Gain weight

Hi again!

Do tell, please…how to gain weight? High fats (not avocado and peanut butter fats, animal fats, right??) cause issues, high carbs (too many per meal) cause issues. Can’t gain weight eating veggies.
I feel like this disease between eating and watching numbers is my whole life! People say don’t let it be. HOW CAN YOU NOT!!! ???
Can you tell I am very discouraged and frustrated!? I’m only 3 months post diagnosis!
I will see my nutritionist. Just wanted some ideas from you!

hi @HopeFloats2020 Now I’m not a doctor, so I am glad to hear you are bringing this up with a nutritionist as well as your medical team.

Here’s how I understand it; insulin is a growth hormone. It provides the key for your cells to use blood glucose in metabolism for energy. You have to balance food, insulin and activity to have decent blood sugar control.

Without insulin, your body starves, (even when you eat) so it burns fats. Your kidneys have a tough job because your blood sugar is high so you pass enormous amounts of water and sugar. So uncontrolled, you are losing water faster then you can drink it, and burning fats = you will lose weight in a horrible way.

Once you get our blood sugar under control, metabolizing the food you eat returns to “close to normal”. so that’s job #1.

Then you balance the calories you burn every day with what you need to eat. At first, you will need more calories because you need to replace the burned fat and muscle loss that occurs with diabetes. You can continue like that - with a calorie surplus - and you will gain weight.

No one should have said you can’t have carbs, and you cant eat whatever. I know many people equate “insulin” with something bad, but it’s not. It’s necessary to stay alive. There is no reason you can’t eat a balanced (carbs, protein fat, etc.) meal. You can gain weight and muscle as a vegetarian if that is your goal. Some folks try to minimize insulin by eating low carb, and that’s possible and even beneficial if you are trying to LOSE weight.

I eat like a person without “diabetes” I eat pasta, chicken, veggies, and an occasional chili dog all the way. Now it’s not easy ( because you need to learn how to use insulin), but I will also have ice cream and pizza once in a while too.

before corona lockdown, I was working out and needed additional calories due to additional exercise. this means more insulin in general, but with exercise, less insulin for the carbs consumed. at first I had ups and downs but I was getting there with re-learning insulin for the new routine. and that’s what we have to do, all the time. you will get there.


Hang in there, Cathy @HopeFloats2020! It DOES get easier, I promise!

Hopefully that nutritionist can give you the detailed direction you probably want right now, but Joe @joe has solid advice, as always.

The first step is to learn how to take insulin to meet your body’s needs, so you can start using the fuel you’re taking in again. Your understanding of exactly how to do this will get more refined over time, but cut yourself some slack and call good enough good enough in the beginning. It takes a lot of experience to become the “insulin ninjas” that some on this forum are today, and they have many decades on you!

Once you’re basically getting the insulin right — which it sounds like you got the hang of pretty much immediately, so kudos to you! — you’ll gain weight the same way anyone else does, by taking in more fuel than you burn.

We were taught from the beginning that a healthy diet for someone with T1D is the same as a healthy diet for anyone else.

Here’s hoping you enjoy every bite!

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Thanks, as always, Joe!
I would eat more than three meals with carbs (usually 60g per meal or less) but as I understand it, there is a risk of carb stacking. Honestly, I have no idea how to eat in between meals. I need to learn this stuff.

@HopeFloats2020 the big question is around insulin stacking. but for example, if you have 15 grams carbs between lunch and dinner, you do dose for those carbs… even with lunch insulin still on board. At dinner of course, you may be higher than your target but assuming it’s been 2 hours, you wouldn’t necessarily dose for higher blood sugar due to snack IOB, but for the carbs at dinner. Further - if you were 150 at dinner, with IOB to bring that back to 140, you would ignore your blood sugar and just does for dinner carbs. DO NOT SWEAT THIS, it comes with the territory. in about a year you will be an expert.

… and coincidentally, a pump is great for this… since it tracks IOB, If I eat lunch and show a 165 at 2 PM, and I want some crackers, I put in my current BS, my carbs, and the pump will add (or subtract) insulin based on IOB and blood sugar. in this case my pump would add a unit based on my numbers and ratios. If my BS was 90 at 2PM with IOB, my pump calculates the insulin needed for the cracker-carbs by subtracting so it will be much less total insulin in an attempt to raise my blood sugar by the time BOTH doses wear off… you can do it manually as well but it takes patience and practice.

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Joe, that is what I meant…INSULIN stacking! I get it, thanks for explaining! To be clear, if I have a snack (15g carbs) at the two hour post-meal mark, dose for that.
2ish hours later for my next meal, do not correct. Just dose for dinner carbs.

Wow, the pump does the work! I like that idea! I will allow myself to get used to the CGM and highly consider that pump!


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P.S. I tend to think that each move I make, I am going to cause damage to my body. I am programmed that way! Ugh.

