Need to lose weight - T1 plus other conditions

[Aginoth]

Hi All, New to forum

Diagnosed T1 in March 2000 at age of 30, my weight was a steady and acceptable 100kg (I am very large framed ex-rugby Forward with 48" chest and 18/19" neck). Diagnosed with Psoriatic Arthritis in 2007, Fibromyalgia in 2012 and became less and less able to excercise due to joint pain, used to be a keen cyclist but now my knees and hips can't cope with even the slightest gradient.

Now 45, and 115kg. Need to lose weight and get my Hba1c down has risen to a scary 80, want to get it down to below 55.

I'm carb counting and using insulinx meter, restricting myself to 2000 Calories after GP advice (but to be honest most days I don't top 1800) trying to keep carbs to 100g per day max.

As I said I also have Psoriatic Arthritis and Fibromyalgia, this limits my ability to excercise to moderate walking on a good day; over the last couple of months I have gradually upped distance walked in one block every day from approx 2km to 5km. Oh and I hate swimming, plus my arthritis medication knocks back my immune system even more than T1 D, so if I go to a public pool I can pretty much guarantee to get ill, further knackering my BG.

Diet is well balanced, plenty of dietary fibre, fruit/veg, etc as we're told to do. managing BG in rage of 6 to 10 mmol/l most of the time, attempting to get better control in 5 to 9 range.

Really struggliing to lose weight despite almost halving my insulin intake.

Any advice on how to better lose weight appreciated.

 

[azure]

Welcome It sounds like you're doing everything right, Aginoth.

I'm much smaller and slighter than you so this may not be relevant to you, but when I want to lose weight Ive sometimes needed to go below 100g carbs. What I do is reduce gradually, so I'd, say, go down to 80g carbs and try that for a while. I don't like to go too low with my carbs and normally eat around 150-180g a day if I'm not trying to lose weight.

I see you've got other medical conditions. Is it possible that a medication you're taking is causing you to put on weight? Has your doctor said anything about it?

 

[Aginoth]

Welcome It sounds like you're doing everything right, Aginoth.

I'm much smaller and slighter than you so this may not be relevant to you, but when I want to lose weight Ive sometimes needed to go below 100g carbs. What I do is reduce gradually, so I'd, say, go down to 80g carbs and try that for a while. I don't like to go too low with my carbs and normally eat around 150-180g a day if I'm not trying to lose weight.

I see you've got other medical conditions. Is it possible that a medication you're taking is causing you to put on weight? Has your doctor said anything about it?

several of my other meds cause insulin control and weight issues, I've been told there are issues with Methotrexate, Infliximab, Amitryptaline, and all my pain meds ( I Rattle when I walk). Guess I'll just have to keep at it and hope for a slow loss of weight.

 

[buckley8219]

Go on veg, meat, fish diet, lean cuts and lots of green veg. Ditch the fruit. Really cut carbs down e.g less than 50g a day. Lower insulin accordingly.

Cut calories down down further to 1500 and drink loads of water.

I bet after 12 weeks you'd drop a good deal of weight.

Walk on an empty stomach in the morning. It's a great fat burner.

 

[azure]

several of my other meds cause insulin control and weight issues, I've been told there are issues with Methotrexate, Infliximab, Amitryptaline, and all my pain meds ( I Rattle when I walk). Guess I'll just have to keep at it and hope for a slow loss of weight.

Ah, ok. At least that might explain it. I know it must be frustrating when you're trying to lose weight and it's taking ages through no fault of your own. Just a case of slow and steady, I guess.

 

[Aginoth]

Go on veg, meat, fish diet, lean cuts and lots of green veg. Ditch the fruit. Really cut carbs down e.g less than 50g a day. Lower insulin accordingly.

Cut calories down down further to 1500 and drink loads of water.

I bet after 12 weeks you'd drop a good deal of weight.

Walk on an empty stomach in the morning. It's a great fat burner.

