Insulin, weight gain and diabulimia

For many years my diabetes was completely out of hand. My blood sugars were way too high and totally out of control. I felt like I was on a crazy roller coaster ride that never stopped. Until I found something I could control, my weight. There were times when I honestly just forgot to bolus (due to being busy with work, out with friends or constantly on the go) I think this happens to more of us than we would like to admit. But after a while those completely innocent forgetful moments turned into something much, much more. I read an article when I was in high school in a women's magazine about diabetics not giving themselves insulin in order to avoid gaining weight. They called it "diabulimia". Before reading the article I had never heard of anything like this. But once this idea was in my head it was impossible to shake off. Right before I went away to college I was at my heaviest weight. I told myself that if I could just loose some weight I would look better and be able to control some aspect of my life. I couldn't have been more wrong. I started to cut out my bolus here and there until eventually my body was relying only on my basal rates. I lost some weight but have never felt worse in my life, both my physical and emotional well-being were at an all-time low. Deep down I knew what I was doing was wrong but I continued with the diabulimia and became hyperglycemic on almost a constant bases.
At one of my endo visits once finishing my sophomore year in college the doctor asked me "Gabrielle do you ever eat something and purposely not give insulin for it?" My endo had uncovered my secret when he saw I was losing weight and my a1c creeped higher and higher from 8.5 to 9.0 to almost 10.0. I am so thankful my endo caught what I was doing and confronted me about it even though I was embarrassed of my secret. If he hadn't I probably would still be self-destructing. I am on the road to recovery now and bolus for everything I eat, however it is a daily internal struggle. I have always known how absolutely unacceptable it is to not give insulin as a type 1, but I wasn't strong enough, or comfortable enough with myself, to do the right thing.

Has anyone else had difficulties with managing insulin and weight gain?

Another new member just posted on this subject. You are by no means alone. I haven't had this problem but my heart goes out to you. Here is what I posted on the other discussion:

I worry about myself with food issues but I don't have anything as difficult as Diabulimia. Despite that, you certainly should not feel alone. There is a group here Diabetics with Eating Disorders. I would also recommend looking into Ginger Vieira's book "Emotional Eating." And you always need to remind yourself, every day is a new day. What happened yesterday doesn't matter, all that matters is the choices you make today.

I have (and do). I am currently in outpatient treatment at the Melrose Institute here in Minneapolis, which is one of the few places in the country that has a specific program form Type 1's with eating disorders. PM me if you want to talk.

What kinds of foods do you like, Gabrielle?

Are you familiar with how carbs, protein, and fat are metabolized after digestion, and how each impact fat tissue?

I ask because current research seems to be pointing strongly in the opposite direction as historical nutritional advice, which traditionally calls for high carb, low fat diet mix in order to maintain or lose weight.

It seems the opposite is true: That same quantity of calories in a high carb diet will cause weight gain, if you are controlling your BG (which is unavoidable for non-diabetics), where a high fat/protein mix will not.

This is the science behind the Atkins diet, roundly criticized decades ago when Atkins first promoted it, but now has gained a great deal of serious respectability.

If you like meat and other high protein/fat foods, then getting a handle on this is easy. Regardless, look into low-carbing -- it will change your diabetic life. And, eventually after you have your weight where you want it, your social life too.

If you're regularly packing away 200-300g of carbs every day, that's your problem. Cut it back to under 100 to start. Get a rich menu of low-carb meals and snacks built up over time and get yourself under 50g/day.

You'll lose weight, BG will be much easier to control, and you'll feel much better.

Thank you Brian!! Just joined the group

Thank you so much for sharing Kathy. Makes it a little easier knowing I am not alone

I typically go for starchy foods that are high in carbs, A lot of comfort food. However I am not a picky eater and can eat whatever is put in front of me. The carbs have always been a problem for me. Recently I am trying to focus on meats and other proteins to fill me up first before I can get to the carbs.

Accept my friend request, I can't PM until we are friends. I'd love to talk more! I have a friend who got treatment at Melrose Institute

I've struggles with disordered eating and insulin restriction in my life. When I'm at my worst, I would very consciously not check my bloodsugar, because I knew I wouldn't like or use that information. It's the worst feeling physically and mentally. And during the periods of time in my life where I would engage in such behavior, I'd feel very ashamed. Honestly, I still am that I've ever done that kind of thing.

But! I recently started wearing a Dexcom cgm. Maybe it's the constant accountability, but all of the sudden I care about my diet exponentially more than before and want to use the data to get my act together! And I am approaching it in what feels like a really healthy way!

I don't know if it's just because it's unavoidably in my face or what... but! Yes. I've struggled. Life is made of peaks and valleys and getting a CGM has brought me to a peak.

I'm easy to reach if you'd like to talk. And I've known people who have experience at the Melrose Institute saying very positive things.

