Type 1 and weight gain

I was diagnosed with Type 1 diabetes in 2013. I went on a Medtronic insulin pump in 2015. I am careful about what I eat and try to minimize my carb intake as much as possible. I have given up sweets and refined flours entirely. I walk for exercise several times a week. I was a caregiver for an elderly parent until last Thanksgiving, when the parent died. I had been planning to join a gym, but then covid-19 happened and all the gyms closed.
Over the last 4 years I have gained over 30 pounds despite my carb care and exercise. I have been doing research and have found articles linking insulin use with weight gain. My endo thinks this is nonsense (“insulin does not cause weight gain!”). I have also found recent research papers during which taking Metformin by Type 1 helps with weight loss. My endo refuses to prescribe Metformin for me. I’ve been going up a dress size every two years and I am now in the pre-obese category. I’m at my wits’ end and am thinking of switching diabetes doctors.

hi @hallomar and welcome to Type One Nation and the forum! I am really sorry to hear about your frustrations.

I think your endo should at least refer you to a nutrition expert with knowledge of diabetes. I agree… taken out of context, insulin does not cause weight gain… but that’s where it ends. If you are finding you have significant insulin resistance, and also intake considerable carbs then the excess of carbs and insulin will in my experience cause weight gain. What is your total carb intake?

so it is my opinion that the things you can control are daily calories and total carb intake. With a nutrition expert you can figure out the calories you need to lose weight. I find when my calories are just under what I need to sustain, that with exercise and curbing total carbs I get smaller. This (especially the exercise and the limiting carbs thing) usually comes with having to use much less insulin as well.

I also have to say that diabetes often causes hypothyroid, and I hope you are getting regular thyroid, liver, and renal function tests. If there’s a pathological reason you are gaining weight it needs to be the first thing to control. If you are dealing with excessive insulin resistance, this is something (in my opinion) your endo should seriously consider.

please let us know how you are doing and we are all rooting for you !

Hi, Joe. I try to keep my carbs under 25 per meal plus a non-sweet snack in the afternoon, such as a spoon of no-sugar-added peanut butter. My current endo has expressed no worry about my ballooning weight. Over the past few years he has kept trying to get me to take pills for hyperthyroidism. I told him if I had an overactive thyroid, I would not be gaining all this weight, and I refused to take the pills. His office has a nutrition expert - I am fairly well versed in the nutrition of diabetes, so I doubt visiting the nutritionist would help all that much. I see you are male - that counts for a lot in the battle to lose weight. My 72-year-old husband (not diabetic) went on the nutrisystem diet starting in February (I actually call it “the Nutrisystem-plus diet” because he eats extra food at many meals. He has lost over 40 pounds so far, and he gets NO exercise. I eat less than he does, and I minimize my carbs, and the scale doesn’t budge. I don’t understand my endo’s refusal to prescribe Metformin - according to the journal articles I’ve read, that helps with insulin resistence.

Hi @hallomar metformin also comes with special risks and potential side effects. If a doctor prescribes medication, it usually means They believe the benefits outweigh the risks. If they don’t believe that, then they won’t prescribe. You can always fire a doctor and get another one. I hope you find a solution.

Oh and yes, I am male!

Hi @hallomar. It sounds like you’re really on top of things so I don’t know if this applies to you, but I’ve found if my basal rates are too high I gain weight because of the snacks. Just thought I would mention it.
PS - as I looked over my original note I saw I typed “freaky” rather than “really.” I just corrected. No offense was intended, and I do apologize.

@hallomar Welcome, Mary Ellen, to the JDRF TypeOneNation Forum. I hear what you are saying, and can feel how you must be feeling, although I can not relate directly other than to your efforts to live a healthy life while managing your diabetes.

If you are not happy with your current doctor, you could consider finding a different endocrinologist; ask other medical professionals in whom you trust to make recommendations. The BIG mistake you could make in “doctor shopping”, is to select one who will just say “yes” to you rather than attempting to help you fully understanding your entire body function.

As for insulin causing weight gain, there has been discussion in the medical field of the increase in Double Diabetes; a condition that comes about in persons who have autoimmune diabetes [currently referred to as TypeOne], who because of the present ease to take additional insulin to also develop Lifestyle Obesity diabetes - one of the several “Type 2”. This DD is primarily present in people diagnosed with TypeOne at young age who find having a pump attached throw-in a bunch of extra insulin to compensate for over-eating. But, quite obviously, with your limited carb diet this isn’t what is causing your weight gain. When I was diagnosed in 1950, I’d need to boil a glass syringe for sterilization and then poke myself with a thick old, dull stainless needle which really hurt.

As for diet, I never stuck to a “low-carb”, but rather ate just about what everyone else was eating - other than the wonderful pie and cake that was served every day at supper table; I was fourth of my parents eight kids and ate the same meat, potatoes, and veggies as everyone else - no special diet for me. I currently stay active, and eat between 200 - 250 grams of carbohydrate every day while maintaining a BMI less than 20.2. A “good” doctor, who has observed you for a couple of years should notice, and investigate with you why you are gaining weight. It is common that people who have TypeOne, also have thyroid conditions, although one does not cause the other, that can cause weight gain. A couple of the medical provides I see, check my thyroid function at least annually.

I hope that soon, you and your doctors are able to identify what might be behind this issue.

Hi again @hallomar. As I said in another reply, you seem to be on the ball with your health. As much as you share how much you do for your health you have shared a number of things you won’t do - or choose not to - as well. That is your right and even responsibility. If your thyroid is overactive your logic about medication makes sense; but I am wondering if your doctor tested your thyroid levels and found your thyroid was hypo- rather than hyper-active? Underactive thyroid can be a cause for weight gain and can be treated easily. You are also on top of nutrition, but it may not hurt to get another perspective, in this case from a nutritionist. I’ve found I sometimes miss things that another set of eyes can catch.
There’s also the possibility that growth hormone that goes into the foods we eat contributes to our weight. As the saying goes, “You are what you eat” and while you do eat healthfully, if your food contains those chemicals then you may get them too. A nutritionist might be able to give you some guidance on working around that.
Wishing you the best.

My first Endocrinologists told me that insulin is a fat retaining hormone and yes I can gain weight - as I did, then I drastically again adjusted my diet and exercise routine. I cut down on carbs only eating on certain days not everyday but beware if you get headaches you’ve cut out too much. I increased my exercise routine to EVERY day which is exhausting, but i’ve gone down two pant sizes in 6 months work. Just keep working on it - be creative and don’t give up you can do it. I also found ways to eat plant based diet most days which requires very little insulin and for me beautifully shows BG rise slow and low and drop the same. cut any corner you can it works, like for me I cut out creme in my coffee, now drink black only…if I have a wrap i eat the 3net carb high fiber - if i have a sandwich I eat rye high fiber lower carb and only one slice. I know its strict on myself but its worked - then on one or two days per week I eat what my body is craving and take the appropriate amount of insulin even if its more than i’d like to take…you can do it. all the best. m