My Issues with Insulin & Weight Gain

Okay, my issues with insulin are that when first added to my protocol to better regulate my BG I gained 22 pounds in 6 seconds, or so it seemed. I now struggle with that 22 pounds and if I am not careful I can gain weight extremely easily. So, I am trying to lose that 22 pounds today by NOT giving myself the corrective bolus that I have come to rely on. If I really need more insulin to correct a BG level of 250 or more then I will take it, but, I am trying to cut back on my Novolog to see if I can drop those unwanted pounds. So far, I have not taken but 2 corrective boluses in the past week, that is great for me because I am used to about 2 per day. I am not going to weigh myself for a few more weeks, I don’t want to jump on the scale too soon and be disappointed. In most cases when my BG has been too high 2-hours post I have been able to get back to normal with water and some form of exercise. Even a 20 min walk and a good amount of water seems to help. So,below are some facts I found if you are interested. I will let you know in a few weeks how I did.

Insulin Posted By Dr. Ben Kim

If you have too much sugar floating around in your blood vessels, it is likely that you also have too much insulin traveling through your system as well. Even if your fasting blood sugar level is in a healthy range, it is possible that you have too much insulin floating through your vessels, particularly if you have high triglycerides and/or are overweight. Normal blood sugar and high blood insulin can be the result of your cells losing some sensitivity to insulin, which necessitates that your body releases extra insulin into your blood circulation in an attempt to stimulate your desensitized cells into sponging up excess sugar out of your blood circulation.

What’s the problem with having too much insulin in your circulation?

Excess insulin is known to cause:
• Weight gain, since insulin promotes the storage of fat

• Lower cellular levels of magnesium, a mineral that is essential for keeping your blood vessels relaxed and your blood circulation efficient

• An increase in sodium retention, which leads to holding excess water in your system, which causes high blood pressure

• Increased amounts of inflammatory compounds in your blood, which can cause direct physical damage to your blood vessel walls and encourage the development of blood clots which can lead to heart attacks and respiratory failure

• A reduction in HDL, an increase in undesirable small molecules of LDL, and an increase in triglycerides, all of which increase your risk for heart disease

• Possibly a higher risk for cancer due to insulin’s ability to contribute to cell proliferation

You can test your insulin level by asking your doctor or laboratory for a fasting insulin test. Less than 10 IU/mL is ideal. Anything over 10 IU/mL indicates that you are eating too many foods that are stimulating excess insulin release from your pancreas, paving the way to all of the negative health effects listed above.

What can you do with your food and lifestyle choices to support healthy blood sugar and insulin levels?

  1. Make non-starchy vegetables the foundation of your diet. Dark green leafy lettuce, tomatoes, celery, cucumber, cabbage, kale, Swiss chard, bok choy, zucchini, broccoli, cauliflower, and all unmentioned green vegetables are excellent choices.

  2. Reduce or eliminate your intake of sugar and all foods that contain sugar. Some of the most concentrated sources of sugar are soda, cookies, chocolate bars, donuts, pastries, ice cream, and ketchup.

  3. Reduce or eliminate your use of sweeteners like molasses, corn syrup, high fructose corn syrup, pasteurized/heated honey, and maple syrup.

  4. Limit intake of fruit juices. Even freshly squeezed fruit juice taken over the long term can lead to high blood sugar and insulin levels. If you want to taste fruit, eat whole fruit, not the juice. The fiber, vitamins, and minerals that come with whole fruit help to slow down the pace at which the natural sugars from fruit enter your bloodstream.

  5. Do activities and exercises that build or maintain your muscles. Muscle tissue acts as a storage site for extra sugar. The more muscle tissue you have, the better you can regulate your blood sugar and insulin levels.

STOP! I think you are misinterpreting what Dr. Kim is saying. He is saying that you should take the above steps to lower bg / increase insulin sensitivity thus lowering your insulin requirements. He is NOT saying that you should walk around with high bgs because you shouldn’t take ‘too much’ insulin.

