Food Intolerance and Need to Gain Some Fat

My 18yr old son has had type 1 for 11 years. He has had stomach issues since he was a kid and it is exacerbated by eating loads of carbs and his sugar spiking. A few years ago, we discovered he had several food intolerances, and when he quit eating those foods, his stomach stopped hurting constantly. He is a gluten-free eater, and can easily eat meats, veggies (loads of them!), fruit, and nuts/nut butters. He limits starchy foods, like potatoes and rice, because of the sugar spikes. We can’t seem to get that under control even after much discussion with his doctor and keeping a tight control on portions and giving correct insulin. (Pretty sure teenage hormones play a factor in that to some degree.) So the problem now is the fact that, since he eats so clean, he is nothing but lean muscle. He uses the Medtronic 670G pump, and is having issues with his infusion site because there is no fat on him anywhere. The needle is ending up going in muscle, causing a site infection after a very short time, and the muscle is basically pushing the needle back out. Help! He eats the way he does because he doesn’t want to feel sick anymore. The foods that he’s given up are the ones that generally cause weight gain and fat. We have no clue how to proceed. Would appreciate any advice from others who have super skinny teenagers with food issues and a pump. How can I get some fat on this kid so we can keep this infusion needle in his body?

I don’t really have any tips, but, I bet you might get some from others around here. Both of my brothers went through a super thin stage in their teens, but, they were not diabetic. Does he have a nutritionist at his Endo’s office? Maybe, they could offer some guidance. Do you think that he consumes enough calories? Does he eat much in high calorie foods like avocado or peanut butter?

hi @Colesbunch Nicole, welcome to Type One Nation.

I hope your son can find some relief. It is very common to be on the very thin side with diabetes, because of limiting carbs and the limiting of insulin required for these carbs. Your son is essentially on a “keto” diet without realizing it.

I have no idea what eating clean means. sorry.

Since insulin is a growth hormone, if you want to get larger, you up calories via more fat, more protein, and more carbs. The insulin requirements will go up. IF you don’t care where the big goes, you can stop right there. If you do care, then exercise such as weight training can be very helpful. Swimming running and biking will create very lean and very moderate muscle mass, less aerobic such as the weights can put mass in key areas.

If he eats, on purpose, to increase daily insulin by about 20%, (TDD of 50 units… new target TDD of 60 units) he should start to see results but these results be slow and that’s okay.

Short cannula are better than long ones if you have no fat… I prefer to use 6mm plastic cannula over the more common 9mm

hitting near muscle will hurt a heck of a lot more, and can occlude easier than in fattier parts. top of the butt is my favorite there is always a little cushion there.

some people have to use metal cannula. The medtronic Sure-T can be used if you get a lot of occlusions. Some people cannot tolerate infusion sets and so if he really is getting infected… and it’s often, a long hard discussion with the doctor is in order.

you can gain plenty of weight and be gluten free. for example, you can get the fat and protein from steak, fish, nuts, and combos for example pesto… Get the carb load from apple juice if you need to.

You didn’t comment on his activity, but if he’s athletic there are new books such as “The Diabetic Athlete’s Handbook” and Think like a Pancreas - both are worth a read.

good luck.

Thank you for those suggestions and the book recommendations! I’ll definitely look those up!! Didn’t think to say, he actually uses a Sure-T 6mm needle infusion, because the cannulas were always getting crimped and then resulted in super high BGs. So the needle stays in. We have been doing a hip, since that was pretty much the only fat left on him, but that, too, has turned into muscle. Clean eating is just really healthy foods. No processed stuff, good fats, and healthy snacks as opposed to junk food.

Oh okay. I get it. Well that’s good but for higher calories he can go to high fat high sugar items including maybe cookies. My son has peanut and dairy allergies so I find “Enjoy Life” brand cookies to be heavy hitters in the fat and sugar department and they are soy/gluten free they use rice flour. Please check back in and good luck!