I hope the forum helps you learn to re-think things, at least in terms of your diabetes.
I see you are looking into pumping. Not to discourage you but keep in mind the pump does not do all the work for you. You’ll still need to recognize how your body responds to fatty meals, stress and other factors. And while you will work with your team to determine initial settings, there will be tweaking involved - you’ll find that’s a favorite word of mine. A bit of input from me, which you can take our toss: I’m a firm believer in knowing the basics - being familiar with the low tech stuff before progressing to the high. Many people do fine on injections and some people prefer them. On the other hand some people must have a pump to get their best control. If you have the option a pump is great but I recommend you become as proficient as possible in managing with injections first. You may want or need to take a pump break and will need to know how to manage.
If/when when you decide to get a pump, and the loop system which helps manage lows and/or highs, I suggest you learn to use the pump manually without those features first. Again, there may be times when you have to “go solo” and it’s good to know how.
Okay, your head may be spinning and you’re looking for some combination of aspirin, coffe, and/or alcohol. Don’t go there😊. My point is, take - your - time. You’re just getting started and there’s a lot to learn, so concentrate on the basics and then progress on to the more advanced stuff so you don’t find yourself even more overwhelmed. The technology will still be there and so will we.


well - yes! at least at first, until you really get good at knowing how much more you will drop. a CDE can help here based on your comfort and practice. To be 100%, if I saw I was 220 mg/dl at 2PM, i’d skip the snack, subtract out what IOB my pump thought, and “correct” with a dose (for me 4 units but I know my sensitivity).

y’arent gonna break anything. a body can take tremendous strain. it takes a lot and a sense of confidence before you will make your own decisions, but you are capable!

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@HopeFloats2020 Joe gives good advice. There are also apps that calculate Insulin on board similar to what the pump would do. Before pumping, and occasionally now with a needle stick, I use RapidCalc. It wasn’t free but it does allow you to calculate insulin bolus just like a pump would.
Of course you have to set it up when the proper settings for your insulin/body. You would want to consult your endo or diabetic educator to get those settings started.

Oh and 1 more thing…unfortunately, diabetes is not a math problem. If it was we would all be perfect all the time…that doesn’t happen.


Wow, yes, a lot. But thanks @wadawabbit

Good to know I won’t be breaking anything!
Thanks, as ALWAYS, @joe

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Good point about the math!! Thanks @Grumpy .

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Cathy @HopeFloats2020 , my thoughts on this may sound trite and making a difficult to manage condition sound insignificant. Being very recently diagnosed, I can understand how the many “negatives” like don’t eat that, don’t do this, etc., have taken priority over what YOU CAN DO; combine that with all the negativity you’ve heard about diabetes over your last half-century.

My suggestion, don’t let numbers rule your life. The numbers with which you are being presented from a BGM or CGM are NOT scores for a game you are playing, but rather guide points that suggest action you may need to take, or some activity [including eating] for which revised planning for this activity in the future may need to be modified. That may sound like a lot, and may be confusing in the way I wrote, so a summary would be, Live life actively and productively the way you want to live and make effective diabetes management fit into your plans. Not easy at first while you are trying to learn how your body reacts to different foods, and to the different formulations of insulin, but you can learn. Similar to the examples @Joe mentioned how he knew to exact amount of insulin to “correct” an elevated glucose level.

It is often said that an insulin pump will cause unwanted weight gain - not true, at least for me. During my continuous time with four insulin infusion pumps, my BMI has stayed very steady at about 20. The pump does not select the foods we eat, nor does it select the quantity of food, nor does it select activities.

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THANKS, @Dennis ! It is very overwhelming and new. I will try and be a little easier on myself!
Always appreciate the replies, everyone!

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There are lots of well known people living with Type 1 - professional and Olympic athletes, a Supreme Court Justice, and a Prime Minister, and performers. The list below is from 2019 - there may be more that aren’t listed.


We are going to set up looping LoopDocs for our son. It is nonstop looking at the graph. Looping should remove a lot of this manual work by automatically adjusting basal.
All the best

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One more thing: if/when you do decide to use a CGM and/or pump, you will be assigned a rep who will work with you. Do yourself a favor and let them interface with your insurance - it can be confusing for even knowledgeable patients to navigate, and the reps do it for a living. They will work with your doctor to get any documentation needed for authorizations, and can better navigate some of the technical jargon and requirements to make sure things are in place for your coverage.

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One quick comment as a dad of a 16 year old diagnosed about a year ago - hang in there! It does get better, and although I am not diabetic, we are very involved in our son’s management of his T1D. He has done really well, and has learned how to keep himself in the right place. Of course there are ups and downs but he has really become great at knowing what to do - and so will you. This group is such a caring and knowledgeable place to come, and I am always so grateful to see all the positive comments and helpful advice.