Weight Loss and Dexcom

I recently switched from MDI to Omnipod and was hoping that my insulin needs would go down as my management improved. Well, that hasn't happened, and I'm getting extremely discouraged. I really honestly count carbs and bolus as accurately as I can all the time, but I am still gaining weight like gangbusters and my insulin rates keep increasing. I've tried to limit carbs, and overall I do a pretty good job, but I think I'm still eating too many. The sandwich at lunch runs me about 30 grams and that's the biggest amount of carbs I eat all day.

I eat a lot {A LOT} of meat, nuts, cheese and {low carb, low fat} yogurt. I drink only water and coffee, no sugar. We rarely eat out. I've asked my doctor and CDE if they can help me figure this out, but so far have not had any response.

I've been waiting on my insurance to approve me for a Dexcom system. I go next week to do a trial for a week. Does anyone think this will help me improve my numbers and actually help me lose weight? I don't want to take more insulin to get my numbers down, but not sure what else I can do.

Any advice anywhere?

It sounds like you're making some good choices with your goals in mind. Yay for that!

I went Paleo (no grains and no dairy.. lotsa protein and veggies) and lost 30lbs. Doesn't work for everyone though. My insulin (basal mostly) needs are only half of what they were. I also try to focus on delaying my meals until I am actually hungry. That made a big difference for me too.

Has your endo done any thyroid testing lately? If you are experiencing hyperthyroidism, a pill a day could help normalize your thyroid hormones and metabolism.

Yes, I am already on synthroid. I had it adjusted recently and my thyroid numbers look normal now.

I'm about 75% cut off of grains....maybe I should cut out dairy too. I try to eat on a schedule, the same time every day. Weekends throw me off a little, but during the week I'm set in the times I eat. I can go without breakfast, just drink coffee, but I know that's not supposed to be good for you. I'm usually only a little hungry at lunch and pretty hungry by the time I get home for dinner and eat (around 6).

I've cut out all soda, all artificial sweeteners, and as much high fructose corn syrup as I can {I still randomly find it in foods that I didn't expect, so that's a battle}.

I just find it really weird that before, when I wasn't managing my diabetes well at all, my sugars ran high (in the 200-300 range) and I lost weight really well. Now that I'm actually TRYING and working hard and doing so much better, I gain weight like crazy, have random highs that won't come down for anything, and am just tired a lot.

I feel like something needs to give soon. I'm going on vacation in October and I want to have energy and not be tired all the time.

Hey KCCO, I'm sorry you're struggling. I know that frustration well as I've had my share of struggles too. Weight loss is a tough one but remember, too, that blood glucose control is more important than weight loss. If your numbers are better, then you should be very proud of that achievement.

First off, if you were running 200-300 and losing weight easily, that's because your system doesn't use food properly when your blood sugar is that high. When you are more in range, your body uses the food properly and it doesn't pass right through you.

You haven't mentioned exercise but starting or increasing an exercise plan will help with weight loss.

For me, eating low carb helps with losing and maintaining weight. Try cutting back on nuts and meat a little unless you're really hungry because they are calorie packed so an adjustment there may make a difference. You could add more vegetables to take the place of the meat and nuts that you cut back on.

As for the Dexcom, the Dex will show you what's going on between the finger sticks. I love it because it gives you so much information. It will help you identify the foods that cause spikes so that you can either eliminate those foods or reduce the quantity.

Just a few thoughts but I wish you the best. :)

Although totally delicious, nuts and cheese are packed full of calories. I eat fairly low carb, but actually eat a lot of nuts so that I don't lose too much weight. But when I do gain weight, it is almost always from eating the yummy mixed nuts from Costco. Cashews particularly are super high in calories and also end up having a big effect on blood sugar. Nuts are definitely not a "free" food and IMO are not your friend when trying to lose weight except in small quantities.

Although low carbing makes weight loss easier for many people, you really can't forget calories because long-term it is definitely calories in vs. calories expended.

It's really tough to balance having good BG numbers and trying to reduce insulin use. I'm sure Acidrock will chime in here, but I remember him saying that when losing weight, he often would take the amount of insulin needed to maintain the weight he was trying to get to. Also remember that exercise can be your best friend.

I don't know whether the Dexcom will help you with weight loss. One thing you will need to do is not over-react to the information you get from the Dex. There are times that the Dex will show straight-up arrows for me and it makes me want to take another bolus to stop it. But then it quickly levels off and I might end up having taken too much insulin.

Good luck to you. It is definitely possible to lose weight, but insulin sure makes it more complicated.

First, if you were running high for a long time, then as you've gained control, your body is finally able to use the carbs you eat, so you're putting on weight that you only lost because you peed it out.

Second, you say you eat "a lot {A LOT} of meat, nuts, cheese". Those are all very high calorie foods. I mean, a handful of almonds is almost 200 calories. Weight loss or gain really is about calories in-calories out. When you were running high, the calories you thought you were eating weren't taking, so your net calorie consumption was much lower than than what you needed. Lots of meat, cheese, nuts will still make you gain weight, even though you don't have to dose for them. I highly suggest you start counting calories and carbs, not just carbs.

Kimberly is right on.

