U-500 Weight Gain, pretty pissed

so I moved over to U-500 due to a high intake of insulin and it made my life easier, except awhile ago I started pushing myself harder for weight loss with zero to negative results. This is now affecting my professional life because it is now a physical problem that is restricting my capabilities(firearms instructor). I think I have put on probably 40-45lbs while maintaining healthy eating habits.

Not fun to give up all the fun foods only to get nowhere. For awhile I think my wife said I was running on around 1200 calories a day.

I just wanted to see if anyone had any other thoughts before I give up U500 and head back to running humalog only.

Currently using omnipods with a 2 to 1carb ratio.

Current weight 265lb


Hope this is the right spot to put this question.

Thanks in advance!


Fire - I'm a T1D, so my diabetes struggle/experience is a bit different than yours. I did become insulin resistant (IR), however, so I share some with you. My IR came on gradually over a few years. I aggressively fought off high BGs with ever increasing insulin doses. I was giving myself more and more insulin to correct highs. My insulin to carb ratios degraded and I doubled my total daily insulin.

I finally turned my situation around by reducing my carb intake to 50-70 grams per day. I lost 15% of my body weight in 90 days. My blood pressure returned to normal and I stopped taking meds to control it. My insulin needs were cut in half and my A1c dropped almost a full percentage point. My initial goal was to improve BG control. I lost weight without much effort!

Any insulin in excess of your minimum metabolic energy needs goes right to work storing fat. Your switch to U500 insulin led to (my opinion) an inevitable weight gain.

I'm not a doctor or a dietitian or even a T2D. If I were you, I would seriously consider experimenting with a lowered carb diet, < 100 grams per day. If you look around on this site you will find many T2Ds that have done very well using low carb. I've looked at their profiles and have seen many with A1c's in the low 5% range. And many of them have reduced or eliminated medications. Here's a website of a group in the UK, many of them T2Ds, that promotes low carb diets.

If you decide to try low carb, you need not reduce your calories to starvation level 1200 calories per day. In fact the satiating properties of protein and fat often will naturally limit your intake of calories to a healthful level. Be aware that if you ask the typical doctor or dietitian about low carb, you will be warned off in no uncertain terms. But they don't have to live in your skin! Most of human history (99+%) was spent eating low carb. During that time we evolved larger brains fueled by a low carb diet.

You can see the path you're headed down. That future is not pretty. You need to take charge and do something that will work. Good luck to you. I wish you the best.

Why would U500 make you gain weight? Unless you're taking, proportionally, more insulin now, I don't see why U500 would affect your weight.

If you multiply your current TDD by 5, is it higher, lower, or the same as it was when you were on U100? If it's lower or the same as, I don't think switching back would do any good.

How are you defining "healthy eating habits"? I've reconnected w/ some friends who are deeply into the P90X thing and macros, or scoring their diets on the %protein/carb/fat. I've been doing it for about a month and have buzzed off about 10 lbs (/195...) and it seems pretty reliable. When I hit 50% Protein/ 20% Fat/ 30% carb, I can drop weight very readily. I don't always do it because I'm sort of lazy and work out a lot which seems to allow some levity regarding what I munch on but I peaked at 275 lbs c. 2004 and have lost most of it by finding ways to cut carbs out, although I never quite made it to "low carb" except for short, experimental stints.

Awesome responses guys, honestly better responses than deserved for such a poorly written original post to start.

Eating habits focus heavy on the protein side light on the carbs. Reviewing my intake for the past few weeks I had a high of 200carbs and average around 80-90 carbs a day.
Example meal, tonights dinner: bit of rice, pork meatballs, nappa cabbage.

Of course I don't run flawlessly and enjoy cheat meals occasionally.

I lift (freeweights) whenever possible and cardio on the light side, (walks and keeping up with little man on/at the park). Last year I had an injury and lost the ability to walk for a couple of months and still have issues with my ankles and faster paced activities so I have to be cautious.

