Type 1 and Weight Loss

Hello and welcome @Tegan97

Can you tell us more about your diabetes, so are you on multiple daily injections and which insulins are you using ?

Do you carb count? I think that's an essential because if you want to control your food intake then you really need to be able to dose adjust your insulin properly (assuming you are on MDI). That way you would be able to eat less without going low. If you are on a mixed insulin then I think you'd need to discuss this with your diabetes team.

If you haven't been taught to carb count properly then maybe you could ask your DSN about the possibility of going on a course?

Hi @Tegan97 Are you comfortable adjusting your ratios on your pump or do you get guidance from your nurse ?

I don't pump, so I'm afraid that I'm not going to be much help to you. I'll tag a couple of pumpers - @helensaramay and @Mel dCP and hopefully they might be able to offer some assistance. I know there are lots of pumpers but perhaps @Juicyj can remember who! The plot and I have separated this morning ....

Hello @Tegan97 I pump using the 640g, I would recommend increasing your activity rates as the best way to lose weight, however you need to be comfortable either adjusting your ratios or having regular contact with your nurse to review. The issue with increasing activity levels is the risk of hypo, so taking advice before you embark on any regime would be wise.

I run/cycle and swim but do a few things depending on exercise, I either take a 50% bolus on the meal before I exercise or I put a temp basal pattern on for the duration of the exercise, usually starting 30 mins before I start, When I started exercising a few years back I started off slowing/gently to see how my body performed and have increased intensity and time of exercise since. My requirements are different to yours or anyone elses, but gaining confidence over time has told me that if I start with bg levels above 7 and apply a reduction in bolus or a temp basal, that I can manage the exercise fine, I also monitor carefully for the following 24 hours too as muscles can deplete glucose stores whilst repairing afterwards.

Hi @Tegan97, before considering diet and insulin and exercise further, have you been to your doctor and asked about weight issues and possible medical causes such as a thyroid problem?

I would NOT suggest increasing activity on the basis that you'll lose weight. There's a saying, you can't outrun your fork, which is sadly true. Increase activity to improve your fitness, because it's good for your mental health, whatever - just not with an expectation that you'll lose more than a kg or two. I am a regular long-distance runner and gym-goer and am not thin...

Tegan97 said:

Hi! I do carb count (very closely) and I'm on a pump. I find that when I lose even the smallest amount of weight my basal rates need adjusting because my levels go down regularly, which obviously means I have to eat to get them back up.
I should have also mentioned I follow a very healthy diet already. I eat plenty of vegetables, fruit and lean meats. I just have a slow metabolism.
Thanks!

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Hello Tegan, I am type 1 on a pump too and tend to have different basal rates set up in advance so that I can easily swap to them (illness, pmt etc.).
I am weight stable but always struggled with weight when eating the standard 'healthy' diet of wholegrain carbs because dosing was difficult and if I got it wrong I ended up having to eat a biscuit or 2 to bring it up and if your basal is bringing you too close to your own nypo borders then you will feel hungry and crave more sweet stuff particularly if you are following the standard advice to 'eat less, do more' which I don't believe works well in the long term.
Like many type 2s on here, I now focus on quality fats, protein and green veg so that I can minimise my insulin doses.
I started with 1 meal where I dropped the carbs and then upgraded all my meals to low carb with the rule that a) I would not go hungry and b) would have carbs if the social situation demanded it (don't want to be a diet bore). I truly believe that if you give your body high quality fuel that keeps you satisfied your body will find its happy weight. You are young so I think your body could respond well to that approach.

Weight loss is not something I have dealt with.
However, I am very very familiar with adjusting the basal on my pump to avoid going low rather than eating more.
I would definitely advocate adjusting insulin doses for your food and exercise rather than food and exercise to match your insulin doses.
There are two ways I do this
- setting new basal pattern/profile for different types of activity days such as a basal pattern for the day I have a spin class or the day I go climbing or the day I do nothing. I always start these profiles by creating a copy of my normal profile and then adjust it based on experience.
- temporarily adjusting my basal when I see my bg getting low. For example, If I measure my bg and it is 5.0 or less.. but not hypo... I temporarily reduce my basal by 50% for 30 minutes). I also adjust it when I am about to do something which will significantly reduce my bg, I will reduce my basal. For example, I suspend my basal completely when I run for 30 minutes.

If you are not comfortable adjusting your basal, I recommend talking to your diabetes team for some training. This capability is the reason a have a pump.