Struggling to understand Type 1/Insulin/Weight loss

odeshee

Honestly more serious than ever before, been tracking since 1/1/12, and very frustrated. I am a type 1 Diabetes for about 6 months, and first attempt since Insulin came in to play. Not looking for excuses but how much if any could insulin come in to play? Any others dealing with this ?:embarassed:

Trying to drop 5 a month. :embarassed:

odeshee

wow noone:sad:

calliope_music

do you mean type 2 diabetes? type 1 is normally diagnosed quite early in life - it's also known as juvenile diabetes.

from what i have gathered, it's harder to lose weight with diabetes because your insulin isn't effective at lowering your blood sugar. additionally, your pancreas, which releases insulin, has to work harder to get your sugar lowered. when your body's cells can't use the sugar as fuel, it wants more fuel (food) and it makes it harder to drop weight. i would also talk to the doctor. but insulin definitely plays a role.

wikipedia actually has a good article: http://en.wikipedia.org/wiki/Insulin_resistance

LabRat529

Are you SURE you're type 1? Type 1 diabetes is caused by an auto-immune attack on the pancreas. Type 2 diabetes is caused mostly by obesity.

There are many many things that effect weight loss. Insulin can be a small art of the bigger picture, but if you are in a calorie deficit, you really should be able to lose weight.

If you aren't already trying it, you might consider a low carb diet. I usually don't recommend low carb to people, but I've read some really interesting literature that suggests diabetics do better than the average person on low carb.

But really... the best thing for you would be a heart-to-heart with your doctor and a recommendation to a dietitian who can help you.

sweetptgrl

If you are having a lot of trouble, see if your MD will refer you to a Diabetes Educator. Part of their job is to help you with the medications, food and exercise that affect your blood sugar levels. My bf is a diabetes educator and he would love it if more of his patients wanted to exercise and understand how it affects your blood sugar and insulin use. The best thing to remember is the make sure you test your blood sugar after you exercise so you can see how it affects you.


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deggersuk

My fiance has type 1 diabetes and in answer to your question yes by abusing/neglecting her insulin she can drop weight fast. She can also put it back on as fast under good control. I wouldn't recommend it but fact remains some type 1 diabetics do abuse to control weight.

From Yahoo Answers:

"Uncontrolled type 1 causes weight loss. Essentially insulin is the key that lets nutrients (carbs) into your cells in your body to create energy. Type 1's do not make insulin, so the cells are starving. For energy, the body will burn off fat cells and this is what causes a type 1 to have rapid weight loss."

itsablondething

If you've just been on insulin for 6 months, you may be considered insulin dependent, but most likely NOT type 1.

What I can tell you is this.. losing weight will make you more receptive to the insulin, and so weight loss will most likely decrease, if not entirely eliminate your need for insulin BUT you do need to check your blood sugars regularly, and continue to take your insulin.

Don't know how you are doing it now, but I would suggest you talk with your Dr. and find out how often you should be checking your sugars and if they want you to do a sliding scale, or adjust your dose based on carb intake.

Also.. each meal that is a combination of fat, protein and carb will be digested more slowly and contribute to better blood sugar control than if you just have these things by themselves (a glass of juice will spike you sugar fast because it is all sugar, but a glass of 2% milk will give you a steadier blood sugar because it is fat, protein and sugar.. so it will take your body longer to break it down.

You really need to talk to the doctor or dietician.

KLK1986

Great question! I've had Type 1 almost 20 years and I am also struggling with weight loss.

I actually saw my endocrinologist today and we talked about it. He said that with improved control comes weight gain because improved control usually means lower sugar levels....and higher insulin levels in the body. The way to balance this is to eat lower carb (he is recommending a life change to 100g a day of carbs, max) so you need less insulin, and to time the majority of your days simple carbs around times you will work out and be able to use many of them for fuel instead of needing insulin to cover them. He also disagrees with MFP's goals for me, which said I need 1270 calories a day to lose a lb a week and has told me not to go lower than 1500 or I may hurt my metabolism.

Feel free to friend me or send me a message if you have more questions!

ETA: You people telling the OP that he doesn't have Type 1 obviously know nothing about it. Type 1 can be diagnosed AT ANY AGE, for someone at ANY WEIGHT. It's a complete and utter fallacy that it's diagnosed only in young people. Go Google LADA and educate yourselves.

itsablondething

My fiance has type 1 diabetes and in answer to your question yes by abusing/neglecting her insulin she can drop weight fast. She can also put it back on as fast under good control. I wouldn't recommend it but fact remains some type 1 diabetics do abuse to control weight.

