Weight loss, Type 1 and the insulin pump factor!

I know that it is common thread amongst us type 1 diabetics who pump and seem to gain weight yet our eating habits have not degraded and to some extent may have actually improved. I am not overweight by any means and my numbers are good. The 15-20 lbs I have put on since I have begun pumping has been a challenge to get rid of. In fact I just recently started looking at my insulin usage now compared to a year ago and what a surprise that was to say the least. My insulin usage is up big time yet I am not eating more at least when I look at the numbers. I think what I have been doing is bolusing more because my carb counts have been incorrect so the insulin shows up as usage but not part of my total carbs. Eating more means that my basal rate have slowly climbed upward to the point where it is a big mess.

What am I doing to correct this? I am watching everything I eat. I was bolusing around 18 units a day. I am now around 6-8 units a day. I am eating a lot more salad and I am cutting down on the carbs. I am also doing more temp basal rates so that I am not forced to eat when I exercise, which I think used to be a problem. Interestingly my morning BG was usually around 122 when I would wake up, today it was 75, signaling to me that I need to adjust my basal rates a bit which should further reduce my insulin usage. The reason why I am paying so much attention to my insulin usage is that I personally believe that the more insulin I take the more weight I am going to put on. This is not even counting in the extra calories from eating more food.

Has anyone else had success at shedding pump pounds? If so how did you do it? How quickly did you begin to see results?


I’ve lost about 10lbs in the last 5 weeks. I simply (ya, simple) set a lower daily insulin target. I was 90+ units a day. I now shoot for less than 70. My last 10 days are 75.55 (bad set), 54.75, 61.10, 63.70, 53.55, 58.40, 47.80, 55.15, 59.90, and 64.65. I also found after about a week my basals droppped to about 85% of the previous level. But lately they’ve been drifting back up, so maybe it’s a temporary phenomenon¿ Exercise is a must too.

I am currently dealing with trying to lose a few pounds as well (only 5-10). I have only been on the pump for about 8 months but that is almost half the time that I have been a T1. Also, I was diagnosed when I was pregnant, so it’s impossible for me to tell if my few extra pounds are leftover stubborn baby-weight or caused somehow by the diabetes? I don’t eat any more or less than I did before diagnosis. I also started back to the gym about a month ago and have since put ON 2-3 pounds and now I need to raise my basal rates again. Why do you think that weight gain has something to do with insulin amounts instead of the normal slowing-with-age metabolism? I’m curious to read other responses to your post.

PowerPumper, so by setting a lower daily insulin target, you mean that you basically ate less food? I have a hard time seeing a difference between “pump pounds” and regular pounds that anyone could put on as they get older and maybe are eating more. Am I missing something?

This from an article from the Mayo Clinic:

What’s the connection between insulin and weight gain?

Weight gain is a common side effect for people who take insulin. The more insulin you use to control your blood sugar level, the more glucose that gets into your cells and the less glucose that’s wasted in your urine. Glucose that your cells don’t use accumulates as fat. If you continue to eat as you did before, you’ll likely gain weight when you start taking insulin.

Think about it this way: Before you start taking insulin, you may be able to eat more food than you need without gaining weight because your body doesn’t use the food properly. But when you start taking insulin, all bets are off. When your body uses food properly, you may need less food than you think.

And the concern about insulin and weight gain goes beyond what you see in the mirror. Excess weight can make your body resistant to the action of insulin — which means that you may need to take even more insulin to get sugar into your cells.

My endo told me that I needed to be very careful about weight gain with the pump, because it was so much easier to eat something and instantly bolus it, as opposed to taking an injection. He was right – I added about 15 pounds over three years.
When I decided to finally do something about it, I went on a crash weight-loss program, with heavy duty calorie counting and exercise. As a result, I lost 58 pounds in about 6 months and was actually told to put some weight back on, which I did with weight training to avoid getting fat again.
I counted every calorie I ate and tracked BGs very closely, limiting myself to 1800 calories a day and 150 grams of carb per day. Insulin use went down significantly. There were also lots of lows (requiring glucose tablets to treat), but control improved significantly, as did overall health.
Even for diabetics, weight loss comes down to a simple formula – calories in minus calories burned (exercise – yuck!!). We just have to be so much more careful and adjust our boluses and basals to take care of ourselves.

I just started on the pump about a month and a half ago, and although I’ve been 20 lbs overweight for awhile, I have noticed the pounds slowly creeping up since starting pumping. I’m in the same boat you are now, working hard to lower carbs (in turn lowering my bolus rates), and fine tuning my basal. I’ve been the same weight for years, so I’m really hoping that it will be as easy as just adjusting my insulin requirements (and more exercise of course). I’ll let you know how it goes. Hopefully we’ll both see a difference shortly.

