Double Whammy!

Anyone here experiencing double diabetes? Is there such a thing? I think I’m having it. I have beenType 1 for 33 years. Lately, I have been experiencing many symptoms of Type 2, namely, weight gain and insulin resistance. It’s like the insulin I take does nothing (unless I take a huge dose) and it is very hard to lose weight. I tried Metformin for a year and it did nothing for me at all.

Anyone else dealing with this? Has anything helped?

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I don’t. But a couple of things have happened that have caused it. First my dawn phenomenon, for a few hours later it, I take a lot more insulin and it seems to take longer to work. So I bet any hormone fluctuation potentially might cause an issue (like menopause)?

And then being sick or having an infection. When I had a tooth infection my BG’s went up for 2-4 weeks? At first I didn’t even realize what was going on until a tooth finally started to bother me a little and it turned out under a cap I had a bad infection.

I’m not sure how long this has been going on for you and if you tried metformin it sort of sounds like it might be a longer term thing. But menopause who knows, I’ve heard some complaints.

@Marilyn did Mastering Diabetes that helps this problem and is doing great. This tag I think has her notice this? Otherwise she is around the forum all the time.

Medication-wise, you might consider trying Jardiance. It’s off-label for T1 but a lot of us are trying it. In my case it has lowered my TDD considerably and significantly evened out my high/low excursions. Supposed to help with weight loss, too, though for me that’s been an eternal struggle. Anyway, you might ask your endo about it.

I’m a T1D and did develop lots of insulin resistance many years ago. My increasing insulin resistance took hold during a five year period when I slowly gained about 20 pounds.

One of the biggest things i learned from that experience is that anyone, no matter their diabetes diagnosis, can develop insulin resistance and that it’s an over-abundance of insulin itself that causes insulin resistance. This high level of insulin can be driven by the home-grown variety as in the case of the earlier phase of T2D or it can result from injecting/infusing too much external insulin as in my case.

I remember correcting high blood sugar with fairly aggressive insulin doses and my glucose level would not budge. It was like I injected water!

I finally made a breakthrough with insulin resistance using a low-carb way of eating. I started with eating less than 50 grams of carbs per day and relaxed that restriction to 100 grams/day for a few years. I now eat less than 30 grams/day.

That eating change led to a 25 pound weight loss and cutting my total daily dose of insulin to less than half what I had been taking.

I know that there are other ways of eating to address this issue but I found enduring success eating a low-carb, high-fat diet. I now eat no processed foods, no grains, and no added sugars. My diet consists of meat, fish, veggies, cheese, heavy cream, yogurt, nuts, seeds, and berries. I limit serving sizes of starchy veggies like legumes or beans.

I don’t think the term, “double diabetes” is helpful in this situation. T1D is auto-immune mediated and T2D is more aligned with straight forward insulin resistance. I did learn, much to my detriment, that insulin resistance can arise in anyone, including people with T1D.

This way of eating allows me to keep my weight in the normal range, feel satiated between meals (I only eat two meals per day.), keep my A1c in the non-diabetic range and reduce my glucose variability as measured by my standard deviation to about 20 mg/dL or 1.1 mmol/L.

This reduction of glucose variability has enhanced my quality of life. It removed much of the metabolic drama associated with swinging blood sugars. I no longer ride the glucose roller coaster like I did when consuming a high-carbohydrate diet.

I know that some people can eat a low-fat, high-carbohydrate diet in a plant-based whole-foods regimen and still benefit from good blood glucose numbers. I think the key take-away from that is that the worse path you can choose, diet-wise, is one that contains both high fat and high carbs, especially processed carbs. This is sometimes referred to as the Standard American Diet or SAD and includes lots of processed foods.

Good luck going forward. Few people like to change the way they eat. It’s akin to changing your political or religious views. It is, however, the most effective lifestyle change I’ve made to improve my health.

I’ve also used fasting as an effective way to increase insulin sensitivity. Even missing one meal helped me. My fasts are usually in the 16-24 hour range.

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Marie 20 mentioned my name and Mastering Diabetes in her post. I hadn’t noticed much weight gain, but a change in the way I eat greatly reduced any insulin resistance that I had. Eating a plant based very low fat diet works miracles in reducing insulin resistance. I can now eat almost 300 carbs a day when I used to be able to eat only 30 carbs a day. I only take about 3 units more of total insulin. Eating 30 carbs with lots of fat, I used 17 to 20 units of insulin. Now eating 275-300 carbs daily of plant based low fat foods I use 19 to 23 units of insulin.

See Mastering Diabetes.org, if you are interested in learning how to lower your insulin resistance. Most people also lose weight eating this way. The two guys who run the site are both extremely fit, very well educated type 1’s.

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I don’t have double diabetes. However, I’ve had T1D for 28 years and as an adult have become significantly overweight (more than a hundred pounds over my ideal weight). As a result, my insulin doses has risen dramatically, although I don’t believe I technically have insulin resistance, as my insulin doses still fall within the range that would be expected for my weight. I started taking metformin several years ago, which didn’t bring my insulin doses down significantly but did help my blood sugar become more stable overall. My endocrinologist advised that I continue to take it when I asked if I should stop (because my B12 level dropped low). I have tried SGLT-2 inhibitors, which worked extremely well at reducing my insulin dose, but I had to discontinue them due to issues with urinary tract infections (two infections within six weeks). I also take blood pressure and cholesterol medication (small dose for the latter) and am hopeful I may be able to get off these if I’m able to lose weight. So, I can easily relate to people with both T1D and T2D as I experience struggles of both.

I’m not following a low-carb diet in large part because I’m allergic to dairy and eggs (and more, and the severity of my allergies stops me from being able to eat out or eat many prepackaged foods), and don’t eat processed or red meat due to an immediate family history of cancer, which makes such a diet challenging. However, this summer I will be testing the “calories in, calories out” method, which I know many on this site disagree with… I’ve recently met with a dietitian and have ramped up my exercise to 45-90 minutes of moderate exercise every day after six months of zero exercise due to health issues. So I am hoping to build up my strength and fitness, and hopefully lose weight in the process.

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I’d like to lose 35 lbs, but I’d be happy to just lose ten!

I certainly did at one point. I had all the classic symptoms and things were closing in quickly. Frankly as far as I know the only way to over come it is to lose a good deal weight. It has taken many years but I have been able to drop the second diabetes. Today I am happy to be back to type 1 alone.

Incidentally the for thing my docotr did was counter intuitive and looking back so smart. In addition to reducing calories dramatically, he cut insulin by 1/3. I was stunned and said so.

At my peak I was using 8 vials a month, today I use 3 and 2 seems possible. It still seemed to make little sense. But darn if in addition to calorie restrictions it has not worked. It still blows me away.