I’m sure this has been asked before. But, im a newbie on this site. I haven’t been on a pump in over 7 years. I feel like when I was in the pump before, my weight stayed the same. But I’ve been hearing different? When I get out on an insulin drip during DKA, the insulin made me gain a lot of weight. Now I’m worried that getting insulin CONSTANTLY is going to make me gain. I am a HUGE fitness and nutrition person. So, this is killing me. Info?!? Opinions? Help!
I think the key here is that the correct amount of insulin to meet your needs, eating the correct amount of food for you will not make you gain weight. Too much insulin to manage too much food will. The pump is simply a delivery system. Everyone needs some active insulin in their system at all times to live - either via the constant “drip” from healthy beta cells, long-acting injected insulin or, as you are doing, small increments via a pump.
I started on a pump 3 years ago (10 years MDI before that, and 20 on R/NPH before that), and I’ve had this question too. I see people saying things on both sides, so I don’t know that there’s a definitive answer. But I gained about 20 lbs in the first year on the pump that I’ve been fighting to take off by upping my exercise rate. So far I’ve only been managing to hold it steady. One repeated comment I see says something along the lines that it’s nothing to do with the insulin, it’s just that the pump makes it so easy to eat whatever you want that people find themselves indulging in foods they didn’t used to eat as much of. I KNOW this was not the case for me. I basically treated it as a more nuanced version of MDI, and I stayed on the same LCHF diet I’d been on before. Which meant that my basal was quite a bit higher than my bolus intake on both regimes. But even though my TDD actually went down a significant fraction on the pump, I put on weight. I can only guess that there was something about Lantus insulin that wasn’t as conducive to fat storage as the all-novolog regime I was now on but I don’t have any sources to back that up, just my experience.
Interresting @DrBB. For me, it was a bit the opposite. I gained weight rather rapidly after starting on insulin (MDI)- even though I’d decreased my food intake. Nothing I did seemed to help me lose any of the weight I gained on insulin. When I started on the Asante Snap, my TDD dropped by about 35% and I was able to lose about 15lbs over 6 months. Unfortunately, when Asante left the scene and I switched to Omnipod, I gained that weight back almost immediately – despite no change at all in my diet; however on the Omnipod, my TDD increased around 10% from the Snap levels. Now on the Animas Vibe, my TDD is somewhere in between and I have at least been able to hold the weight steady – but still unable to make a serious dent in it.
Thank you! I understand that people think that if they’re on the pump, they’re okay to eat whatever… But I know that won’t be an issue for me. I am big into nutrition, so I’m not gonna ruin what I am doing, just because I now have something hooked to me to give me insulin. Thank you for your opinion/ecpiercence! It’s helpful.
I lost a lot of weight while pumping, but have also gained a lot of weight while pumping, too. I think it comes down to calories. I want to switch to pens but keep talking myself out of it. Right now I’m 50 lbs overweight because during my last semester in college, I would go to Dairy Queen every day after class and eat two double cheeseburgers and a medium Oreo Blizzard. It was so easy to bolus 20 units and not think about it. If I had to do a pen in my car I would probably think twice about it. Now I’m doing low carb and weight 230 lbs and want to get to 180 lbs. I keep telling myself I’ll switch to MDI once I get back to a healthy weight. I did injections from 1994 at the age of 7 to 2001 at the age of 14 . I couldn’t imagine having had grown up as a kid using a pump. Injections just seemed simpler during those ages. For whatever reason or another, I think I have to pump now.
they may have given large glucose and insulin to clear the DKA ketones, that may have put on the weight.
get your basal dose right with the miss a meal basal testing and just watch your carb intake. less carb=less insulin, normal protein and a bit more fats for energy…LCHF adjusting carb intake controls your weight without getting sick.,
I haven’t gained weight on mdi or the pump. I gained back the weight I lost from dka and I have stayed pretty much the same since then. I was losing a bit at some point I think when I was in a hyper phase from hashimotos. I’m eating more now because I haven’t been eating enough prolly due to it making bg control too hard, but now due to other health reasons I need to eat more so I’m curious to see if I gain more. Even if I do gain a bit I won’t be overweight so I think it’s ok.
If you didn’t gain on it before why would you think it would happen now… I’m a bit confused. Maybe the weight gain has nothing to do with dka/iv insulin. You have aged and your body and metabolism have changed or there could be other health issues, like hypothyroid.