Insulin doses should be based on what your body needs, which it communicates to you through your bg meter. Lowering insulin levels should be a side-effect of your approach to weight loss, not the center of it. Taking the steps Dr. Kim has listed will increase insulin sensitivity and lower your bg, and thus also lower your insulin requirements as a consequence. The changes will be gradual, but you will notice that you need smaller (not necessarily fewer) boluses as you progress.

In other words, you start with the lifestyle changes, not by skipping boluses unless your bg hits some arbitrary limit. The lowered insulin requirements will come as a natural result of a healthier lifestyle. The negatives you list for taking too much insulin are dwarfed by the consequences of walking around with elevated bg levels. Please, please, please do not intentionally walk around with high bgs because you want to take less insulin. I applaud your efforts to live a healthier lifestyle, but you’re putting the cart ahead of the horse. Good luck!

Ditto what Tom says. Insulin only causes the weight gain when paired with large amounts of carbohydrates.

The only thing Dr. Kim says, but not explicitly (so let me define it here for you) is that breads and grains can also be considered forms of sugar. They convert to sugar as soon as they hit your tongue. Yes, even “whole” and fermented grains.

Eat lots of good-sourced animal protein and fat, and non-starchy veggies. Avoid everything else. You will lose weight. You will also take less insulin because you’ll be eating less carbohydrates (the only carbs coming from those non-starchy veggies), and your insulin sensitivity will improve as well. The first two weeks can be difficult (weaning yourself off those grains is a big process for your body to go through), but you will come out of that funk with lots of great energy and feeling fantastic. Be sure to eat enough protein and fat to feel full, most people are so used to the horrible non-fat diets that they don’t include enough in their meals to start with and fall of the wagon because they’re left hungry.

I’ve been eating this way purely over two years now and will never go back. Your diabetes will thank you too. Also, it’s an ideal diet for the whole family, so if you have family get them on it with you. Clean out the kitchen. Cook most meals at home. Meal plan in advance. All these things will make your efforts more successful.

For more info, you can google “the paleo diet” and also check out Dr. Bernstein’s book The Diabetes Solution. The paleo diet does allow fruit because it’s considered non-inflammatory, but I don’t eat any as it causes blood sugar rises.

I think a good strategy for decreasing body fat is to increase your insulin sensitivity, reduce your blood glucose load (through carb restriction), match your carb bolus as closely as possible to your eating (both timing and dose) and to get your basal set tightly so you can walk around between meals with a blood sugar of 83 mg/dl and just humming along as a lean mean fat burning machine.

As to corrections, I believe that corrections should be an indicator of how well your control strategy is working. I generally correct if I am off target 2-3 hours after a meal. I rarely correct. But last week, I was at a conference, all the food was provided and it was “off plan” “and out of control.” I thought I could count it properly and bolus, but I was wrong. Not just once, but consistently. I had to correct basically after every meal. It wasn’t that I needed to stop correcting, what I needed to do was reduce the carbs in the meals, count the meal properly and take the insulin needed to cover the meal. I still need work.

You will lose your 22lbs…GREAT!

Your elevated BGs however, are going to lead to nerve, blood vessel, and kidney damage however.

Fair trade-off?..No.

What you are doing is dangerous for the long-term health of your body. Stop now before you cause IRREVERSIBLE damage.

I did the same thing for years (granted, for different reasons). I now have retinopathy. I’ve needed dozens of painful laser treatments, a vitrectomy (they cut my eye open, sucked out all the gelatinous inside, and replaced it with saline before putting STITCHES in my eyeball) - I have permanent vision loss (color vision, peripheral vision, depth perception are all lacking, can’t drive now). Was it worth it? NO.

You have insulin. A wonderful tool. USE IT, and use it appropriately. There are other ways to lose weight that AREN’T dangerous.

