So much weight gain since I started insulin

Hi Leeter,

What a pain. It's coming across loud and clear from what you're saying that you're having to eat for the insulin (rather than the other way round, which is desirable). Your insulin dose sounds too high.

Eating to cover insulin will put weight on you. I would try low carb. Have you checked out LCHF online? Even a 100g daily limit on carbs would help. Hard low-carbers go down to 30g/day. It's up to you. The point is that as you lower carbs, you'll need less insulin.

Talk to your diabetes people before taking any kind of action, though. Maybe be assertive that this dose is too high and you want to dose for a lower carb intake.

Technically one can drop one unit for three days, test, look at results, then repeat, 1u at a time and giving each change at least 3 days to take effect. Better to do it with the knowledge of your people though.

You may also question whether a fixed insulin regime is what you want. You may decide you like it, once the dosage is down, or you may decide you want to ask for basal/bolus, which gives you more flexibility. I prefer basal/bolus myself. That way you can truly fit your insulin intake to what you eat, rather than the other way round.

Two useful links: diet doctor on the general principles of LCHF: http://www.dietdoctor.com/lchf

And Jenny Ruhl's nutritional calculator, enabling you to look at and try out various versions of low carb: http://www.phlaunt.com/diabetes/33614154.php

Jenny Ruhl's whole site is reliable and quite excellent, by the way. And it's written up into a book on Low Carb that can be downloaded: http://www.amazon.co.uk/gp/aw/d/B0080JVKMK/ref=mp_s_a_1_3?qid=1421580863&sr=8-3&pi=AC_SX110_SY165. Excellent book.

Also, everyone recommends Think Like a Pancreas: http://www.amazon.co.uk/gp/aw/d/B005XQ97FK/ref=mp_s_a_1_1?qid=1421580978&sr=8-1&pi=AC_SX110_SY165. Fantastic practical guide to managing your insulin.

Good luck and power to you, Lucy

Hi and welcome,

I have the exact same problem. I started insulin mid October and have put on a stone in weight since then. I'm on mixed insulin too and I take 8units in the morning and 13 at night but I'm having to lower it as I'm going low both at lunchtime and sometimes through the night.

Basal/bolus apparently gives more flexibility but I'm not ready to start taking more injections per day yet as I'm still bruising and it still hurts!

Sorry I'm no help as I'm having the exact same problem but I'm going to bring it up at my review tomorrow so I will let you know if I get any pearls of wisdom from my DSN. Not holding my breath mind :-/

Hi. LADA is effectively T1 and the right insulin regime is Basal/Bolus unless your LADA is early days. On Basal/Bolus you don't always need up to 5 injections per day. For example I have one Basal dose at night i..e not split and have my Bolus for lunch and dinner. As the Basal has a peak in the morning I don't need to Bolus for breakfast as this is usually low-carb. That totals 3 injections. I may have more if I have if I have a large snack of carby breakfast. Carb-counting with Basal/Bolus means you can decide exactly how much you are going to eat each day and you can avoid hypos if you keep things under control. I haven't had a hypo in the 2 years since insulin although been near one a few times.

What news, Leeter? It really sounded as if your medical team had put you on a much too high insulin regime. They tend to do that in my experience. They're not used to LADAs or to moderate levels of carbing, and they think in terms of rigid categories, either insulin-dependent whap slam full-on or not insulin-dependent at all. It sounded to me as if the insulin weight gain was entirely due to you having to cover a way too high insulin load. (Of course I know nothing about it, that's just one diabetic's reading.)

How are you getting on?

As you know I'm sure, ways to reduce your insulin dose: low carbing, exercise, take Metformin as well (often prescribed in conjunction with insulin in the U.S., it seems, but almost never here. I'm going to try this myself).

Unless there's something weird going on, your overall calorie surplus will determine whether you put weight on or not. So even with insulin, if calories are <2,000 a day or whatever your individual level is, you shouldn't put weight on. That's why I love the Jenny Ruhl calculator (which I'm sure I posted above as I post it everywhere - it's a tool of genius).