Discussed a lower calorie intake with My GP (thankfully the practice Diabetic Specialist) already and he was pretty much against less than 1800.

Already moved off of red meat completely, and eat fresh fish at least 2 days. May attempt to cut out more starchy carbs though and replace with veg as you suggest.

atm have to walk when my 4 kids allow, once they are back to school I do plan on doing 5km walking on an empty stomach after walking them to school

Looks like I'm on the right track, just frustrating that taking insulin buggers up trying to lose weight.

 

[Daibell]

Hi and welcome. 100gm/day for carbs is a very good target. Personally I would ignore any daily calorie intake advice as it's pure guesswork and the numbers are far too high for many people. Focus on the carbs as you are doing and as a poster has suggested reduce the 100gm still further for a while and keep portion sizes of proteins and fats not too high. BTW you mention halving your insulin intake to reduce weight? Note that insulin itself doesn't cause weight gain; it's the glucose it metabolises for energy or fat storage that causes the problem. Always maintain enough insulin to keep the blood sugar right. I wonder whether some of you other meds are raising your blood suagr; many do?

 

[ButtterflyLady]

You appear to have several risk factors for obstructive sleep apnoea (OSA) syndrome, which contributes to weight gain and being overweight.

Those risk factors are - overweight, neck circumference over 17 inches, age over 40, male, and on pain meds (assuming they are opiates, which can suppress breathing).

Signs and symptoms include loud snoring, breathing pauses followed by gasping in sleep, getting up during the night to pass urine, headaches, and excessive daytime sleepiness and fatigue.

OSA is diagnosed after referral to a sleep clinic for an overnight sleep study.

 

[Aginoth]

You appear to have several risk factors for obstructive sleep apnoea (OSA) syndrome, which contributes to weight gain and being overweight.

Those risk factors are - overweight, neck circumference over 17 inches, age over 40, male, and on pain meds (assuming they are opiates, which can suppress breathing).

Signs and symptoms include loud snoring, breathing pauses followed by gasping in sleep, getting up during the night to pass urine, headaches, and excessive daytime sleepiness and fatigue.

OSA is diagnosed after referral to a sleep clinic for an overnight sleep study.

I'm actually waiting for an appointment for the Sleep Clinic in Bristol right now for those very reasons.

Part of why I desperately want to lose 15kg.

 

[ButtterflyLady]

I'm actually waiting for an appointment for the Sleep Clinic in Bristol right now for those very reasons.

Part of why I desperately want to lose 15kg.

If you have OSA, you will almost certainly feel a lot better once you are on CPAP therapy. I've been on it for 7 years and it has helped me so much. Uncontrolled OSA changes the production of the hormones leptin and ghrelin, which affect appetite. For this reason, many people find it easier to lose weight once their OSA in managed.

In the meantime, I would suggest reducing your calories down from 1,800 a day... I can't think of any good medical reason why you should have to eat that many if you don't want to. As you said, it's hard for you to exercise, so that should be taken into account. Maybe 1,200 would be a better target, I don't know.

 

[Aginoth]

If you have OSA, you will almost certainly feel a lot better once you are on CPAP therapy. I've been on it for 7 years and it has helped me so much. Uncontrolled OSA changes the production of the hormones leptin and ghrelin, which affect appetite. For this reason, many people find it easier to lose weight once their OSA in managed.

In the meantime, I would suggest reducing your calories down from 1,800 a day... I can't think of any good medical reason why you should have to eat that many if you don't want to. As you said, it's hard for you to exercise, so that should be taken into account. Maybe 1,200 would be a better target, I don't know.

target of 2000 was calculated by my Diabetic Nurse at GP practice, apparently my maintenance level is 3200 cals per day due to my build. Once I get my current BG levels under control I will be dropping it to 1600 probably.

Good new however my fasting BG this morning was 4.6 mmol/l, finally hitting around my target of 5