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Started insulin, gained weight. Help please.

S

Starburst02

Member
I began taking nightly basal insulin injections in January 2017. I developed diabetes following Whipple Surgery for pancreatic cancer in 2002, but had been able to control the diabetes with diet and exercise until the past year or so. My HbA1C improved from 7.5 to 6.7 (USA measure) after first three months on insulin (I take a very small dose - 6 units), and unfortunately I have quickly gained 4.5 kilos. Since Whipple surgery in 2002, I have followed a low fat/relatively low carb diet of 1800 calories average per day. (Fresh vegetables and fruit, whole grains, poultry, seafood, small amount of dark chocolate after dinner. No deep fried foods, no sweet baked items, no sweet carbonated drinks. I do have wine with dinner, one to two glasses.) I must take Creon with meals. I am relatively active - walking 4 miles or more 4 to 5 days a week, on days not walking I do moderate intensity spin biking plus free weights afterwards. I enjoy gardening and have spent lots of time with that lately since spring arrived early here. Due to the weight gain, my BMI is 26.2 which is overweight. I am worried about the weight gain which happened quickly within a two three week span, and the possibility of it getting worse which could make my sugar control more difficult requiring more insulin which could result in more weight gain...?? I have tried further reducing calories, and especially from carbs, but so far no luck in reducing my weight more than a kilo which comes and goes. I have at least stopped gaining more weight so far. My PCP says eating less with more activity is the only thing he can suggest. I am 65 years old (retired), active and other than surgically induced diabetes, healthy.

Any suggestions on losing weight with type 3C diabetes? Is the weight gain with insulin permanent? Have you been able to affect weight with diet/life style modification?
 
I am not familiar with T3 to comment AT ALL

but as far as wright gain/ loss I have to be very strict with my carbs. I eat 20 or less a DAY or I gain. I follow a vlc moderate protein and higher healthy fat but not tons, more average. Most of my fat comes from an avocado a day ( the bigger the better) about an ounce of nuts throughout the day as snacks, mayo on egg/ chicken/ turkey salad and whatever fat comes on my protein but I do try to buy leaner cuts. And a little olive oil when I have salads. I rarely eat dairy and keep saturated fat low as well. All grains and dairy make me gain.

Again, this is only about wright loss for me. Please keep in mind when I did lower carbs my insulin needs lowered greatly.

I ate this way for 20 years before diabetes. At DX they told me to eat 20 c per meal and I gained my much needed 20 pounds back but bs was all over the place so I lowered my carbs and hypod until I found my insulin dose. Bs is perfect and weight stable.

Talk to your care team before making any drastic diet changes.
 

Thanks for your comments. I have done more research, and learned I must keep carbs to a minimum if I want to hopefully limit weight gain. My situation is complicated by the fact I must take Creon (pancreatic enzymes) with meals. Creon contains a significant amount of amylase, which helps digest and converts carbs to glucose. The speed of the conversion is accelerated when insulin is added. My blood sugar quickly spikes following meals containing even small amounts of carbs now, and that results in weight gain. It will be a challenge for me to further reduce carbs, but I will try since it appears to be the only option. Thanks again for your help.
 
I gained 12 pounds in the first week (not a typo) I started insulin injections.

It's going to be a lot easier to lose weight when your blood sugar is out of control. Your body can't effectively use or store glucose and without insulin that excess glucose will get filtered out by your kidneys. Unfortunately, that's what eventually leads to chronic kidney failure.

To address your concerns: it's normal to gain some weight back after starting on insulin, but that should subside.
 
Pancreatic / digestive enzymes always worked on my carbs too fast too. Again, no idea anout t3 but I'm sure you can find a meal macro plan that's works for you. As well as insulin dose. I've never heard of carbs halting weight loss. Just keep testing testing and more testing.
 
I experienced weight gain beyond my pre diabetic weight after being diagnosed despite the same diet and lifestyle. In the T1 thread I was shouted down, including by a mod that manufactured insulin doesn't make a difference. I went to a diabetic nutritionist and she said it was a recognised phenomenon, and advised me to keep my carbs to a max of 100g a day. I'm 6'3 and 14.5 stone, so not a huge amount. Low carbing is the way I think.
 

Thanks everyone for your comments. My PCP told me most people experience weight gain when starting insulin, usually around 15 pounds. He thought I could avoid the gain since my insulin dose is low. It will be a balancing act for me. I have found it I cut carbs too much, my blood sugar drops 2 to 3 hours after a meal and I have experienced mild low blood sugar episodes. I know about those because I had serious problems with severe low episodes when on oral meds when first diagnosed. I am working on getting to the right balance. Hopefully, when I find it, I can lose some of the pounds I gained. Thanks again for your help.
 