Hope it's going okay - Lucy

Hello Leeter - I had quite a weight gain over the past 6 months since going on insulin. About 13 Kg. I had been 7 years on oral meds - metformin and then januvia for the final 2 yrs all the while gradually losing weight. The GP had diagnosed me as type 2 but when my A1c started going off the dial and random glucose was getting up to 18 it was off to the Endocrinologist. I was sent for the C peptide test which showed virtually no C peptide production. The diagnosis was in fact type 1 at 55 yrs of age.

I am not too concerned about my 13 kg weight gain as I was literally skeletal when I went on to insulin. It was fun eating my way up to some needed weight gain. What I keep an eye out on is that my BMI is comfortably in range. There are plenty of BMI apps you can check out to keep an eye on your progress. My insulin doses of 4 per day (3 rapids and 1 Levemir at night) were gradually ramped up under specialist advice in the early weeks until good BG levels were reached. Recently they were adjusted down slightly under the advice of my treating specialist and my weight is now stabilising.

While going on to insulin is a thing we all initially dread I find that 4 shots a day is far more preferable than eating less and less as our type 2 colleagues generally have to do to keep BG in range. Interesting that you are still on metformin. I was taken off oral meds upon commencing insulin. I shudder to think of what hypo would result for me if using metformin along with insulin.

PD Oz said:

While going on to insulin is a thing we all initially dread I find that 4 shots a day is far more preferable than eating less and less as our type 2 colleagues generally have to do to keep BG in range. Interesting that you are still on metformin. I was taken off oral meds upon commencing insulin. I shudder to think of what hypo would result for me if using metformin along with insulin.

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I so relate to what you say here. As I was complaining on another thread, I was virtually having to starve till I started bolusing. It was such a relief. I freaked out completely in the early days and thought I'd do anything to keep insulin at bay, but a) I couldn't, and b) life is so much better now. No anxiety !! I'm good, generally, and keep to my Bernsteinian low carbs, but if something goes wrong - Hey!! I can take a correction dose !!!

Also feel very grateful to be living now, in insulin age. Would only have lasted another five years without, methinks. And miserable starving years, too.

Lucy

PD Oz said:

Hello Leeter - I had quite a weight gain over the past 6 months since going on insulin. About 13 Kg. I had been 7 years on oral meds - metformin and then januvia for the final 2 yrs all the while gradually losing weight. The GP had diagnosed me as type 2 but when my A1c started going off the dial and random glucose was getting up to 18 it was off to the Endocrinologist. I was sent for the C peptide test which showed virtually no C peptide production. The diagnosis was in fact type 1 at 55 yrs of age.

I am not too concerned about my 13 kg weight gain as I was literally skeletal when I went on to insulin. It was fun eating my way up to some needed weight gain. What I keep an eye out on is that my BMI is comfortably in range. There are plenty of BMI apps you can check out to keep an eye on your progress. My insulin doses of 4 per day (3 rapids and 1 Levemir at night) were gradually ramped up under specialist advice in the early weeks until good BG levels were reached. Recently they were adjusted down slightly under the advice of my treating specialist and my weight is now stabilising.

While going on to insulin is a thing we all initially dread I find that 4 shots a day is far more preferable than eating less and less as our type 2 colleagues generally have to do to keep BG in range. Interesting that you are still on metformin. I was taken off oral meds upon commencing insulin. I shudder to think of what hypo would result for me if using metformin along with insulin.

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Hi. I asked my good DN to stop my Metformin when I went onto insulin but she said to keep it going as it has various protective properties (cancer etc). A study I once ready on the web showed that Metformin with insulin had a slight additional effect in reducing blood sugar but not enough to induce hypos or need any real change in insulin units.

That is a great HBA1c Daibell. Mine went down from 9.2 to 6.7 about 3 months after going on to insulin and was 7.2 last time.

Lucy is right about how much better we have things now with insulin. My mother was type one from an early age of 12 and on the earliest type of insulin available back then. She did things tough. Watching how she would have to inject was mortifying when I was a kid. With the pens now and the accurate meters we really have it made compared to what used to happen.

I barely feel the pen injections and after a few injections don't think twice about it. It would have been much different though if I had to use the old style syringes and try and draw up the dose which my mother always cursed about

Can you ask to go on Forxiga? I take it alongside insulin and it removes sugar from your blood and into your urine. It has helped me lose weight, I've not gained any since starting it 6 months ago in fact I've lost around a stone.

