I wish I havent' read about type 1:s lack of amylin in types 1 :-)
Having said that I just want to ask you guys if this is something you experience as well?
It doesn't matter if I eat little or a lot, I never feel full. I've tied opting fat, i've tried opting carbs (BG went craaaazy) and so on.
I haven't had D for a long time, so I can not blame Regular and NPH for messing up my "wires". I have OK D control, I am hardly low or high (if I don't binge that is :-))
Do you think it is:
a)wrong dosages at wrong time (although recently I've tuned my insulin intake and I have great number postprandial as well, I use very little bolus insulin, wait before meals etc, didn't change my satiety att all).
b) it is the fact that we lack amylin and only portion control will help?
c) psychological? Once a binger always a binger?
Is it about too many restrictions? Although I try mental training and plan for treats as its recommended in Emotional Eating with diabetes.
I try to think that people without D do not eat cakes for breakfasts as well :) But I actually tried higher carbs and my numbers went all over the place, I felt very bad and went back to LC.
Can anyone relate to this or am I the only one with these issues?
I'm fairly new to this and dx'd at 60, so my personal take on this may not apply to most but from my previous ups and downs I find that for me, when I uses smaller plates and get used to portion control that going back to a larger more American size portion makes me nauseous. I'm just glad I'm pumping so I can dose to my meals rather than eating to a dose as I needed to do on MDI.
Does my weight still fluctuate? Absolutely, but it is related to what I eat and how active I chose to be rather than having to eat to correct lows.
Do I occasionally have the stuff your face munchies with a low. Yes but I keep premeasured correction packs handy and so far have been able to correct with out wild over runs. I'm lucky to have CGM and can see it before it gets so low to trigger the blind panic response.
Also as a fairly newbie, I must have some preserved pancreatic function since my TDD is less than 10U a day.
I don't have any previous experience to compare to (I was diagnosed at 9), but I don't think I feel properly full the way other people do. Having good BGs helps a lot, but I can eat a meal (even high protein/fat) and be hungry an hour later, which makes no sense to me. I try not to snack between meals even when I'm hungry. Unless I am over-full or was absolutely starving prior to a meal, I don't feel any different after a meal compared to before. There is no "satisfied" feeling people talk about.
Maybe these are normal, but I wonder sometimes if it's from a lack of amylin. I have never tried amylin but from talking to others who have had Type 1 for a long time (since childhood), it makes a dramatic difference. I'd be open to trying it if it ever comes to Canada, although it adds another factor to think about, but to me it makes sense to replace the hormone if it's missing.
i have only had t1 for a little over two years and LC, try to eat lots of fat, middle of the road for protein. i am almost never hungry, except when i dont eat for hours on end/skip a meal.
i do notice though, that the feeling of real hunger and hypo hunger are very different. i guess the hypo hunger has all the other hypo symptoms with it and so it feels very urgent and horrible. when im hungry for real because theres no food in me, its such a good, clean feeling. beautiful!
i was always a binger. now, when i do it, i know im going to pay with bg so i dont do it very much and its always on a smaller scale. now, 5 squares of dark chocolate is like a binge whereas before it was like three bowls of some chocolately, carby cereal. those were the days!
I have had the problem of feeling hungry a lot of the time ever since going on insulin. I tried symlin which helped but the way it helped was by making me first nauseous and then because it slowed down the emptying of food I often went hypo even with adjustments of doses etc. I also often didn't even feel like eating after I took it. I got fed up and stopped using it. I found that increasing the fat intake in my meals helps a bit as does drinking wine with dinner. However as soon as I take any insulin, basal, bolus correction I get hungry if I wasn't feeling that way already. In the past I ate many smaller meals throughout the day and a large dinner. Now I eat two meals, a brunch and dinner and sometimes snack at night, but I have to be careful because I can go very hypo at night even with one unit, so I usually have some cheese/nuts to also stop lows which I do with the night time basal. Lately I have been chewing sugar free gum with only xylitol, no aspartame/sucralose etc. That seems to help me a bit due to the peppermint/spearmint flavor maybe. Another thing that helped me was increasing portion sizes of protein/fat/veggies.
I do have issues with hunger since diagnosis. Most people feel full after eating high calorie food such as nuts, cheese and chocolate. I do not anymore. I used to eat whenever I felt hungry and not gain any weight. I felt in balance. Now, I need to pay attention all the time because I'm most of the time hungry. I usually feel full if I eat large portion of vegetables or I eat something I do not allowed myself often like a croissant. The pleasure of eating something special and good seems to send enough signals to my brain. It's weird and annoying.
It may well be that amlyin which slows gastric emptying and promotes feelings of fullness is at the heart of eating issues. But it is also true that insulin itself has a role and despite what people claim, this isn't solely a T1 issue. Since amlyin is produced by beta cells along with insulin every diabetic who suffers beta cell loss also has deficient amylin. Ralph DeFronzo has argued that once a T2 is actually diagnosed they have lost 80% of their beta cells. I know my last c-peptide was 0.4 ng/dl. I'm clearly insulin deficient T2 and probably have problems with lack of amylin as well.
