice or solutions you may have to offer regarding this balance between weight, diet, and glucose levels. Many thanks for reading my post, and please feel free to ask if you have more questions or need further clarification.

Warm regards,

Mark.

 

[urbanracer]

Hello Everyone,

I hope you are all doing well. This is my first post here, and I’m reaching out to share my experiences and hopefully gain some insights from this knowledgeable community. I have been living with diabetes for over 12 years. I’m currently using NovoRapid and have recently switched to Tresiba from Lantus. I’m a very active person, exercise regularly, maintain low body fat, and consider myself to be in generally excellent fitness levels.

About three months ago, I started using the Libre system to monitor my glucose levels more closely. I was devastated to see all of the spikes in my glucose levels, even though I was diligent about cooking and weighing every single meal. This led me to seek more information on how I could achieve better results.

Two months ago, I read "Diabetes Solutions" by Dr. Bernstein and decided to try a low-carb diet. I saw phenomenal results with my glucose levels, sometimes even going a week without a reading higher than 10mmol/L. However, I ran into a different problem. Despite consuming around 3200-3300 kcal (roughly 36g carbs, 220g protein, 250g fat), my weight dropped from 82kg/180lbs to 78.5kg/173lbs. For reference, I am 187cm/6’2” and already have a very lean build.

This weight loss discouraged me from continuing the low-carb diet, prompting me to return to a moderate amount of carbs (around 180-210g per day). Unfortunately, this reintroduced glucose spikes, with my Libre often showing readings of 10, 11, or 12mmol/L, 1-3 times a day. My time in range is around 68%, but this doesn’t seem good enough for me.

I’m reaching out to ask if anyone has encountered similar issues and has found solutions. Do I just need to consume more calories, despite already feeling satisfied with my current intake? The goal is to maintain my weight and not lose the gains I’ve achieved through years of exercise, while also maintaining optimal glucose levels.

I value any advice or solutions you may have to offer regarding this balance between weight, diet, and glucose levels. Many thanks for reading my post, and please feel free to ask if you have more questions or need further clarification.

Warm regards,

Mark.

Hi Mark

I am also on the 'lean' side, some might say skinny but anyway.

The UK governement's dietary guidelines for carbs for a normal healthy person are 220 to 230 grams per day - depending on where you get the information from. So your intake is at the top end and in my opinion is not 'moderate' - but I haven't come here to start a fight over terminolgies.

I have always struggled with 'normal' carb intakes and if I take enough insulin to stop the spike then I usually go low a couple of hours afterwards so I
have reduced my intake to around 40g per meal and often less. This requires less insulin but I don't seem to get the lows afterwards. So basically, I eat smaller amounts but maybe more frequently if I need the calories.

Sometimes, I deliberately aim to do a 2nd injection of rapid insulin sometime after the meal. This can lead to 'insulin stacking' - basically you're probably injecting more insulin before the previous insulin has worn off so please take care if trying it. If you eat cheese or other fatty foods it can slow down carb absorption and you'll go high later so you need to understand how different foods affect you.

Also look at the timings of your injections. The profile of rapid acting insulins shows that they normally take about 20 minutes to show an effect on a CGM (Many folk report that Novorapid is slower than claimed) and some people wait for the CGM curve to start falling before eating. You will be on the side of the 'wave' when you start eating and some folks call this 'sugar surfing' or 'dynamic glucose management'- look on Google and Youtube, there's plenty of info about this. This practice can reduce the magnitude of the spikes.

Are you aware that sudden extreme exercising can raise glucose levels? This is your body's response to stress, but I guess you will know this if you're using Libre.

I will tag @In Response and @Juicyj as I think they are both active in sports.

Best wishes
Urb'

 

[Westley]

Hi and welcome Mark.
I'm also interested to hear answers to this as I've faced similar issues.

I've lifted weights fairly seriously for many years and have a lot of muscle. So far the periods when I've really packed on strength and size have always been moderate to high carb, but I'd like to know more about what's possible without.

I've done some periods of strict keto, and when I do, I find it becomes relatively easy to keep near perfect BG control, which is wonderful but I've only ever lost weight on it, which isn't what I want indefinitely.

It's normal for the weight to fall off very quickly for the first few weeks after switching to keto, but a lot of that will be glycogen and water, and it won't continue to fall at that rate.
I never felt I actually lost much muscle doing keto, even when I got into the fat burning stage, and despite bodyweight going down and muscles feeling a bit less full, have maintained strength during these times (though admittedly struggled to increase it). To be fair I've not tried for really long stretches though, and I've got lean but never Helmut Strebl level shredded!

You say you've only been using the Libre 3 months - it took me much longer than that to get used to adapting my eating/dosing based on readings.
Eating some carbs makes keeping great control harder than on keto but not impossible.

Personally I find I can deal with carbs more easily in the middle of the day (especially when I train in the late morning). At breakfast they tend to make me shoot up, and in the evening I find the delayed effect of a large meal including carbs, fat and protein hard to dose perfectly for, then correcting up or down too close to bedtime tends to mess things up overnight.

So keeping most of my carbs near workouts but eating low carb the rest of the time seems to work fairly well for me, and still lets me maintain or gain weight. I believe having most of my daily bolus around then helps with muscle growth too.

Still, my control is never quite as good as when fully keto, and if others have successfully bulked without carbs I'm keen to hear about how.

(Also 220g of protein seems excessive. I'm 185cm, 95-108kg depending on bulk/cut, I eat less than 150g protein a day and don't believe that's held me back. Aside from stressing your wallet, digestion and kidneys for marginal if any extra gains, having more protein than needed can also make BG management harder because of the delayed rise from gluconeogenesis.)

 

[JAT1]

Welcome to the forums Checshorts. This is an excellent place to learn, ask questions, and talk about our experiences. It helped me a immensely as in my physical world I am quite alone with diabetes. I too have found that keto is the solution whenever my blood sugars are unexpectedly erratic. A couple days keto and my blood sugar 'normalizes'. Like you though, too low carb and I lose weight and I am already too thin. I experimented, gradually increasing my carbs with near obsessive testing (finger prick) and found the amount (60 carbs/per day) at which I maintain my weight. Again, more self research, to find out how to avoid the spikes which inevitably happen when I eat carbs. I started with prebolusing at 20 minutes before eating, and then measuring my blood at the half hour mark, one hour and so on every half hour to establish when the spike occurred. Meanwhile I ate the same everyday and still pretty much do. Gradually increasing my prebolus time with the goal of matching the action of the insulin to the sugar peak, I found that I have to prebolus by 1.5 hours for lunch and consume max 15 carbs at that time. Then I have the rest of the carbs (another 15) 1.5 hours after that. This way my spikes are rarely more than 2.5 mmol and I catch the drop in time. I spread the carbs at evening meal too - never more than 15 every 1.5 hours. After learning this about myself, I stopped the obsessive testing. For evening meal I can prebolus one hour. If I'm hungry while waiting, I eat the meat with its fat, and I snack between meals on cheese or home cooked chicken legs. It is complicated but I eat alone (except for Xmas and birthdays) but it works. I don't use CGM but knowing my highs and lows, I'm confident I'm always in range (except for the occasional crazy days).

 

[JAT1]

Oops - I meant to say my spikes are rarely more than 2.5 mmol higher than my before meal read, so usually no more than 8 mmol.

 

[Juicyj]

Thanks for the tag @urbanracer sadly despite exercising almost daily, running 3-4 times a week, weight training. gym classes and eating low-med carb I am not losing any weight, which I put down due to menopause, so not much help, sorry !

However my thoughts in regards to losing weight, I would think about increasing my fat intake.