From Yahoo Answers:

"Uncontrolled type 1 causes weight loss. Essentially insulin is the key that lets nutrients (carbs) into your cells in your body to create energy. Type 1's do not make insulin, so the cells are starving. For energy, the body will burn off fat cells and this is what causes a type 1 to have rapid weight loss."

And doing this can lead to a deadly condition called Diabetic Ketoacidosis. (can have a mortality rate of 50% in otherwise healthy individuals) DKA sets off a deady chain reaction in the body. Bad bad bad.

deggersuk

And doing this can lead to a deadly condition called Diabetic Ketoacidosis. (can have a mortality rate of 50% in otherwise healthy individuals) DKA sets off a deady chain reaction in the body. Bad bad bad.

Fully aware and she was in hospital with Ketoacidosis at 19 due to going out partying/drinking and not injecting insulin trying to keep a size 10 figure.

She is now 29 and learnt a valuable lesson from that experience. Still remains though that insulin abuse is common to control the weight gain.

atomiclauren

It may be frustrating to try to lose weight while taking insulin, but wow - DKA is practically a death sentence!

I've also had type 1 for a while now (about 22 years) and it's definitely more of an uphill battle, but definitely doable. Like mentioned above, low carbing can help, and most of all, lots of patience.

itsablondething

Regardless of Type 1 or Type 2, these are issues that need close attention with a doc. A lot of type 1s have a lot of success calculating insulin dosages based on sugar levels and carb intake. But this requires sugars at least 4 times a day.

And a diabetic should not "low carb" it without keeping a close watch on their sugars and the involvement of the medical professionals. It can lead to blood sugars that swing to low. Not saying the lower carbs aren't beneficial, but you can't switch to a low carb diet without addressing the need to adjust insulin dosages.

Short term, low blood sugar causes a higher risk for serious complications if left untreated then high blood sugar. High blood sugar (not talking high enough for DKA) generally takes years to damamge at a microscopic level before the big bad issues come up.. like heart disease, kidney issues, neuropathies, etc).

chuckles217

You need a Doctor and Nutritionist team to see the best results.

Ideally for T1 or T2 diabetes, you want to eat a Low Glycemic Index diet. Most type 2 can even control their diabetes with a strict low GI diet and can come off medications.

For either, you need to stay away from Keto type diets. Diabetes is in essence a vascular disease. It accelerates atherosclerosis (hardening of arteries) throughout the body, most notably in the retina, heart, and kidney. One of the first signs of diabetes is a positive urine test for micro albumin and the volume of protein in urine directly correlates with the progression of diabetic kidney disease. Any type of diet which increases organic acid secretion in the kidney such as atkins or keto will put undue stress on the kidney and rapidly progress it towards failure. This goes for diabetic ketoacidosis which is triggered by improper insulin use and excess carb eating.

Ultimately, get a doctor and nutritionist team and get your plan worked out.

badgerbadger1

You need a Doctor and Nutritionist team to see the best results.

Ideally for T1 or T2 diabetes, you want to eat a Low Glycemic Index diet. Most type 2 can even control their diabetes with a strict low GI diet and can come off medications.

For either, you need to stay away from Keto type diets. Diabetes is in essence a vascular disease. It accelerates atherosclerosis (hardening of arteries) throughout the body, most notably in the retina, heart, and kidney. One of the first signs of diabetes is a positive urine test for micro albumin and the volume of protein in urine directly correlates with the progression of diabetic kidney disease. Any type of diet which increases organic acid secretion in the kidney such as atkins or keto will put undue stress on the kidney and rapidly progress it towards failure. This goes for diabetic ketoacidosis which is triggered by improper insulin use and excess carb eating.

Ultimately, get a doctor and nutritionist team and get your plan worked out.

I disagree on several of your "facts" here.

OP, see your doctor. There is no reason you cannot lose weight while on insulin, but it requires significant monitoring and dosage adjustments. Get a referral to a dietician who specialises in diabetes.

odeshee

Thanks for all your ideas, Type1 or Type 2 just going by whay my Dr told me, 10 yrs ago started taking oral meds for it, within in the last yr yhey were no longer effective so I was put on insulin shots fast acting and the slow acting to cover the entire day. I am going to look into the dietician referralas recommended. I don't think I am really interested in flirting with disaster by choice, when I fall into a low sugar condition it really scares me.

chuckles217

You can disagree but they are facts, or so I was taught in medical school which may be wrong.