I haven’t gained any weight from pumping. Still as underweight as ever, despite getting older.
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If you want to gain weight without increasing carbs, Dr Bernstein recommends increasing protein, he tried increasing fats an extra 500 calories a day, but it didn’t gain weight for his patients.
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Oh goodness lol. Well, as a pen user for the past 7 years, I would say don’t do it 
of course it’s up to you! I did really bad on the pens. I’d accidental leave my pen at home. And sometimes I just wouldn’t eat, just so I didn’t have to inject. Or, I was hungry and would eat, then realize I didn’t have my pen with me. Of course, my blood sugar would go sky high. If you decide to go on the pens, I sure hope you do a better job at it! Haha
I didn’t mean for it to sound like I am going to gain weight this time around. My body has been through hell and back since I last used the pump. I went through complete organ failure, 2 years ago. And now my body is just messed up. I’m a healthy weight. I am a very active person. A coworker of mine put it into my head that I will gain a lot of weight, and now it’s stuck in my head. A lots changed since 2008, when I last used the pump. Whether it’s the fact that I’m 25 now, not 17, or the fact that I’ve had a child, organ failure, etc. I’ve let diabetes take over my life. It’s put me through a depression. It just sucks. I think too much about crap.
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Funny how different circumstances change everything. I had been on R/NPH for 20 years before finally finally FINALLY getting a referral to a real endocrinologist (at Joslin) who took one look at what I was doing and switched me to Lantus/Novolog MDI. It was like being released from prison. Being able to skip a meal, or eat a late lunch if I had a meeting or whatever, after two decades of “Eat Now Or Die!” was incredibly liberating. Switching to a pump was far less life-changing for me–I actually had a pretty rocky time for the first 3-6 months–though I do prefer it. I wouldn’t be pleased if I had to go back to MDI, but I wouldn’t panic. If I had to go back to R/NPH, though… ugggh. Just thinking about it makes me feel a little ill.
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sounds horrible. i did injections with syringes for 7 years and it was no fun. i guess pens would be no better. maybe i should look past the negative vanity aspect of the pump and focus on what it does for my health.
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I gained about 12 lbs. i walk 5-6 miles per day and my weight has been pretty strady. I have been using a pump for 3 months. I use an omnipod and it could not be a less invasive device. Love it!
Hi h3babe,
I’m sorry to hear you went through all of that. I wouldn’t do anything too drastic in terms of dietary changes due to the upheaval your body has been through. If you go back on the pump and it causes wg you can go back to mdi, nothing is set in stone. I would not go back to mdi because my bg fluctuates too much and there is no way to control it. At lease with a pump I have some real control for lows especially but for highs too.
The insulin pump does not make you gain weight. What you eat makes you gain weight. It is much easier to bolus with a pump and so you may find that you eat more. You still have to watch what you eat and exercise. Been pumping for 24 years and my weight has pretty much stayed the same. I use under 30 units of insulin daily including basal and boluses. Been T1D for 46 years.
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I’ve only been on the pump for a month but I’ve stayed the same weight as when I did MDI. I like the convenience of not having to remember to bring my pen and needles with me. I would be at a restaurant ready to eat and realize that I had forgotten it.
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Isn’t weight gain a side effect of insulin–no matter if you do MDI or pump. Not everyone has every side effect of a drug but still… I was diagnosed 3 years ago and I have gained weight. 2 years on MDI and 1 on the pump, it doesn’t matter. I eat moderately. Doesn’t matter. I should exercise more but ugh!
“Negative vanity aspect of a pump” sounds like you have visions of a pump hanging off your belt and tubes running out of an infusion site to the pump. Pumping does not have to be that way. I have used the OmniPod for the past seven years, and no one (other than my husband) even knows I am wearing the pump. It is either under my shirt or my pants. Do I try to hide it? Not really. I just find the best sites for me happen to be under my clothes. Plus, when in a restaurant, I can do a quick blood test with the PDM in my lap (since I know some people are freaked when they see blood), and then bolus with a push of the buttons. No syringes, no pens, nothing. The OmniPod gives you the benefits of pumping without the vanity aspects at all. I hope that you consider making the change. Your body will thank you for the increased control.