I actually think that our minds have an important role. We all have to worry obsessively about our diet and that in itself gives us problems. Merely having to deny ourselves at mealtime in itself can cause us to have emotional issues related to eating.
Here are my unscientific observations. I belong to a JDRF-sponsored support group for women with Type 1 diabetes. Quite a few of the women at the group have mentioned that they are always hungry. Really hungry. Me, I can eat and get full, and after hearing the stories of the always-hungry women at the group, I am quite grateful that I get full! I don't think their experience is in any way "just mental," I think something is going on there.
I too have heard lots of people having hunger issues and am very grateful that I don't have that problem and don't even experience the extreme hunger most people seem to have when low. I have mixed feelings about the cause, though. I think, like many things, it is probably a combination of mental, emotional and physiological.
Just a comment on Symlin. I was having some problems with weight gain (despite not overeating!) and tried Symlin. I found it extremely hard to dose and adjust insulin for it, and there wasn't any help available for this. But I did eventually figure it out with the usual trial and error. I was able to take significantly less insulin (I believe it was around a 50% decrease!) but I didn't lose an ounce so there was no purpose to it for me.
I agree, this isn't a psychological issue at all imo, it has to do with whatever goes on metabolically when your natural insulin supply shuts down and with whatever other things happen along with that and then you have to supplement insulin. I think we forget a lot of the time that supplementing insulin, whatever type, is never going to even approximate what our pancreas does when it's healthy. Why some people get it and others don't I don't know, but it is truly horrible. I noticed in the starvation diet notations that they gave the patients alcohol to help stop them from feeling so hungry so this does help for some reason.
It helps to wear tight pants. That way you can feel when you are full. :-) I remember when I asked my husband - who always says that he is 'stuffed' - whether he really feels that full? - and he insisted that he does. I remember that I used to feel full - but I realized that I don't anymore. If I wear tight pants - and I eat too much - I can feel miserable too! :-)
I have had type 1 diabetes for about 33 years. I use Novolog via the OmniPod. I can definitely achieve that full feeling. I do not restrict how much I eat, but I am very selective about what types of foods I eat. I generally consume only fiber-containing foods; both starchy and non-starchy.
As for lows, I think it's perfectly natural to want to eat everything in sight. What works for me is drinking the juice I know need to correct the low and then eating, but bolusing for the food.
I've used Symlin since shortly after it hit the market. I've had lapses where I haven't had any insurance coverage and missed it terribly because it helps me so much. It gets rid of the insulin munchies and helps ease my stomach, which got really bad about seven years ago(maybe longer) when I developed gallbladder dysfunction and then gallstones. With my first pump I actually use to mix it with my Humalog - I don't recommend it for anyone else, but it worked for me. Now I just use the pens as it doesn't mesh well with any of the other analogs and I can't use Humalog anymore.
I remember when I was first diagnosed when I was eleven, the Doc warned my mom about the hunger and told her to let it go and let me eat what I wanted as long as it wasn't loaded with sugar(no discussion of carbs at that point) and to just feed the insulin. I was almost a typical type one diagnosis for the time, but my mom caught it just before I went critical. I'd lost weight, about fifteen pounds at that point, which was a lot for me then. I was still honeymooning just enough to keep me going, but I was creeping into DKA territory. What the doc explained to my mother was it was in part due to the fact that I was literally starving to death and my body was going to be in a sort of safe mode while it replenished itself and every high could contribute to it going into this mode, thus the importance of control. He also did say that it was also a side affect of the insulin. Twenty years ago, they didn't get into the amylin deficiency, I'm not sure to what extent they understood of it at that time.
According to my doc here in Sweden it is still not that common that they understand :) I was really surprised. And not in a positive way :(
I think I am chasing that feeling to get satisfied after a meal because I remember it. I still haven't figured that I will never get it :( ANother thing to learn about D acceptance. Thanks for sharing! It helps a lot!
Sounds great, I hope it will continue that way for you!
The high fat food is so much dense in calories, so if I binge now, it is 5 times more calories :) plus it is always protein in it. I know I will pay for it, but it is somehow not enough reason for me to stop. I know that some people exclude some food groups, like nuts or something, or dairy that will trigger them even more, I feel I have enough NO-NO food groups so if I will avoid even more that is left, I will binge even more :)
thanx for sharing about Symlin!
I am big Spry xylitol gum fan :-) My dinner time is the worst, I know even healthy people have hard time stop snacking at night, and historically we usually had fruits or something after dinner.
I try different strategies now, like adding extra tea time with extra bolus in the evening after dinner, but it helps so and so...
I've looked up my last tests and I have the same c-peptide count, it didn't change from my DX.
I wish I could trick my mind into eating less. I feel it always sneaks on me and finds its ways.
:) I am skinny jeans person :) But if I continue that way of eating I will soon need to buy a new wardrobe :)
Yes I've learned that the hard way about lows as well. If I get low, and that is not that often these days, I do allow myself only 1-2 carb glucose tablet or if I am low at night a small apple, it keeps me around 4,8-5 without going up too much.