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Insulin resistance and weight gain with t1

E

ExtremelyW0rried

Well-Known Member
Messages
333
Type of diabetes
Type 1
Hi all,

I'm asking this on behalf of my dad.

He was diagnosed aged 28 - originally told t2 although he had no risk factors for it such as family history or being overweight - and he didn't take insulin for several years but he did low carb and exercise which may have delayed it.

He was then told actually he was t1. He is now 65 and he has gradually put more and more weight on over the last few years. He isn't huge, but he would be classed as overweight and in truth he eats very little. The background insulin I know makes you gain weight and unfortunately it's a vicious circle. He gains weight so needs more background (toujeo - spelling maybe wrong, sorry!) and then gains more weight. A1c is usually around 7. It's really getting him down. He's taken metformin before but it made him quite unwell so doesn't anymore. Cholesterol is highish so takes statins.
Usually most days he doesn't eat breakfast, he might have some cheese and crackers at lunchtime and perhaps some raspberries or strawberries and in the evening he has fish or chicken with vegetables - usually not potatoes. So you can see he isn't exactly high calorie or high carb.

He is seeing his consultant in a couple of months but does anyone have any advice? He's been doing an hour's walking a day too. I feel sad to see him so down about it all.

Thanks!
 
The background insulin shouldn't make him gain weight. In the abscence of other problems you eat enough for the energy you need to exert. Eat too much = weight gain. Can he not get in to see his GP & explain the problems with metformin? Are those walks energetic enough to get his heart rate up?
 
ExtremelyW0rried said:
Hi all,

I'm asking this on behalf of my dad.

He was diagnosed aged 28 - originally told t2 although he had no risk factors for it such as family history or being overweight - and he didn't take insulin for several years but he did low carb and exercise which may have delayed it.

He was then told actually he was t1. He is now 65 and he has gradually put more and more weight on over the last few years. He isn't huge, but he would be classed as overweight and in truth he eats very little. The background insulin I know makes you gain weight and unfortunately it's a vicious circle. He gains weight so needs more background (toujeo - spelling maybe wrong, sorry!) and then gains more weight. A1c is usually around 7. It's really getting him down. He's taken metformin before but it made him quite unwell so doesn't anymore. Cholesterol is highish so takes statins.
Usually most days he doesn't eat breakfast, he might have some cheese and crackers at lunchtime and perhaps some raspberries or strawberries and in the evening he has fish or chicken with vegetables - usually not potatoes. So you can see he isn't exactly high calorie or high carb.

He is seeing his consultant in a couple of months but does anyone have any advice? He's been doing an hour's walking a day too. I feel sad to see him so down about it all.

Thanks!
Click to expand...

There are two sorts of Metformin. There is the regular stuff, and also a Slow or Modified Release version. Whereas some folks have issues with the regular stuff, most do pretty well on the modified release.

There may be other meds suitable for helping with insulin resistance, but only hos Doc would be able to help with that.
 
Hi. That is strange. Back ground insulin or any insulin doesn't itself cause weight gain but enables the body to use the carbs it is offered and these can cause weight gain. I don't understand why he should gain weight with low-carb intake? Metformin SR (Slow Release) may help a little so ask for that but I would x-check his actual daily carb intake just in case...
 
He saw one of the top specialists regarding diabetes in the uk and the specialist told him that the only background insulin that doesn't cause weight gain is levermir. Unfortunately levemir isn't particularly effective for my dad so he doesn't use it.
 
I think his total daily carbs would be under 50g so not at all high by anyone's standards
His total daily dose of insulin (background and bolus) is around 120u.
 
If your dad has insulin resistance he needs more insulin to cope with the glucose levels.

In Type 2s the more circulating insulin there is, the worse the IR becomes. The worse the IR becomes, the more insulin he will need. High excess circulating insulin will cause weight gain in most people. This is well known, although I do not know if injected insulin has the same effect. Certainly natural insulin does, it is a fat carrying hormone. It tells the body to store fat instead of burning it for energy. The trick is to eat foods that require less insulin. Obviously carbs require a lot, certain low fat dairy products, and fruit.
 
Bluetit1802 said:
If your dad has insulin resistance he needs more insulin to cope with the glucose levels.

In Type 2s the more circulating insulin there is, the worse the IR becomes. The worse the IR becomes, the more insulin he will need. High excess circulating insulin will cause weight gain in most people. This is well known, although I do not know if injected insulin has the same effect. Certainly natural insulin does, it is a fat carrying hormone. It tells the body to store fat instead of burning it for energy. The trick is to eat foods that require less insulin. Obviously carbs require a lot, certain low fat dairy products, and fruit.
Click to expand...

Yes, would this still apply to a t1? Can you be t1 AND 2?! Is that possible??
 
ExtremelyW0rried said:
Yes, would this still apply to a t1? Can you be t1 AND 2?! Is that possible??
Click to expand...

I have read on this forum that there is such a thing as "double diabetes" whereby a person has both T1 and T2 but have no idea if that is an official diagnosis, or just a T1 with insulin resistance. I'm afraid I don't know anything much about injected insulin, but T1s on here do report they have insulin resistance.
https://www.diabetes.co.uk/double-diabetes.html
 
120u of insulin a day? What's the split? Background to Bolus.

Does he have many hypos at all? Background insulin should not make gaining weight any more possible than without. Insulin ensures it stores carbs for energy and what it doesn't store as energy can then be stored as fat.
 
No he doesn't have many hypos - I mean the odd high 3s one here and there but certainly no more than you'd expect an insulin dependent diabetic to go low. Maybe once a week?

I will have to check the split. I think it is about 50:50. He takes bolus even when not eating though as the background doesn't keep it down. He needs to increase the basal but he is too worried about putting more weight on.
 
I have to say again what I said earlier that insulin only increases weight if it has some carbs to work on and store. It's a hormone not a food and needs glucose to do it's work. By itself I don't see how it can cause weight gain and I'd like to see the evidence on the earlier post ref the specialist that Basals such as Lantus cause weight gain whereas Lantus doesn't?
 
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