Hi @leeter .........the way to use twice daily insulin to best effect is to eat carb every 2.5hrs but in small amounts.....so 'little and often'. If you are putting on weight with the carb you are eating, then you can reduce it and also reduce yr insulin. As long as you test yr bg levels frequently, you will be able to adjust yr carb and 'eat to yr bg level on yr meter'. Good control is probably 6.5mmol before eating food and then allow a bg rise of 8.5mmol 2.5hrs later to allow for the way twice daily insulins affect bg levels.

This is really interesting. I have been on insulin for a year and for the first ten months I was also taking Metformin. My endocrinologist - who I saw for the first time two months ago - took me off Metformin as she said there was no point. I have put on 2kg since then despite a diet which is certainly below 2000 cals a day. If there is one good thing about diabetes it is that I am now slim and really do not want to gain weight. My BMI (with the 2kgs extra) will be 20-21. One thing I have thought of is that when on Metformin I drank NO alcohol (as the docs here say no, although my brother in law, also a doctor, says a little won't harm) for fear of liver damage. Now I drink a moderate amount which, although calorific, will not add up that much. Average 2 glasses a day. I'd rather go back on Metformin and ditch the couple of glasses of red wine if I could stop further weight gain though in an ideal world would keep the weight off and still have those maximum couple of glasses. They are one thing which doesn't affect my blood sugar readings and frankly I like them Don't eat or drink very much that I like nowadays...

Jacquelineann said:

This is really interesting. I have been on insulin for a year and for the first ten months I was also taking Metformin. My endocrinologist - who I saw for the first time two months ago - took me off Metformin as she said there was no point. I have put on 2kg since then despite a diet which is certainly below 2000 cals a day. If there is one good thing about diabetes it is that I am now slim and really do not want to gain weight. My BMI (with the 2kgs extra) will be 20-21. One thing I have thought of is that when on Metformin I drank NO alcohol (as the docs here say no, although my brother in law, also a doctor, says a little won't harm) for fear of liver damage. Now I drink a moderate amount which, although calorific, will not add up that much. Average 2 glasses a day. I'd rather go back on Metformin and ditch the couple of glasses of red wine if I could stop further weight gain though in an ideal world would keep the weight off and still have those maximum couple of glasses. They are one thing which doesn't affect my blood sugar readings and frankly I like them Don't eat or drink very much that I like nowadays...

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My first thought is to ask you exactly how many calories you're eating each day. You mentioned it was below 2000, but the BMR of the average 58 year old female is around 1200-1300 calories/day. Eating even 1500 calories could explain the weight gain you've experienced.

It's my understanding that Metformin is occasionally prescribed to overweight type 1 diabetics, but it sounds like you have a long way to go before you're considered "overweight." I realize 1200 calories isn't a whole lot, and it's more like 950 calories when you account for the two glasses of wine you're drinking each day (~250 calories).

If you're not willing to adjust your diet and don't want to give up your glasses of wine, that really only leaves one option: exercise more.

TorqPenderloin said:

My first thought is to ask you exactly how many calories you're eating each day. You mentioned it was below 2000, but the BMR of the average 58 year old female is around 1200-1300 calories/day. Eating even 1500 calories could explain the weight gain you've experienced.

It's my understanding that Metformin is occasionally prescribed to overweight type 1 diabetics, but it sounds like you have a long way to go before you're considered "overweight." I realize 1200 calories isn't a whole lot, and it's more like 950 calories when you account for the two glasses of wine you're drinking each day (~250 calories).

If you're not willing to adjust your diet and don't want to give up your glasses of wine, that really only leaves one option: exercise more.

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You're right on the calorie front - normally I have 1050 per day so if I have two glasses of wine that takes it up to 1300. Still seems odd that I should actually have gained so much in such a short time but I guess the wine has to go!

