Um, I’ve known literally scores upon scores of T1s who have been severely underweight, including one 5’10" male who rarely weighed more than 135 lbs, generally averaging around 125 lbs (giving him a bmi of 17.9, or underweight). He’d been underweight since his diagnosis at age 8 and in his nearly 50 years with dm before he died in 2004, he could never be called “overweight”. My weight has been as low as 88 lbs, which gave me a bmi of 19.7 – which, in 1995 was considered “underweight”, though it is no longer.
Brian, it took me the better part of a decade to gain the 12 lbs to get me into the triple digits. Because of idiotic doctors who refused to listen to me, it took a mere 4 weeks for me to lose that weight. I know you were speaking in generalities when you said that in general “a T1…will have to struggle more than a non-diabetic over weight issues”. I have to emphasize that it is not true. Not all of us struggle with weight, or at least not the way it is usually meant. And yes, I know there are overweight type 1s, and that there are far more overweight type 1s today than there were 18 years ago when I was dx’ed. I blame the DCCT, doctors, and patients, who place the goal of demanding ultra low A1cs over everything else, even the health risks associated with overweight and obesity. My plea is for doctors and patients to more rationally manage their diabetes!
Agree that Brett isn’t that thin & said he runs his BG intentionally high. Not exactly a role model, nor is Halle Berry who went public that she cured her diabetes. Don’t think we’ll ever forget that brilliant statement:) Sad obsession we have with celebs.
Parents who let their diabetic kids eat whatever are setting them up for failure later. Hard to change eating patterns & preferences as an adult when they’ve been ingrained as acceptable since childhood. I’ve known a couple of diabetic kids who never ate junk., so they never craved it. They didn’t feel denied; they didn’t want it.
Sometimes I strongly suspect that there’s widespread PWD denial. The eat whatever attitude is part of the denial as evidenced by the uproar every time alternatives are suggested.
Living with diabetes for almost 29 years. ; I weighed more on MDI ( over 10 years ago …by 5 pounds …@ 145 ) than while being on the pump . I think due to corrections, when I was on NPH and also knew less about my diabetes. Have been under 140 for years , stable weight …and not a low carber , however a mindful eater .As far as I know complication free .
I am 5 feet 7 . …medium sized boned female at age 71 plus .I guess I am not answering andrea’s concerns .
( have been trying not to loose weight , while doing some training for my Team Diabetes walk /run which takes place , Kelowna , BC, Canada October 9 ( please pray for nice weather ) …afterall it is Thanksgiving !!
My comment had nothing to do with yours regarding kids eating junk, so no need to get upset. There’s a lot more to eat low carb besides protein & vegetables. Whether whole wheat bread & fruit are healthy is the topic for another discussion.
Halle Berry is part of a new blog here about famous diabetics, where she is held up as a role model.
Point is that you eat low carb & not large portions & you’re able to handle this well. Not the case for most people who eat far more. Your current ratio may not continue if you’ve still got some insulin production. Appropriate bolus is part art, part science & part luck. It’s not that simple to just bolus.
It could very well be the luck of the draw. We don’t know if we’re one of the lucky ones or not, so leveling the odds is a wise strategy. Some researchers believe it could have been the C-peptide in animal insulin that protected people. It’s not in analogs. Every now & then there’s talk about adding C-peptide to current insulin, but it doesn’t appear that’s going to happen any time soon. Animal insulin isn’t even available in the US. There’s a movement in the UK to keep animal insulin available as an alternative.
How would you define “far more” though Gerri? I don’t think there’s “good ratios” or “bad ratios” and my ratios seem to drift independently of what I’m eating, I really think that it’s a seasonal kind of thing, as much as anything.
I also seem to be able to eat carbs fairly regularly and skip carbs regularly. I work out when I skip carbs and I workout when I eat carbs but mostly it’s a convenience and slack thing as it is definitely less work to keep an eye on it. Although a lot of times, I think my solution for big carbs is to overestimate and just snack until my BG gets in line but, as long as I am having a quiet evening at home, that usually works out ok too?
Not sure where this reply will show up since after many replies there’s no reply button.
Opening up a can of worms about what’s far more, but here goes & let the flaming begin:) From over 3 years on Tu, it appears that the majority eat at least double Lynne’s 50-60 daily carbs, which is low carb. No judgement assigned to this, simply what I’ve observed. Think we can also safely assume that most PWD follow ADA & CDA carb recommendations & the food pyramid (or new plate thing) because that’s what we’re all told. Between the two, 15 carb snacks & 45-60 carb meals, that’s way higher than Lynne’s carb intake.
I didn’t say anything about good or bad ratios, just that they change. Agree there’s nothing good or bad & it’s only about getting where you need to be. Mine change seasonally also. My original point, kinda lost now, was that using large doses (to cover higher carb) usually results in unpredictable results. And also that excess insulin causes weight gain. Lynne’s fortunately using very small doses which gives her more accurate results. Her ratios could very well change over time.
