Insulin and weight gain?

When they put me on insulin at dx, I was still a little zonked out from the DKA but remember asking if insulin had any side effects. ‘Weight gain’, the doctor told me, ‘but don’t worry too much about it’.

I did start to worry when, in the first month on insulin, I put on 10% of my dx weight. This was despite being literally too scared to eat anything. Again the doctors told me it was ok - my body had been eating itself up in the time leading up to diagnosis and this was just things going back to normal.

Then I started hanging out in online forums and reading other people’s advice about how insulin causes weight gain. It made sense.

The low-ish carb diet (50-100g a day) did wonders for the A1C but did nothing at all on the weight front. Another 10% of my pre-dx weight crept back on. My A1C, blood pressure and lipids are all good - I told myself this was more important than what the scales say.

10 months after diagnosis I found myself pregnant. The first (and to date only symptom) was an overnight doubling of my insulin requirements. Mornings are particularly bad - it’s triple insulin bonanza. I need a unit of Apidra for plain old oxygen first thing, then two units of Apidra per cup of tea with a splash of milk, no sugar. Two eggs? That’ll be another four units of Apidra please. I can’t touch any carb before noon. Indeed, this morning I took 8 units of Apidra for 2 cups of tea and some smoked trout, and my postprandial was a jaw-dropping 8.2 (147).

To make things worse, my diabetes team is ganging up on me and literally shouting at me to eat more carb. They don’t care how low-carb I go when not pregnant but they’re insisting that things are different when you’re pregnant. They want me to eat at least 100g a day, which is more than I’m used to, but still not high-carb by any measure.

All of this means that I am going through vats and vats of insulin. Two to three times what I was using before. And that’s been making me really worried about weight gain.

I am now at the end of my first trimester. I weighed myself on the super duper hospital scales this week. My total weight gain after 13 weeks of tripled insulin?

100 grams.

I am relieved that there were no nasty repercussions from the industrial-sized insulin doses but also a little confused now.

Carbs does not cause weight gain. I am going to side with your medics on this one, especially as you are growing another little being inside of you. You have him or her to think about and if you starve yourself, then you are going to be starving him or her.

Insulin can cause a bit more weight gain, but nothing really bad. Insulin that you do not need is going to cause you hypos and then is stored as fat. The secret is to exercise - walking instead of taking the bus, walking up stairs instead of the lift etc is sufficient, keep the insulin to a minimum (at least when not pregnant) - this will help reduce hypos and of course weight gain. Regular testing etc is key. Do not skimp on food, but eat small amounts regularly throughout the day and go to bed on a snack.

I do know what you feel, but which is worse, out of control diabetes or a few extra pounds? The diabetes control is vital, whether pregnant or not, the few extra pounds is a bit of a nuiscance, but can be dealt with by regulating your sugar levels and more exercise. You do not have to go to the gym to work up a sweat, just doing something sustained that makes you a bit breathless.

Another point, your two eggs is not going to affect your blood sugars one point of a point. It is what you have with your eggs that might - the bread. One word, either make your own bread using only a small amount of sugar to activate the yeast, or try to buy bread with the minimum in it. When I was visiting my sister in the US I found bread to be a nightmare as there was sugar, sugar, sugar everywhere in bread, and unnecessarily high amounts!

Dear Latvianchick,

The 2 eggs are exactly that, a 2 egg omelette fried in a little butter with NOTHING else. That still requires 4 units of Apidra when eaten in the morning. When eaten anytime else, 1-2 units would suffice for the total available glucose from the protein.

Actually, a lot of us that follow TAG do bolus for eggs. Up until recently, I was eating 2 eggs every morning for breakfast and bolused 3 units for those 2 eggs. I don’t eat gluten so I don’t eat toast or anything else with those 2 eggs. Most mornings I drink coffee that I also bolus 2 units for, but I have had to skip the coffee some days and still bolus the 3 units for the eggs. I also know that it is not DP or basals set wrong because I do basal testing & don’t eat for 24 hours.

Lila, I really know nothing about being pregnant or doing low carb while pregnant, but this might be a good question to post in the Bernstein group. I do know that it is important to keep your BS in good control while pregnant and that is harder to do if you have to take a ton of insulin to eat those carbs.

I did want to comment about not losing weight while doing low carb. I know some people think counting calories is out of date, but I do better when I watch my calories. I read something on another site that some people lose weight in the beginning with low carb but then hit a plateau. They said that some people eat a lot of things like cheese and nuts that are high in calories so you should watch that stuff – not that you can’t eat it but you don’t want to add 2,000 extra calories because you are snacking on high calorie foods. I love cheese but have to limit it because of the sodium or I gain weight.

If you are eating meat that has a lot of sodium in, that can cause a problem. A couple years ago, I heard a story on CNN how some stores were injecting something that contained a lot of sodium into chicken to give it a longer shelf life. I immediately looked at the labels were I bought my meat and I was safe. I was eating chicken every day for lunch then. That was also after I had gained weight during my foot infection and the weight was coming off once I started exercising. I moved and had to start shopping at a different grocery store. All of a sudden, the weight loss stopped even though I was eating the same food every day and using my treadmill. One day I felt really puffy and remembered the chicken story. My chicken was in the freezer and I did not have the labels but decided to stop eating chicken – the weight started coming off again. I quit buying chicken at that store! Sodium content of foods really does impact your weight.

My basal insulin has already quadrupled and I am only 15 weeks along, I have some of the same concerns and have been battling highs nonstop and increasing insulin nonstop. I only eat about 40 carbs per day. My endo told me that if I was going to restrict my carbs that I HAD to check for ketones EVERY morning and if I have more than “small” ketones then I must increase my carbs even if it’s just 5g at a time. With eating high protein and 40 carbs per day I usually only have small ketones in the morning and my endo and ob/gyn are okay with that, granted they do not know I am only eating 40 carbs all they seemed to care about were the ketones so I just keep record of my ketones. So far my baby is strong and healthy.

So how much weight have you gained so far? I have gained almost 4 lbs which the doctors say is perfect so I am not concerned about my baby not getting the nutrients it needs. For cryin out loud some women have morning sickness until they are 4-5 months pregnant and theres no doubt in my mind that they are prob in ketosis from vomiting and not being able to eat very much.