Jacquelineann said:

This is really interesting. I have been on insulin for a year and for the first ten months I was also taking Metformin. My endocrinologist - who I saw for the first time two months ago - took me off Metformin as she said there was no point. I have put on 2kg since then despite a diet which is certainly below 2000 cals a day. If there is one good thing about diabetes it is that I am now slim and really do not want to gain weight. My BMI (with the 2kgs extra) will be 20-21. One thing I have thought of is that when on Metformin I drank NO alcohol (as the docs here say no, although my brother in law, also a doctor, says a little won't harm) for fear of liver damage. Now I drink a moderate amount which, although calorific, will not add up that much. Average 2 glasses a day. I'd rather go back on Metformin and ditch the couple of glasses of red wine if I could stop further weight gain though in an ideal world would keep the weight off and still have those maximum couple of glasses. They are one thing which doesn't affect my blood sugar readings and frankly I like them Don't eat or drink very much that I like nowadays...

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I'm not T1, I'm not diabetic at all but,
I have a blood glucose disorders, where I overproduce too much insulin, when I eat carbs and sugars.
I f I eat carbs at all, I have too much Insulin in my blood!
Where does this excess insulin go?
It goes around your organs as visceral fat.
I don't eat carbs, so no excess insulin, I lose weight!

We need insulin to get rid of glucose but too much is bad for you as well!

Make sure you have got your dose of insulin correct for what carbs you are having or eat really low carb and you don't have to use as much insulin.

nosher8355 said:

I'm not T1, I'm not diabetic at all but,
I have a blood glucose disorders, where I overproduce too much insulin, when I eat carbs and sugars.
I f I eat carbs at all, I have too much Insulin in my blood!
Where does this excess insulin go?
It goes around your organs as visceral fat.
I don't eat carbs, so no excess insulin, I lose weight!

We need insulin to get rid of glucose but too much is bad for you as well!

Make sure you have got your dose of insulin correct for what carbs you are having or eat really low carb and you don't have to use as much insulin.

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Thanks - valuable advice. I think I have the dose correct for the carbs I eat - in fact I am sure I have because anything OTT and I am hypo. However I admit that I am rather allowing the amount of insulin I use to dictate how many carbs I eat. I guess my main question though is this: does Metformin help keep weight off and is it okay to drink alcohol with it at all or should i completely abstain? I don't really mind, but as I say if I can have a drink that's great - even if only occasionally because I live right in the middle of the vineyards and it's not really considered sociable to always so no!!

Metformin for most is an appetite suppressant.
So it should help, but I agree with your endocrinologist, that metformin is not for you.
Do you have no hypo awareness?
I think you do need to talk with your medical team and get their advice!
A glass or two per week is fine., I think!

Jacquelineann said:

Thanks - valuable advice. I think I have the dose correct for the carbs I eat - in fact I am sure I have because anything OTT and I am hypo. However I admit that I am rather allowing the amount of insulin I use to dictate how many carbs I eat. I guess my main question though is this: does Metformin help keep weight off and is it okay to drink alcohol with it at all or should i completely abstain? I don't really mind, but as I say if I can have a drink that's great - even if only occasionally because I live right in the middle of the vineyards and it's not really considered sociable to always so no!!

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From personal experience only, I don't have any problems with drinking alcoholw hole taking metformin except that one glass now has the same affect that two used to. Or maybe that is because I'm not the party animal I used to be so don't have the tolerance I used to have for it.

nosher8355 said:

Metformin for most is an appetite suppressant.
So it should help, but I agree with your endocrinologist, that metformin is not for you.
Do you have no hypo awareness?
I think you do need to talk with your medical team and get their advice!
A glass or two per week is fine., I think!

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Yes I have hypo awareness and it's a good thing too as I am very prone to hypos. My medical team is actually not at all helpful and by their own admission very unclued up about diabetes. Actually an appetite suppressant is not what I need as I have to force myself to eat most of the time. I followed a very low carb diet for about a year and still had blood sugar level which were extremely high. I lost weight at the rate of 3kg a month

Chook said:

From personal experience only, I don't have any problems with drinking alcoholw hole taking metformin except that one glass now has the same affect that two used to. Or maybe that is because I'm not the party animal I used to be so don't have the tolerance I used to have for it.

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Thanks - that's interesting. A glass from time to time is fine by me - it's just that my doctor said one should never ever drink with metformin. He's the only medic I know who has said this I hasten to add - and I come from a family of diabetics/medics. My father was type 1 from his twenties until the age of 89 and if he was still alive now I could ask him for clarification - sadly he passed away 4 years ago. Great role model though - I grew up thinking insulin dependent diabetes was a pushover!!