Hi David,
I read this and many other articles online yesterday and I still don’t see the difference between weight gained from improving your BG control with insulin and weight that we would have gained as a non-diabetic anyway. The mayo clinic article sounds like what to expect as you improve your BG control by starting insulin therapy but wouldn’t a non-diabetic be getting all of the calories they are eating into their cells as well because their body is already producing insulin? So, I can see how having good control with insulin would make us as prone to gain weight as non-diabetics but I still don’t see how insulin would make us more prone to gain weight? Is there really a difference between diabetics and non-diabetics when it comes to losing weight via cutting back your carbs (which is what we’re doing by cutting back insulin)?

I understand what you are saying and it is confusing. Here is my deal, before I had diabetes (that would be 32 years and younger) I could eat anything I wanted and for the most part I NEVER gained weight. I could eat cake, cookies and fries every day of the week and sit on my butt without a concern that I would gain weight.

Now as a diabetic who is on an insulin pump I have the ability to eat the same way but if I do eat the same way I have to take more insulin which will cause me to gain weight. I think it comes down to the fact that the insulin our bodies used to produce was a “pure insulin” that was manufactured by the pancreas. While the insulin we take now is made in a lab and while it works in the same way it just is not the same as the natural real thing our bodies used to produce. My endo has told me repeatedly that the less insulin I use the easier it will be to manage my weight and BG.

Numbers and A1c wise I do very well. I have a good A1c, 6 and less usually. I rarely hit the 200 mark and I have 1 or less hypo episodes a week. Having good control does not mean however that I can’t do a better job eating and watching what I eat. Bolusing using a pump or shots makes eating whatever way too easy and that is what I have done I eat more freely but I take more insulin to cover the carbs and therefore my body has responded by slowly adding pounds which requires more insulin to manage good BG numbers.

Your question about “losing weight via cutting back your carbs” is the same for both diabetics and non-diabetics. However diabetics get a double hit because of the carbs and the insulin usage. If I cut back carbs I will use less insulin up front but I still have to wait to get my basal rates to fall to an acceptable level so I use even less insulin. For me as my weight has slowly increased so have my basal rates. I am now taking everything back to where it needs to be! Minimal amounts of basal insulin and small amount of insulin to cover carbs. Less insulin should equal better sensitivity and response when I do bolus.

Does this help or answer your question?

The sensitivity part makes sense, that the more weight you gained the more insulin you would need ……like so many non-diabetic Americans these days.
As to the part about the lowering of the basal rates with less insulin use, couldn’t this also be the case for non-diabetics? That the less they eat, the less insulin their body is usually producing, the lower their resistance to insulin becomes? I’ll ask my endo about this next week during my visit. I understand the correlations and how they work in the body to gain weight. I guess I’m just curious as to if the same principles work for all people instead of just for diabetics? I can’t totally buy into the “double-hit” theory, at least not until I know that non-diabetics bodies behave differently.
I was just like you and used to be able to eat whatever I wanted until I was about 30 and was always considered too skinny. I didn’t even know what the gym was until I was 31 and my metabolism slowed a bit. I didn’t develop T1 for another 2 years.
Don’t you think that there could be something to just getting older and having your metabolism slow down a bit? Every older person I know either says that they can’t eat the way they used to or they have put on some extra weight around the middle.
Just curious, what kind of daily calorie and carb amounts to you usually go for?
I also read on a couple of websites that “Patients with type 1 diabetes typically require an insulin dosage of 0.5 to 1.0 units per kg per day.” Would you say that you were within this range before and are you now?

i’ve noticed a few things since being on the pump. 1) i’m a lot more consistant and exact in my insulin dosages (though i still need to tweak my ratios…i just lack the energy these days). 2) i do believe that the insulin we put into our bodies affects us in a slightly different than what is produced by the body. think of other synthetic drugs we use, particuairly hormones. women who use birth control and are more prone to gaining weight. the same with some psychiatric drugs. i don’t know why it is…but it is. 3) i know that i feel a little more free to eat as i like now. if i decide 30 minutes after breakfast that i would infact like to treat myself to that second bolus, i can just dial it in and not worry about stabbing myself with a needle twenty times a day because i followed a whim.

my weight has definately crept up since pumping. i haven’t tried to hard to correct it yet, but need to get cracking. my plan is on old stand by for weight loss (with a little resistance training thrown in to make the marines happy…blah blah blah…muscle burns fat…blah blah blah). it’s not fun, but it always works. walking/running nearly every day and a very repetative diet of eggs and an english muffin with cream cheese for breakfast, a low carb (usually about 15g per serving…i eat both servings at once though) for lunch, and fish or chicken broiled with veggies for dinner. also a small serving of nuts or some greek yogurt if i want to snack.