I’m certainly in the >100 carb per day camp of which you speak, and I certainly agree with Lynne that FOR ME, I am not willing to be nearly as restrictive with my diet as you are. I eat lots of food every day that Bernstein does not allow: fresh fruit, vegetables (including carrots, peas, tomatoes, peppers), brown rice, whole grain bread. low-fat milk and yoghurt. Banning all these foods and more to get to 30g carb per day would be for me a very restrictive diet - and I think that is Lynne’s major point.
Speaking for myself, I know that eating these foods as a T1, and taking insulin for 36 years to cover this food, does not, as you imply, necessarily lead to weight gain.
That said, I do not pretend to speak for T2’s, nor for you or anyone else.
I eat a lot more carbs than many on Tu - about 160 net (backing out fiber and not counting any green vegetables of which I eat a lot). The fact is that I tend to do better when I have from 40-70 net carbs in a meal than when I have a low carb meal. My ratios are based on certain eating patterns; I really have no clue about dosing for a meal that is mostly protein and fat and as a result tend to go higher when I have one. I’m not saying my way is the best - although I’m pretty happy with my diet and control - but pointing out that higher levels of carbs are possible for at least some of us.
I have a problem with weight. It has taken me almost 5 years to gain most of the weight I lost before diagnosis and when I travel and am more conservative with carbs, I find myself losing two or three pounds which I really can’t afford.
To me the other thing that might be missing from the AMA/ADA “bag of tricks” is to recognize how important it is to get the ratios set really precisely? The standard paradigm is DX then calculate dose based on weight (which is sort of a SWAG…) and then see how it works. The patient is then told “hmm, AVG 140, good job! I bet you feel a lot better than when your AVG was 250” or whatever? Even if the doc is like “well, 140 is a big improvement but we’ll need to work on that…” the doc, in my experience, won’t talk about food at all (as the referral = $$$ to the clinic…) and the patient goes schedules a follow-up in 2 months or 3 months or 6 months and “call me if you have any questions” and is sent off.
I don’t think I’ve heard of any of the “low carb gang” having been told by their doctor “you should eat no more than 10G of carbs for breakfast” but there’s a bunch of people figuring it out on their own. According to Taubes’ science history, docs used to tell people that (more for obesity than diabetes, maybe because then diabetes was generally more challenging to control so there would logically be less of us, from an actuarial perspective?) but don’t any more?
Maybe I am cheating by overbolusing when in doubt and, given my utter aversion to writing anything down, I don’t have any “scorecard” I can refer to but I have also had quite a few times where I shot big and hit the post-parandials right on the target? It might also be that I am extremely dull in my approach to weekday food as I eat pretty much the same thing every day. I switched from ham and cheese omlettes to spinach/ broccoli and chia seed omlettes with the big race coming up but that’s about as crazy as I get. I also am not sure that excess insulin “causes” the weight gain as much as it causes you to eat more than you “need” but, that would leed to the $64 Tolstoy-esque question “how much food does one need?” which, at least according to Taubes, seems to be up in the air, with no agreement.
Maybe it’s my perception of Bernstein’s tone as being somewhat shrill but I totally refuse, at least at this point, to say I’m not going to go to 5 Guys or Taco Fresca and pig out occasionally? And I don’t feel bad when I do it at all? I read tons of posts from people who say “I can’t eat _____” and it always sort of makes me think “what if your carb/ insulin ratio was a shade higher? Shooting to 180 isn’t that huge, if 1U=40 points, another couple of units gets your right back in the ‘sweet spot’ [ha ha] we are all looking for?”. Maybe a “sliding scale” with a bigger carb/ insulin ratio as the carbs themselves get bigger? Still work but not that far removed from the work all of us do all the time anyway?
Just back from dinner out and I like to add : …similar treatment as you Jag1 and still_young_at_ heart and it has been for close to 29 years …I guess , I get hooked by terms " let the flaming begin …* I should NOT get hooked …old and wise enough , I thought but I am here to learn and share …what works for me …please let it be .
I have this disease for years., peed on sticks , guessed how much insulin to deliver and am here to tell MY story l!!.. I am NOT a celebrity , neither will I write a book , but I love my daily movement…my life saver ??
NO ONE who has NO weight problem needs to worry about carbs, diabetic or not. You are lucky enough to have a metabolism that is adapted to the agricultural revolution.
Unfortunately, we aren’t all that lucky; in fact, MOST of us, diabetic or not, are not that lucky. We with the hunter-gatherer metabolism just aren’t adapted to be able to process carbs very well. If we are not susceptible to metabolic syndrome or diabetes, we just get fat if we eat a lot of carbs. There is no real evidence that obesity alone is any risk to health. On the other hand, if we ARE susceptible to diabetes, either type, and metabolic syndrome, then the carbs wreak havoc in our bodies. I have NEVER had such good control as during this last year, when I limited carbs. And whenever I succumb, like I did on Saturday night, to a small roll, 1 small red potato, and a piece of chocolate cake, all the while trying to cover it with insulin, YIKES!! I was up to 288, and that is just not acceptable, except on rare occasions.
