Weight Gain w/ Insulin

OK fellow type 2's, I would like to see how many people can identify with this and methods of dealing with it.

At first diagnosis I started oral medicines. I was active, exercised and I was not overweight so much. I even lost weight at first. I had to moderate my exercise and avoid heavy cardio because it would jet my glucose up very quickly.

I still try to be active. I have been on insulin for about 2 years but gained 20 lbs. To some, that may not be much but to a petite frame it has more impact.

My A1C is great as well as my other blood work values. I am healthy but have my highs and lows in a typical day as it reacts to my activity and food intake.

Anyone else having difficulty trying to balance a healthier outcome with weight gain that makes you frustrated?

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My understanding is that diet is the central factor in weight gain/loss. I think many of us , whether T1 or T2 struggle with the fact the insulin is a fat storage hormone. I've followed a strict low carb high fat diet for years and have been able to maintain weight. Over the last six months I started both consistent intermittent fasting and using Invokana and have lost a few pounds.

If you don't mind my asking, what kind of diet are you on and what have you tried?

Since switching to the pump I have gained 40#...been very frustrating...and yes I do watch what I eat....but my A1C is great...so its a double edge sword for me. I am a type 2.

Dr. Steven Ponder shared some interesting thoughts on FB, just yesterday, suggesting that straight people run about 30% basal, which is quite a bit less than the recommendation for us. I tend run close to 50/50 but had changed insulin duration from 3 hours to 4 hours lately and it seems to be making quite a difference . I don't think that it's insulin itself that does it but maybe more the challenge of balancing things, particularly without much opportunity for detailed coaching.

I agree with Brian that diet can make a big difference although with insulin, it can be tricky to balance things. I lost a bunch of weight a few years ago, pretty much totally on my own, but my A1C went up. Then I got a pump and found the DOC and have lost a bit more weight, although I periodically gain some of it back and then lose it and gain it back and lose it...it's hard! Here's a link to the Stephen Ponder page, it's on FB and you might have to "follow" his "The Power Within" site but he's always been very interesting to follow. He was dx'ed w/ T1 c. 1966 and is a peds endo in TX, A1Cs in the 5s and shares interesting annotated CGM lines "there's the Mexican food and you can see my BG start to go up so I correct by..." sort of things. I like it a lot! Dr. Ponder discussion of basal...

Brian, how does your bg react to intermittent fasting? do you have a cgm? if so, do you see bg dipping down at night? can you describe how you fast, as there are many different methods of intermittent fasting. also, i think i remember you said you used to suffer from sleep apnea. how did/do you deal with it?

You have to remember that you are doing a job that is normally automated and would fix itself when changes happen. This is being done by YOU manually now. Of course its frustrating. But don't beat yourself over it. Just keep doing the best you can do.

In general with my basal set correctly my blood sugar just goes flat, typically 80-100. No cgm and I don’t go low at night. The two ways I do intermittent fasting are to skip breakfast and lunch once or twice a week or to just skip lunch. I rarely eat snacks.

And I do have sleep apnea which I treat with a CPAP.

Something jumped out at me " having highs and lows in a typical day" how do you treat your lows, why are you having them? Exercise? Or not eating? Could increasing your food intake to treat lows be having an impact on your weight? just a thought. Nancy

I am type one or LADA. I gained weight when I first went on insulin - about 10 pounds or so. Am now on a pump, but I would say that I was able to lose weight on a pump. I also try to get away with as little basal insulin as possible and use the bulk of my insulin for meals. So far it is working better than the 50/50 some CDEs have you start out at. Weight has stayed consistent. Yesterday my boluses were 17.65 units and 8.71 units of basal.

did you have a sleep study done first? i found that GERD and sleep apnea may be found together, and that sleep apnea can cause feeling hot at night, which i have been suffering from for several years now. how did you come to get a CPAP machine?

I had a sleep study done, I stopped breathing over 30 times an hour and at one point stopped breathing for 3 minutes. After that I was prescribed a CPAP.

whoah- 3 minutes! i'm glad your cognitive function wasn't (permanently) affected!

You obviously haven't consulted with my wife.

45g of carbs per meal and I try to walk 1/2 mile on my days off. Due to limitations, I cannot run or jog.
I think it is just plain difficult to balance things, irregular work days and irregular meal times do not help either.

Thank you Krztina. Funny how my body is healthier but my weight is a bit of an issue for me.

Thank you for sharing the link with us all. I will read up on this. I am still learning and balance in all things are very difficult for a lot of us.

I am an RPSGT and have treated many for apnea. There was some study performed in which one's ability to metabolize glucose was negatively impacted by apnea. Not to mention strain on the heart. I am glad you got treated Brian.

Thank you Susan. I know it is an issue for a lot of us and some of us have conquered the problem. I am glad you found your balance and shared it with us because sharing helps us all.

Thank you Christlyn. You have made a great point. My A1C has never been 5.7-6.0 until recently and you reminded me of something I told a family member that felt bad about her weight and was going to try something that sounded not so safe. In jest I told her "I had rather be fat and happy than thin and dead.". Sitting here, I question, is weight more important than A1C, Cholesterol or High Blood pressure (which they are all great with me now). Thank you Christlyn. You have helped me evaluate my own situation.

I think you are having the right thought Nancy, in a way. When I eat breakfast before work, I am fine. At work, when I get really busy, I start to drop in my BG. Then I am delayed in my meals and hydration sometimes much longer than I can plan for. I keep some Skittles in my pocket to treat myself when I feel I am dropping. I check my levels at lunch time and usually I am in the upper 60's to 70's if I am 4-5 hours after my arrival at work. When I am home, I only eat 2 times daily most of the time and exercise but do not have to worry about not being available to meals or hydration. This could be an issue Nancy. It is just hard for me to change the work situation as it is.