AutieHamilton

You mean type 2, I'm sure...

I had gestational diabetes (diabetes manifesting while pregnant). I also recently discovered that I am pre-diabetic.

My doctor recommended a low-carb diet. I generally stay away from breads, pasta, and fruit in the am. While pregnant, I lost 15 pounds after I was put on the diet. I was insulin dependant, having to inject myself 6 times per day.

It's hard but, can be done.

Some inspiration for you: a lot of times, getting down to a healthy weight will make the diabetes go away.

Good luck. :-)

AutieHamilton

I agree with those above who suggested seeing a dietician. It helps immensely.

metal530

I have run into doctors that don't know much about the differences between Type 1 & 2. So med school deffinetly could have been wrong.

CaoimheAine

I have had type 1 since I was 8 years old... Whatever you do, don't skip your insulin... Stupid I know :noway: but I did. I lost a heap of weight, but it was not worth getting that sick and nearly dying for. I ended up putting it all back plus another 10kgs lol and here I am now... You can definitely still lose weight, it's been hard and may be harder than a normal person to lose but it just makes it that much more worth it!!!

12skipafew99100

You can disagree but they are facts, or so I was taught in medical school which may be wrong.

Congratuations on your baby. Let us know when he arrives!~

Justkeepswimmin

You can be type 1 at any age, although it is more frequent earlier in life. My husband become type 1 at the age of 29, and was never type 2. His diabetes was caused by chemical exposure in the miltary to something that ruined his pancreatic function, specificially the beta cells in it that tell the body when/how to creat insulin.

A fantastically not so intelligent doctor diagnosed him as type 2 diabetes, gave him pills, and sent him home for the weekend (with 800 blood sugar) By Monday he was in the hospital with DKA.

So now, his body produces absolutely ZERO insulin on it's own, which is only a slight blessing because we can moderate his insulin based on what's in his shots as opposed to what is not. He's 51 and been a diabetic for 22 years.

As for weight loss, he has lost (and gained) weight since being diagnosed with his diabetes. It takes time, and occurs much much more slowly, however some important tips.

1. As with any diet, grains are better than starchy carbs, but not only are the considered 'healthier' they will release into your blood stream slower (the sugar), so you wont spike your sugar, then take a shot to correct that spike, then get into a low (which is just as dangerous as DKA). DKA is scarry but takes a few days (usually) to occur (unless you exercize with high blood sugar then you can go into DKA). Low blood sugar is more frightening for me because my husband has a rediculous tolerance for low blood sugar and doens't notice it is low until it is very low, and it can drop fast. Of course if your sugar is low enough you can pass out, and your entire body can shut down (ie die).

2. Test, test test test (your sugar). Then accomodate what the test shows. So if your sugar is running high, but you're trying to 'snack' every 2-3 hours for a diet...eat protein only when the sugar is high, and focus on the carbs when it is lower.

3. Build yourself a buffer into MFP. Keep your goals for the week 'lower' but try to consistently be under about 100-200 calories of that goal. For example, hubby's caloric 'net' goal *was* 1700. We found that he would get lows sometimes, and then the sugar would put him over goal, and he'd be discouraged. So we decreased the ammt we wanted him to lose/week so his goal is now 1980 (still a loss for him, he's very tall) but he tries to get around 1700 in, and if he goes over due to a sugar low he doesn't worry about it. This is just a mental strategy.

4. Ask your doctor about Symlin - it's not insulin, it IS an extra shot. It's basically a way of making sure your body is processing proteins properly, since it's been discovered that some type 1 diabetics do not process proteins properly. This is important for you to be able to build musle. A great side effect is it supresses appetite. (I think the FDA was going to look into approving it for weight loss too eventually).

5. Try to keep healthy carbs on hand for lows and resort to pure sugar only in desperate situations (ie. 100% juices, and fruits for lows, and maybe some healthy crackers for only slight lows as they take longer to process than juice or fruit)

6. Pay attention to your sodium, diabetics are prone to all sorts of heart issues which are also aggravated bo sodium. This will also curb your bloating.

7. Eat a few carbs before exercize if you find you're getting low during exercize and resorting to unhealthy carbs right after your exercize to bring it up.

8. Keep a routine schedule for eating times.

Being insulin dependent does not necessarily make you type 1. Also, you can be what some call a type 1 and a 'half' (doctors say that about my husband) It does not mean you're between either condition, but more so that you have both conditions. Meaning that your body doesn't produce insulin AND your body is resistant to insulin when it is in your body. It's important that you find a great endocrinologist - most of which have nutritionists that they have in house or one they reccomend.

jamja72

Bump

badgerbadger1

You can disagree but they are facts, or so I was taught in medical school which may be wrong.