I brought it up to my wife and she did say that the weight gain time frame did go hand and hand with the changeover with u500 :(

I thought about the starvation mode possibility a while back but its been way too long that i've been running as low as possible and while it did help me with a healthier running body (improved sleep cycles and energy levels)
I forgot about running metformin, I picked it up, stopped for a bit due to stomach issues but it does sound like a good time/idea to reintroduce it and focus on readjusting my numbers.

I would also just ask to make sure everything else is running okay (thyroid, etc.).

Thought my post on another discussion might be useful?

You would think after 39 years we might be the expert huh?
About 7 years ago or so, I started to gain weight and had no idea why. As an ex-gymnast, I've always been pretty tiny so the weight was a huge issue. Took me 7 YEARS to find the reason and the solution.
1. Fired several Endocrinologists who did not provide ADEQUATE care.
2. Tried several types of diets (name it = I tried it)
3. Interviewed others, chatted, blogged, etc.
FINALLY, 7 years later.....
1. Started going to Valley Medical Weight Loss for weekly shots (October, 2012)
2. Found a decent Endo who suggested a) Insulin resistance and b) Symlin (April, 2013)
The Symlin was the primary "kicker". In conclusion, I had to come to terms with accepting that NO, I do NOT know it all and almost every diet fad out there will NOT work for a type 1.
Since last October, I'm down 60 lbs with another 30 to go. I also just had Laser Liposuction done (ya okay....I'm vain) which should take care of another 10 or more. I seem to lose between 8 to 10 lbs a month so another 3 months and all will be right with my closet.
I'm not a depressive kind of person and am usually going 100 miles an hour at all times. I am the primary bread winner, financial manager and household caretaker so the weight was a HUGE issue.
In summary, for each and every person the secret is going to be personal to you. Low carb, extra water, more exercise....whatever. The only commonality I have found so far with many many type 1s is insulin, be that pump or not. In 1974, they didn't know insulin had a best friend called Amylin but they sure as hell knew about it 10 years ago (probably could have saved me 7 years).
Find your secret! :)

If your blood sugar control was pretty terrible before you switched insulins, and has improved dramatically, then you are no longer peeing out a lot of the sugar than you used to pee out.
Being overweight or obese due to good blood sugar control is way healthier than being skinny or normal weight due to poor blood sugar control.

I'm T1, and I gained 15 pounds the month I was put on insulin (from 92 to 107 lb). After that no more gain.

wow,. super answer super sally! good luck fire!

Oh but it does matter. My endo. said U500 does make your body hold onto every little bit of fat you take in or have. Plus it does cause water retention and hold onto that too. It is very common for this to happen. I became diabetic at 16 when I was pregnant. Was told at 26 cause I finally went back to Dr. that I was T2 and I am now 41 and my Dr. told me I am T1. All the other Dr.
s before her told me I was T2. She did a c-peptide test to find it out. It still works the same weather you are T1 or T2. High and low blood sugar is the same no matter what. I have been on both sides and no treatment difference.

I am not going to advocate going all low-carb and high fat, but try to think moderate protein :) 58% of it still will turn into glucose. And of course metformin and check your thyroid. I know how frustrating it is, don't give up!

you are in the double bind of insulin resistance. The more weight you gain the more resistant you become making you take more insulin causing you to gain weight. The trouble with insulin resistance is that much of it gets used eventually and then you gain weight. I think the key for you is to ask your doc about a med that will reduce the insulin resistance thereby reducing your insulin and allow you to lose weight. With that much insulin in you and so little carb and total calories im surprised you don't have night time lows. Im type 1 with no resistance, I have a 1 to 18 ratio, but I know people who have a bigger ratio than me. I like to run and on days that I run I need to cut my insulin in half. That goes for energy used as well as increasing insulin efficiency. Stll im 6'3 and 190 lbs I eat 2500 calories a day and I dont watch carbs except to count them. I find if i restrict too much then I crave stuff