America on average eats 100 g fructose, 100 g glucose and more than 100 g of starch per day. Dr. Kim is suggesting that this is way too much and he is right.

I think we diabetics have eliminated many of the problem foods he talks about.

Even if we do some of us remain very insulin resistant. which causes us to gain weight which makes the resistance worst a vicious circle.

BSC has a good point we must try to match our food with the insulin we inject. Too much insulin and we will be starving and too little insulin we will be starving. Plus I suspect high BG make IR worst.

Minimizing insulin consumption is a good idea. Low carb diet with the non starchy veggies is a good basis. I have eliminated grain products and all sugars since I cannot cope with them any more.

You could try adding metformin which helps some people a lot with IR.

Exercise is also good not a great effect in my case but every bit helps.

I am trying humalin R instead of apidra to see if slower insulins make are a better match to my diet. Even for corrections I wonder if slower is better but not sure of that.

Tom, i did not say my BG was out of control. I had a couple of bad readings over the past week, that is not uncommon for me.

I only skip corrective boluses when I can get my BG down using exercise and water. I think this is a good thing. I really am in control of my D.

I eat 60G of carbs per day. That is not large amounts.

Well, apparently I did not communicate myself clearly in this post. I am in no way hurting myself and I am sorry I caused any of you concern.

I have been discussing my strategy with a life time T1, we talked thru it, and he agrees with what I am doing. My BG has been better since I cut out the corrective bolus (when I can). I will NEVER stop the insulin injections when I am sure I need them.

I take 1000mg metformin along with Lantus and Novolog.

I never meant to insinuate that your bgs were uncontrolled. We all understand how difficult bg management is, and that high and low readings are part of the package.

I’m glad that it was a miscommunication, but this statement is what confused me: “If I really need more insulin to correct a BG level of 250 or more then I will take it, but, I am trying to cut back on my Novolog to see if I can drop those unwanted pounds.” To me and others reading your post, that sounds like you will bolus for >250 but not between 120-250. You don’t specifically mention exercising every time you test above range. Water is important, yes, but it is not a treatment for hyperglycemia – at best it will just help push sugar out of the blood and into the urine stressing the kidneys.

The reason we ‘jumped’ on you is because someone searching the web for information is likely to land here on Tu and we can’t have people thinking that skipping needed correction boluses is the way to lose weight even if that is not exactly what you intended.

Hi She Ra, I agree that 60 is not a large amount. But, I have no idea what kind of carbs you’re eating. If any of those are grains/sugars/legumes, that can be prohibiting your desired weight loss. If they are all non-starchy veggies and no grains, that will help your weight loss.

Your post frightens me a bit. Having another T1 agree with you doesn’t mean it is a sound plan.

What about trying to change your dosing so you avoid a correction at all? I think it takes much more insulin to solve a problem than to prevent it.

If you are only eating 60 grams of carbs per day do you think your corrections relate to you not getting enough basal insulin?

Also, is Dr. Kim speaking directly to diabetics utilizing synthetic insulin? I’m not familiar with Dr. Kim.

Cutting out corrective boluses doesn’t make your BG “better” – unless you were going hypo.

Please reassure us that you understand that you DO need to bolus when your blood glucose is at/over 130 mg/dl.

Please focus on prevention through healthy diet and exercise, not cutting out necessary boluses after your BG’s are already elevated. Prevention, good. Not bolusing when your BG’s are 130, 180, 200? Not good.…

Thank you! I have already had someone from TuDiabetes contact me with a message that I interpreted to be “testing the waters” to see if I would join with them in behaviors that are, in my opinion, diabulimic. I agree that we need to be vigilant about clarity on this subject, lest TuDiabetes be used as some kind of pro-diabulimia gathering place.

I hope we can all be clear on the fact that with-holding necessary insulin in order to lose weight is a dangerous and inappropriate behavior. It bears repeating and emphasizing, as new people enter these forums every day.