What year are you? 1st? 2nd? Get back to me when you finish your residency. I don't mean to pick on you but you are providing misinformation. Do you have any clinical experience at all? I don't know any nephrologists, endocrinologists, vascular surgeons or even residents who would agree with you.

Diabetes isn't "essentially" vascular, it's endocrine with significant metabolic, neurological, vascular and renal etc sequelae if uncared for.

Diabetes produces vascular sequelae by making the blood essentially stickier, sticking to vessel walls eventually causing them to occlude. By this and higher blood pressure, small vasculature such as renal, retinal, peripheral vasculature, and coronary vasculature are more likely to occlude resulting in the effects noted.

One of the first signs of diabetes is not urine protein. The first sign of diabetes is high blood sugar. Renal effects are not notable until GFR drops to nearly 5% of baseline function. Urine protein would be a LATE sign, therefore.

Diabetic ketoacidosis is not a result of high carb eating. It's due to inability to utilise insulin or lack of insulin usually in the presence of an illness such as the flu or infection.

chuckles217

What year are you? 1st? 2nd? Get back to me when you finish your residency. I don't mean to pick on you but you are providing misinformation. Do you have any clinical experience at all? I don't know any nephrologists, endocrinologists, vascular surgeons or even residents who would agree with you.

Diabetes isn't "essentially" vascular, it's endocrine with significant metabolic, neurological, vascular and renal etc sequelae if uncared for.

Diabetes produces vascular sequelae by making the blood essentially stickier, sticking to vessel walls eventually causing them to occlude. By this and higher blood pressure, small vasculature such as renal, retinal, peripheral vasculature, and coronary vasculature are more likely to occlude resulting in the effects noted.

One of the first signs of diabetes is not urine protein. The first sign of diabetes is high blood sugar. Renal effects are not notable until GFR drops to nearly 5% of baseline function. Urine protein would be a LATE sign, therefore.

Diabetic ketoacidosis is not a result of high carb eating. It's due to inability to utilise insulin or lack of insulin usually in the presence of an illness such as the flu or infection.

I have my masters in biochemistry and am a 3rd year medical student. I have done 5 years of bench research into auto-immune diseases, my particular focus was type 1 diabetes. I have numerous publications as a 2nd author under the MD/Ph.D. I worked under.

High blood sugar is the first "sign" per say of diabetes but is rarely symptomatic, so the first positive test most often to come back would be a non-fasting finger stick of >126 given that 126 glucose is the new standard for declaring diabetes. However, the 126 levels must be found on two separate occasions during fasting episodes for a definitive diagnosis. Most physicians air on the side of caution and run a urinalysis and look for microalbumin and other protein such as a dipstick protein. Dipstick protein [whole albumin] won't be positive until late into the diabetic glomerulopathy of the kidney disease, but the initial uncontrolled blood sugar drives the non-enzymatic glycosylation of the efferent tubule of the kidney's gloumerular blood flow. This in essence increases the GFR of a kidney by constricting the efferent arteriole and leads to the leakage of micro albumin and is a very early sign. It is a very sensitive test, but relatively unspecific which is why it is followed up with the specific test of the blood sugar confirmation.

And yes it is an underlying endocrine disorder varying between destruction of beta islet cells in the pancreas for type 1 or the insensitivity to insulin in type 2, but the disease process is that of vascular. Every symptom relates to a vascular component that results from hyperglycemia leading to non-enzematic glyocsylation of various substrates not limited to the basement membranes of arteries. Why are their neurological symptoms such as peripheral neuropathy and painless foot ulcers? Peripheral vascular disease obliterates the blood supply and necrosis the nerves. If further left untreated, the kidney arterioles further fibrose and those they initially increased GFR since the efferent arteriole was first affected, the afferent arteriole eventually fibroses along with the efferent leading to nodular glomerulosclerosis and ultimately nephrotic syndrome with a steady decline in GFR until chronic kidney disease (aka renal failure) results. Hence why ACE inhibitors are a must to aid in dilating the efferent arteriole and keeping the GFR up.