My heart goes out to all of you. I have been a diabetic for a long time now. I did hear a story about this. But I did not know what it was called. Stay strong and as I do take it one day at a time. The payoff is so much better. My incentive was for myself and most importantly my wonderful pregnancy. I wanted to touch,hold and see this amazing person. That for me was the best moment to try and stay healthy. I wish you the best of luck and I hope you are able to get through this.

Hi Paige!
I also started using a dexcom on monday and I absolutely love it. I am obsessed with checking it and looking at my trend graph. Even though I have only had it for about a week I can already tell its going to make a HUGE difference in my diabetes management. I too, would not check my blood sugar for long periods of time because I knew how bad that number was going to be and I didn't want to face it.
Keep fighting the fight. We are going to get through it one day at a time and are on the road to recovery :) Thanks for sharing and I am always available to talk as well!! I love that I can connect with people on here going through things that I am.

Thank you! Realizing that I am potentially creating long term issues for my body as been a motivator for me to get healthier. I want to live a long happy life and someday have children of my own, so that has been pushing me recently.

Gabrielle- Dave is so right! Try researching low carb high fat (LCHF) diet a little and see what you think. Here’s a couple Facebook groups you should try joining just to read and see people’s results. It’s amazing on both blood sugars AND weight loss. I’ve not had diabulimia but have struggled with weight my whole life. Read Dr. Bernstein’s Diabetes Solution book of you can. His diet is geared for diabetes but is fairly strict. General low carb high fat gives you a bit more room if you are like me and needed a little transition before going full on Bernstein (30g carbs per day)
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Limiting carbohydrates never worked for me. And increasing animal products in lieu of eating carbohydrates murdered my cholesterol levels. What worked for my glucose control, weight, and cholesterol together was eliminating the excessively processed foods (all oils, flours, refined sugars), fatty plant foods (avocado, nuts), and all animal products.

I consume between 300g and 500g of carbohydrate per day of minimally processed foods and have gotten down to a body fat percentage of less than 20 so far. I also take less insulin per day than I have in the last 30 or so years.

I am glad to hear you are taking your insulin regularly now, Gabrielle. I hope you find something that works for you. Best of luck to you!

I'd love to see a sample day's menu for your current diet. It's hard for me to imagine cutting out everything you mention so I'm curious what you eat.

Hi Shadow Dragon. The bulk of my diet calorically is made up of whole grains (oats, buckwheat, millet, rice, corn, etc.) and starchy vegetables (white potatoes, sweet potatoes, etc.). The rest of it is made up of various legumes, fruits, and non-starchy vegetables.

Generally I eat pretty simply with recipes that rarely exceed a few ingredients to simplify calculating the carbohydrates. So in a day I will have either plain oatmeal or oatmeal mixed with fruit (I love oatmeal); a salad and "steak" fries (I take pre-baked refrigerated potatoes, slice them, and put them under the broiler for about 8-10 minutes); a dish of mixed corn, black beans, rice, etc. and roasted vegetables. Frozen cherries or grapes might serve as a dessert now and then, or "ice cream" made from frozen bananas, or cookies made with oats, fruit, etc.

When I started eating this way, I first eliminated the animal products and oils. I eventually eliminated the other things over time thereafter.

Thanks so much for sharing. I think I could probably exist on the foods you mention eating, but it makes me nervous to think about trying to dose insulin for it. Then again, I'll find out next week how my cholesterol is doing (genetically predisposed to issues in that area) and that might be the incentive to consider lowering my consumption of animal products. I wish there were an easy answer to the "what to eat" question. :-)

Whammo. That is the sound of my jaw hitting the ground. I'm glad it is working for you, but eating 100-200 g of carbs per meal would be a recipe for disaster for me. For most people with T1, a single g of carbs will raise your blood sugar 5-10 mg/dl. A meal of that size could raise your blood sugar to 1000-2000 mg/dl. I'm just very impressed with your ability to count carbs and dose insulin. I'm lucky if I can get within +/- 20%.

My blood glucose control was not where I wanted it to be before I made this particular change in my diet. So I had little motivation to be conservative about making changes or trying something new. I also had a CGM at the time and it helped a lot with making adjustments to my doses. What really got me was that I needed to reduce my insulin intake; not increase it. Additionally it was great to be able to eat, not be hungry, and have the weight drop off.

In my early 20s I was prescribed Lipitor to reduce my cholesterol levels. My cholesterol had been elevated since I was 10. I never did take the medication. But my total cholesterol was 124 when I last had it checked in March. It keeps dropping each time I get it checked. I'm really happy with that. Good luck on your blood work next week!

Haha Brian. :)

If I eat at the higher end of the spectrum I mentioned above, I tend to add a couple more meals to the day rather than increase the number of carbohydrates at a meal. The increase is usually due to activity. But eating that much carbohydrate at a time would have been a problem for me too while I was still eating what I think, in retrospect, was excess protein and fat alongside it. After significantly reducing my protein and fat intake, my insulin sensitivity went way up.

I don't know if I am any more meticulous about counting carbs than others, but I do use a scale to measure my food. And like I said, I try to keep my meals simple so I can be as accurate as possible with my carb count.