My diabetes nurse keeps suggesting I start on insulin and I keep saying no way. I think you are right about the low carb approach as it also works for me. Your lows are obviously caused by the meds. I don't want to get trapped by insulin, gaining weight, dieting, low glucose and then more insulin more weight gain. What a nightmare!
 
I don't take any medication for my simple type 2 diabetes, but for decades pre diagnosis I struggled with putting on weight due to the advice that I needed to eat grains - I don't. Certainly not in the amounts recommended as 'normal' and 'healthy'.
My total top amount when doing exercise twice a day and being active was 80 gm, 60gm was a slow but steady weightloss regime.
I would recommend eating low carb foods, with a low percentage of carbs rather than the thumping amounts of starch in grains - and as for sugar - a cup of berries with cream is about my limit, and not every day as it just gallops eagerly into storage around my waist, which I am sure sucks in fats from elsewhere as soon as it feels a draught.
 
Its a very common thing that when you use inulin you can gain weight. The best way is to go low carb because the more insulin you use the harder the weight gain and when you reduce carbs to about 50/60 grams you need a lot less but in your case disvuss it with your consultant and ask for nutritional support.
 
I've never found insulin to cause weight gain and I simply don't believe it does by itself, certainly with T1 diabetes.

Insulin allows glucose to transfer from the blood stream into muscles and fat. It's the glucose which is stored that "makes you fat"; not the insulin itself. The higher the carb intake, the higher the insulin requirements, unfortunately many diabetics correlate the higher insulin dose with the weight gain, rather than the higher carbohydrate intake. Insulin to carbs (or I:C ratio for bolus insulin) is fairly linear. You need the insulin or you don't, it's as simply as that. And what determines whether you need that insulin or not, is almost exclusively carbs. I'm not taking into consideration periods of illness, stress, hormones, etc for this discussion.

Look at it this way, as a T1 - if you have sugar in your blood you need to get it out of there with exogenous insulin. How did the glucose get there in the first place?

-Carb consumption
-Liver's natural glycogen release

Given that we can't really do anything with our liver (metformin is prescribed to some T1's but it's fairly uncommon); the only other variable to change is the carb intake. Remember that there is also the option to exercise and increase the amount of calories burned, so that you're balancing outgoing and incoming energy.

I'm a firm believer that insulin does not make you gain weight. I'm also a firm believer that food makes you fat. The only weight gain I noticed post DX was all the muscle and fat I'd lost due to DKA from my undiagnosed T1. All the weight that returned was absolutely necessary and was simply a case of putting back on what I had lost.

I appreciate that insulin in T2 diabetes is a different story, and I don't know anything about 3c in all honesty. But I've shared my opinion with T1, insulin intake and alleged weight gain.
 
In
 
Well here I am Carol, I’m now on insulin and my weight has rocketed from 81k to 98.5. I have decided to go back to low carbs and will moderate my insulin use accordingly hopefully I will manage some weight loss with diet and exercise. It’s a bit like walking a tightrope, trying to keep my BG low but not too low. Hope you have had some success managing your weight.
 
I’ve been type 3c for about 10 years post septic shock, sepsis, acute pancreas when routine bile duct unblocking procedure went wrong. Was put on humulin 1 plus gliclazide and metformin, and left with minor tweaks of splitting humulin dose twice daily. My HbA1c was regarded as ok, and my remarks about fasting levels in 3s was ignored, until recently. Currently on a course lead by two diabetic nurses running alternate weeks over 5 weeks. They immediately put a Libre 2 sensor on me, then got rid of the gliclazide, then got rid of humulin and replaced it with long-lasting Toujeo ( 16 units) and Fiasp (6 units with meals)….so now nothing below 10 BS. Been swimming and intermittent fasting ( 5 days a week 16 hours fasting) last 10 months and seen nothing re weight loss on old regime; Libre sensor shows from mid morning till 3 pm ( when I eat after swimming) that I must have a continuous glucagon dump from liver as BS just goes up to mid/ high teens tho nothing eaten or drunk for 12 plus hours! I’m wondering about using the Low Carb programme to try to loose weight, but read some comments elsewhere that it’s not suited to type 3 c as our BS is not really linked to carbs. Anyone any experience or comment re type 3c loosing weight successfully?
 
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