This is why we in the diabetes community use the acronym YMMV. Your Mileage May Vary. What works for you may NOT work for me. I’m glad for you, Lynne, that you have a carb-adapted metabolism. I would very much like to have one, too, but I don’t. Even at a normal weight, I just can’t handle the carbs. And if I DID eat a lot of carbs, I would definitely gain weight. And need more insulin. And have a worse lipid panel. And feel like crap. Nope, not for me.
Hey Natalie, I hope you enjoyed that special meal! We deserve it once in awhile…no? I totally agree with you…it has to be a rare meal for me…Cheers! Joanne
For Lynne: insulin has everything to do with weight gain. All the fat non-diabetics you see walking around have TOO MUCH insulin – they just don’t have to take shots. There are certainly overweight and obese Type 1’s – there is nothing that says that having Type 1 means you are going to be thin. Type 1’s can develop metabolic syndrome, which is an inheritance of our hunter-gatherer past, and can be treated with metformin, just like Type 2’s. It’s called “double diabetes”.
Please don’t take your personal, limited experience to represent all Type 1’s. You are almost certainly NOT insulin resistant, and that’s a WONDERFUL thing, but don’t use that to misrepresent the experiences of those who are.
I agree it’s not the insulin, it’s the food you eat when you take the insulin. I think that the medical practice w/ diabetes may tend to be a certain amount of insulin without too much concern for “fine tuning it”. In my experience, being a little bit off can make my numbers go nutso pretty quickly although nutso to me may be within reasonable limits for T1 patients?
I’m not intending to argue, but you seem not to have gotten my point. I sincerely doubt that you could gain even 25 lb. if you tried your darndest. The metabolism you were born with won’t LET you. You already say you can’t gain weight. There is no WAY you could get up to, say 200 lb. You would die puking first! And your thinness is NOT attributable to your eating healthy and exercising. There are those who eat nothing but crap and sit around all day, but stay thin because they were born to be that way.
I have a dear sweet friend with Type 2 who weighs more like 300 lb. and she eats better than I do. And she exercises more, too. So why is she so obese, and I’m normal weight? Well, for starters, she is far more insulin-resistant than I am, and always was. Then, her pancreas started failing, and even WITH Byetta and Metformin, she STILL needs ~80 units of insulin a day on a pump. With shots, and without the oral meds, it would be far more.
Why did she gain all that weight? Her body is insulin resistant, and before she got diabetes, it was producing MASSIVE amounts. And the insulin caused her food to get deposited as fat. Which started the vicious cycle that led to her developing the Type 2 that she was already genetically susceptible to. In a person born with a metabolism like that, it’s DEFINITELY the insulin. No other way to rationally explain it.
I’ve put 10 on this week because I’m trying to load up before the race, nothing outrageous but adding in carbs. Conveniently enough, it’s customer appreciation week which the managers @ work are celebrating with junk food for everyone (cf. Dilbert? LOL…I had a donut yesterday, no sprinkles though…). I think that it would take me about 2 weeks to get back to 200. Pushing the envelope of 44" pants, the last pants size apparently available at “regular” stores was also a motivator to change. I am wearing 34" waists now but I am well aware of what it takes to get to 200 lbs!
Insulin works in the body as a storage hormone. It brings our BG down by taking glucose out of our blood into our cells. If we don’t burn off the glucose, then it gets stored as glycogen (fat), causing weight gain. Taking too much insulin also can cause lows, which force us to consume more calories. Also, the more fat a person has, the more insulin resistance, and the more insulin a person has to take. Definitely a vicious cycle that can lead to weight gain. Obviously, this doesn’t happen in everyone, but is a serious reality for some people.
For some of us, it takes eating ultra low carb or lots of green leafy veggies to stay healthy. YDMV.
That’s what I eat too , Dex4 …I recall well before diagnosed with type 1( in 1983 ) , the mid seventies : I got lazy …drove to work …silly me , only 1/2 hour walk one way , . drank a milkshake after supper ( cause someone gave me a mixer ) …more silliness ; suddenly I was up to 165 …got the message in my head and lost 25 pound : swimming in my Condo pool , less food , walk to work …AND diagnosed in 1983 at 139 pounds …happy to say …still at the that similar weight …on insulin since 1983 …this is MY story …may not be so for others …PS : not a low carber …but please thnik of me , when I participate with Team Diabetes, Okanagan Marathon , Sunday October 9 …there is talk of about 30 percent rain …oh , no
) …afterall it is Thanksgiving !!