bottom line - low (i haven’t tallied it, but i’d say under 100g of carbs matched by about an equal amount of protein to help keep things stable and fill you up so you don’t run to the fridge an hour after you eat and LOTS of walking. i’m not sure why, but walking seems to drop weight off of me better than anything i’ve done, save body surfing since that is both aerobic and resistance oriented. but i’ve blabbed enough for now. i’ll shut my mouth until i can prove i can take off the weight this time with pump firmly attatched to hip. :slight_smile:

Have you heard of Symlin. The beta cells actually make two hormones (that we now know about) insulin and amylin. they both have a lot to do with digestion, how the food is used, how much we eat and how it all gets processed. Anyway. Knowing that hormones work in balance with one another it makes sense to replace any missing hormones so that everything works better. Symlin is the synthetic form of amylin and slows gastric emptying, prevents the liver from dumping extra sugar into our systems at the wrong times and helps with the satiety center in our brains. It does some other things too with the gut hormones that is all very complicated. When one starts taking symlin, the meal time insulin dose is decreased by half and then adjusted from there. Also it is suggested that a dual wave is used with a 2-3 hour square wave. It isn’t supposed to affect basal insulin need but mine has decreased a lot. My basal used to be around 10 units per day and is now less than 7. Meal time insulin is at about 75% of what it used to be so my usage has definitly decreased. One of the big advantages of using Symlin is also the weight loss associated with it. It would be contraindicated with gastroparesis but you may want to research it more and talk it over with your Dr. Just an idea.

Does anyone know of an effective diet to follow as a Type 1 diabetic?

Since I have been on the Dexcom CGM (over the past 6 weeks) and am in much tighter blood sugar control, I have gained 15 pounds! I exercise a lot, do triathlons and try to eat as few carbs as possible…but I am still gaining weight.

Ok so here is what I have been doing and it seems to be working thus far. Like you I exercise a lot as well. I ride 50 to 100 miles a week plus yoga etc. Have the pounds been falling off nope, not a one. So I started really watching my carb intake. I used to eat around 150-180 grams of carbs a day and bolused a lot because of it. I have now cut out pasta, bread potato and rice. I still eat these foods but in tiny portions. My carb intake is below 100 now and probably closer to 75 gr a day. I try to eat chicken, tuna or pork everyday along with a lot more vegi’s and salad.

The Atkins way would be to consume a ton of red meat, butter and bacon. Which I think is absolutely horrible for your body. I have an Aunt who has Gout from doing the Atkins diet but won’t stop and now she can barely walk because of it.

My insulin usage is down by about 10-12 units a day. My BG is very stable and easy to manage. The other thing that has helped me is when I exercise I do a TEMP BASAL which keeps my BG from bottoming out. If my BG goes low it then requires a power bar of some sort which is high in carbs. All the calories I just burned have now been replaced by the power bar which totally negates the exercise.

I have been doing this for almost 4 weeks and I have lost around 5-6 pounds and it is a lot of work. I wear CGM as well and I am expecting that I will have a 5.5 or lower A1c. This in itself makes it worth it. I give a lot of credit to the temp basal, that has helped out quiet a bit.

I have been podding since May and I have gained about 5-10 pounds! I am looking into shedding it! I am glad I am not alone! Thanks for posting this:) I just have to find the time for me. I have a little girl and no family here…it’s a little hard:)

I have been on the pump for 3 weeks now and have lost 10 pounds. I know they are still working on getting my dosages right but im am really surprised i lost weight instead of gaining weight. I still am having quite a bit of hypoglycemia. Hopefully they will figure out my basals and bolus rates. They have been changed over 5 time in last three weeks.

seen i been on the insulin pump i have gain 20 pounds… my endo doctor say it going to take some time because my blood sugar are get normal… going to gym and eat right… please help…

The reason insulin makes a diabetic gain weight, per say, is because pre treatment for high blood sugars causes you to go into keto acidosis, which essentially spills calorie through your urine. Glucose is not stored and used properly by the body. In other words, if you are spilling 500 calories of glucose through you urine and start insuling therapy and your blood glucose levels are lowered, it is the same as adding 500 calories to you daily consumption of food. IE: Weight Gain. Therefore, people that are somewhat overweight, should restrict their calories by such an amount, to prevent the weight gain. I am at a lower weight, but I have found in the last month, I have put on weight. I am trying to discover the reason for this. My blood sugars have been very high the last week. I feel like I am in a viscious cycle. I have gained weight and require more insulin, but, I do not eat a lot of calories all day. Just not sure how this happened and I feel very frustrated.

It is my understanding from my Endocronoligist, that it takes 75 or less carbs to lose weight and 150 to maintain. I find myself eating no more than 75 carbs a day, just to maintain. And, lately, I have creeped up. I am not sure what the answer is. But, I would keep doing what you doing. I bet you look great.

Yes. It is hard getting your rates correct. Everytime you lose, you probably have to do a downward adjustment, as well. The pump and diabetes is very tricky. I freak out, though, whenever I have had to go back to injections due to pump failure. Just hang in there…they will get the adjustments right.