And as far as diabetic ketoacidosis, the glucose stays within the blood stream and has extreme trouble entering muscle and target organs. Excess carbohydrate (specifically that of high glycemic index) leads to large spikes in blood sugar which depending on the type of diabetic, has various effects. Ultimately, it drives the body to a fasting state driving the production of acetoacetic acid, beta-hydroxybuteric acid and other ketones as a last ditch fuel. This produces severe metabolic acidosis if allowed to persist for a while and then combined with the kidney pathology, titratable acids can not be secreted nearly as well further increasing the severity of the acidosis. So the underlying cause may be insulin (whether it be lack of or insensitivity) but the excess glucose load of an uncontrolled diet is proven to accelerate a person towards DKA.

badgerbadger1

So then I'm confused why you stated what you did. You are essentially agreeing with me, however by stating things like "urine protein is the first test/sign" is incorrect, it IS high blood sugar, as you said in your latest post.. Urine protein is more specific for kidney disease. Stating eating too many carbs being THE cause is incorrect, as you are apparently well aware that there are many factors involved in producing a state of DKA. Stating diabetes is a vascular disease is incorrect, as you have just now stated. Your first post does not jive with your latest one and it is misleading to the otherwise uneducated, you must concur.

I think your lab/textbook knowledge is causing you to overthink this, which is a common error. Occam's razor and the concept of KISS apply in medicine. Why would you do a test that is more expensive and less specific when it will tell you the same thing as a simple stick? It's only after the sticks come back positive that you start running more specific tests like urine protein, if and only if, you have reason to believe there may be renal involvement. It's like sending someone for a full body CT when it will not effect your treatment plan or outcome whatsoever.

When speaking to a patient, it is important to use layman's terms and ensure you are not bringing extraneous info into the picture. Urine protein has little if anything to do with the topic at hand.

I'm really not trying to slam you, that is not my intent. However years in the classroom and lab do not compare to years in the clinical environment. As a M3 I'm sure you are already clerking and are aware of this. As a clerk you probably get challenged like this daily by your attending. What you have done in the lab is great, but they are more concerned with how you APPLY it. It does not always translate. We occasionally get M4's in our unit for a 2 week optional exposure and they're way out of their league. Regardless of background. Even PGY2s can struggle and will need our guidance or will be challenged. That's how we learn. When rounding, you know that you can propose treatment or testing options, but you had better be prepared to provide a good rationale for it. Please consider my challenge more like a challenge on rounds, not as a personal attack.

chuckles217

So then I'm confused why you stated what you did. You are essentially agreeing with me, however by stating things like "urine protein is the first test/sign" is incorrect, it IS high blood sugar, as you said in your latest post.. Urine protein is more specific for kidney disease. Stating eating too many carbs being THE cause is incorrect, as you are apparently well aware that there are many factors involved in producing a state of DKA. Stating diabetes is a vascular disease is incorrect, as you have just now stated. Your first post does not jive with your latest one and it is misleading to the otherwise uneducated, you must concur.

I think your lab/textbook knowledge is causing you to overthink this, which is a common error. Occam's razor and the concept of KISS apply in medicine. Why would you do a test that is more expensive and less specific when it will tell you the same thing as a simple stick? It's only after the sticks come back positive that you start running more specific tests like urine protein, if and only if, you have reason to believe there may be renal involvement. It's like sending someone for a full body CT when it will not effect your treatment plan or outcome whatsoever.

When speaking to a patient, it is important to use layman's terms and ensure you are not bringing extraneous info into the picture. Urine protein has little if anything to do with the topic at hand.

I'm really not trying to slam you, that is not my intent. However years in the classroom and lab do not compare to years in the clinical environment. As a M3 I'm sure you are already clerking and are aware of this. As a clerk you probably get challenged like this daily by your attending. What you have done in the lab is great, but they are more concerned with how you APPLY it. It does not always translate. We occasionally get M4's in our unit for a 2 week optional exposure and they're way out of their league. Regardless of background. Even PGY2s can struggle and will need our guidance or will be challenged. That's how we learn. When rounding, you know that you can propose treatment or testing options, but you had better be prepared to provide a good rationale for it. Please consider my challenge more like a challenge on rounds, not as a personal attack.

I understand what you're getting at. I just got off rounds of IM with a nephrologist hence why I am so "full" of knowledge as the area we are in we see large majority of T2D patients with no medication/diet compliance. The whole micro albumin came directly from the attending I was under as he grilled me on that on a regular basis stating more cases of T2D are initially discovered on a urinalysis with Microalbumin than by symptomatic blood sugar levels. So I guess my error lies in declaring frequency, not chronology of symptoms.

Anyways... Tossing out all the jargon and pardon the interruption, back on topic per say?

badgerbadger1

Yep, good luck on your next rotation! I'm out for a run.

Cheers.