Have you given time for your synthroid adjustment to start working? Have you kept track of total calories? Try keeping a diary of everything consumed with calories. I use My Fitness Pal on my iphone but there are a ton out there. There are also a ton of calculators for figuring out your calorie needs. Calories in vs. calories out! :) I keep my carbs down which also results in lower total calories.

I don't think a Dex will help with weight loss either.

My thyroid adjustment was over 8 weeks ago, so I think I'm good there. They ran the numbers again in August and things still looked fine.
I don't particularly count calories. I guess I've assumed that since I'm not eating the high-calorie junk food like I used to, I'm fine.

I usually only eat almonds anymore, and never more than a handful at a time as part of a meal.

Here's an example of a typical day, meal-wise:

Breakfast: 6 oz organic, greek non-fat plain yogurt with one zero calorie sweetener, coffee with about 2 Tbsp half & half and one zero calorie sweetener

Lunch: three small roll-ups made of all natural lunchmeat (2 thin slices each) and one piece of cheese; either cucumber slices or carrot sticks (about a handful) and some type of "crunchy" like all-natural veggie straws or all-natural baked cheetos (under 30g carbs)or the handful of almonds

Dinner: some form of meat (steak, chicken, broiled porkchop) and a good sized salad with limited dressing

I try not to snack after dinner, but if I do, it's only a cheese stick or a small glass of almond milk (only 1g carbs for 8 oz). I always drink at least 64 oz of water a day. Weekends are more unscheduled, but I do try to still keep each meal under 45g carbs.

What do y'all think?

What I think is this is the pits. I've been watching carbs AND calories for a long time and my butt just keeps getting bigger. I did 45 days of below 900 low-carb calories a day, to no avail. So I'll be watching to see what kind of suggestions you get, and hoping that your body does a better job for you than mine is doing.

Your diet is probably fine...it's your activity leavl that needs to be increased...this will also reduce your insulin requirements.

Run or ride a bike...the weight will fall off...JMHO

My butt too!!
I thought for sure that I'd be losing in my stomach--when I was on MDI, my stomach was the only place I did insulin because I was never taught differently. Now that I wear my pods on my arms a good deal of time and have increased the crunches that I do, I thought for sure I'd be losing some of that insulin belly, but NOTHING.

I've gained about 50 lbs since my wedding last November, even after starting to work it off beginning in February. I get so discouraged because it seems like the more I try, the opposite affect is achieved.

And yes, I have been steadily increasing my activity level.

Are you eating carbs (glucose tabs, juice) to treat low-BGs very often? Those calories, of course, are exactly the ones that you want to cut out in order to lose weight.

How has your overall BG control been? Is it good or have you been on a BG roller coaster? If you're taking many corrective insulin doses to bring down high BGs and then having to eat to bring up low BGs then that will likely add weight.

The foundation of good BG control (and good weight loss) is getting the correct basal rates set. Have you done fasting basal rate testing? If you skip a meal, does your BG trend sideways or does it go up and down?

I started low-carbing (50-75 grams/day) on May 1. I've been able to reduce (with the help of a CDE) my weight by 24 pounds, about 13% of my total body weight, while cutting my daily insulin use in half. The key to my success was getting the basal rates set right. Once that was done, everything else followed.

Losing weight while maintaing good BG control is difficult. I tried many times on my own and failed. It's nice to have a competent and available CDE to coach (available by phone and/or email every day) you on this project.

Thanks Terry.

No, I have not been having too many lows. Less than once a week, I'd say. I have the 100 calorie juice boxes that I use mostly to treat.

I trend higher overall. Since I've started on the Omnipod, my rates have been tweaked at least once a month as I see my CDE or send her the info downloaded from my pod. That's part of why I'm concerned--they just keep going up.
I will admit, I do not always take a correcting bolus mid-day or post prandial. Sometimes I know they won't do any good and I KNOW my sugar won't budge, so I won't take any until time for my next meal. Why waste the insulin? I've done that many times.
If I skip a meal....it just depends. My BG will usually drop, depending on the time of the month. Sometimes it won't matter at all--I think I'll be at least under 100 since it had been over 6 hours since I ate, but it'll be around 140. When I wake up in the morning, after at least 8 hours of sleep and no food, my numbers range 140-200.

My last doctor's visit when I had the trial Dex sensor removed, we talked about my numbers overall and my doc was very happy with where I was. My a1c is still in the 6 range. She suggested that I keep each meal under 45g carbs in order to help lose some weight. For the most part, I've been successful there. I find that it isn't hard. I don't miss the breads and pasta and potatoes. Yet my weight never fluctuates beyond 4 or 5 lbs.

KCCO - If you haven't done it before, I would recommend fine-tuning your basal rates. I've successfully used Gary Scheiner's protocol. He's a CDE, a T1 himself, and author of Think Like A Pancreas.

I'm curious if your CDE will help you with this. It's valuable to have another set of eyes looking at the data and helping with adjustments. It requires more frequent contact with your CDE for a while. Maybe you should raise Scheiner's basal rate testing protocol with her and see what she says. While I have had very good results using this protocol. your diabetes, of course, will vary.

Even if there are other wild-card factors affecting your control at this time, getting your basal rates right will definetely help. Good luck!

thanks. I'll try them again. We adjust basals just about once a month, but I may need to check them more often.
I have a great CDE who uses email (new concept, I know!!) and will get back to me within a day.