Losing weight through health diet and exercise is one thing; diabulimia is something else altogether!

Oh no I do not corrective bolus for BG 130, that is insane, I would be severely hypo!

Here is an example okay. 1st off I try to bolus the correct amount, if that doesn’t happen and my BG is 161 2-hours post instead of more insulin I would drink lots of water and take a 20 min walk. The result of BG 66. That would take about 1 hour.

I am not a radical controller, any A1C under 6% is 3 months loaded with hypos, it is much more dangerous to be going hypo than to carry a BG a little higher than norma.

Basil isn’t for meals so pretty sure it wouldn’t pertain to this discussion. I do know that the basil dose I am on now works fine for me.

All I am doing is cutting out a corrective dose of rapid insulin when I can. It doesn’t mean I am sabotaging my control.

I am in better control now, I swear it.

OK, walk through this with me, please. I think we’re having some confusion about terminology: correction vs. corrective bolus vs. correction factor. Eeep.

It’s time for your dinner and you haven’t injected any short-acting (Novolog) insulin or had any food in over four hours.

You test your blood glucose before you eat an it’s 143.

In addition to whatever you need to inject to cover your food, you also need to cover your elevated blood glucose, right? In my case, let’s say I was going to have 20 grams of carbs for my dinner. I would calculate the amount of insulin I need to inject to cover 20 grams of carbs plus a correction factor of 1 unit of insulin for every 15 md/dl above 100. To get 143 down to 100 I would inject 40 divided by 15 (rounded up) or 3 additional units beyond what I needed to cover the 20 carbs in my dinner.

If you know what you need to inject for food and for your correction factor, you shouldn’t (normally) go hypo. If I figured out that 1 unit for 15 mg/dl over my baseline was too much, I would change my ratio to 1 unit for 18 mg/dl or 20 mg/dl or 22 mg/dl. Once I had it properly adjusted, then I’d keep track of it to see if it changes over time (perhaps if I exercise more or less, lose weight through watching my diet, got an infection, etc.)

Only correcting down to 100 gives me a 30 mg/dl buffer between 100 and 70 – that is, it shouldn’t make me go hypo (below 70) unless I do something silly like go for a long walk right after injecting insulin without eating any carbs.

I think you’re talking about correcting two hours after a previous Novolog injection? Which does have the danger of “stacking” insulin and going hypo, unless you’re fairly high and not coming down. I haven’t done many of those, but if I realize I made a mistake earlier (I write everything down and can go back and double-check my calculations) in which case I would feel comfortable making a correction then. But if you’re 3-1/2 or 4 hours or more out, and your BG is too high, you will need a correction factor in addition to anything you’re injecting to cover your meal. Unless you are free to always take a brisk walk for an hour, every time you’re too high, being prepared to give yourself a corrective injection is an important part of managing diabetes. Otherwise, the cumulative damage can be devastating, much worse than being a few pounds overweight for a few months longer as you slowly lose weight the safe way.

That is a rather dangerous way to lose weight in the long term. Perhaps you need to reduce by one or two units of insulin rather than cut it out altogether. You are setting yourself up for complications if you continue this.

By reducing the insulin slightly you are less likely to go hypo - which is one of the reasons why we put on weight.

Well, I understood you. You were trying to tighten up your blood sugar control, your diet and use exercise to “avoid” any need to correct. I think that is an admirable and beneficial goal. I think the thing that set of peoples alarms is that you “can” lose weight by withholding insulin and letting your blood sugar run high. I think we would all agree that is a bad thing, but I’ve never seen anything suggesting that was your intent.

I am trying R humalin instead of apidra because the food I eat do not spike at 1 hour but later. Seems to reduce hunger a bit. I have eliminated the grains and veggies and meat are not so fast. This is like BSC mentioned is to tailor the kinetics of the insulin to the kinetics of blood sugar production from the food.