How to gain weight

[Ian67]

Good evening everyone could I ask for a little advice please. I’ve been type 1 for two and a half years and still struggling a bit with it .
I lost a lot of weight when I was first diagnosed and never seem to be able to put it back on .
I’m now 75.5 kg my height is 5’10 and BMI of 23 and my age is 53 . I would like to put on another 5kg but no matter how I try I can not gain it . Would be grateful if I could get any advice thank you .

 

[Nick Cliff]

Hi @Ian67
I found advice on the NHS website about this. Suggest you look there. The gist of it was to eat the same amount of food but over more meals. For me as a Type 2 that made sense and seems to work. Not sure how that would work for a Type 1 who has to take insulin to coincide with meals.
Regards. Nick.

 

[Ian67]

Thank you and well done .

 

[Inka]

Good evening everyone could I ask for a little advice please. I’ve been type 1 for two and a half years and still struggling a bit with it .
I lost a lot of weight when I was first diagnosed and never seem to be able to put it back on .
I’m now 75.5 kg my height is 5’10 and BMI of 23 and my age is 53 . I would like to put on another 5kg but no matter how I try I can not gain it . Would be grateful if I could get any advice thank you .

Im assuming your blood sugar is ok and you’re not regularly going high? Are you carb counting @Ian67 ?

Assuming that’s all ok, keep a food diary for a few days, then see where you can add in extra calories and carbs. You’ll need to do it consistently day after day, and you should put on weight. Something like MyFitnessPal can help too because you can set a calorie target and make sure you hit it all day.

 

[Ian67]

Thank you for your reply my consultant wants me to run at a 10 due to being very insulin sensitive I only take 1-2 units and sometimes that’s too much. I suffer from high blood sugar on morning when I wake up .

 

[Inka]

If your blood sugar is running high that could be contributing to your inability to gain weight. Are you saying that 1-2 units is the total amount of insulin you take per day?

 

[Ian67]

Sorry no I eat 3 times a day with 1-2 units humalog each time depending on what I’m eating . I also take 7 units of of tresiba daily. If I’m really active during the day I can eat what I want and my levels will plummeted without humalog.

 

[Inka]

Sorry no I eat 3 times a day with 1-2 units humalog each time depending on what I’m eating . I also take 7 units of of tresiba daily. If I’m really active during the day I can eat what I want and my levels will plummeted without humalog.

Ok, I understand now. If your levels are plummeting withoutHumalog when you’re active, maybe you’re on too much basal? Tresiba is a very inflexible insulin because it stays working a long time. Levemir or another twice-daily basal insulin would give you the flexibility to reduce your dose when you’re going to be active, for example.

It sounds like you’re not carb counting - ie adjusting your insulin to ‘match’ your carbs? You should be able to eat enough to put on weight by adjusting your Humalog to allow you to eat more carbs. Do you have a half unit pen for the Humalog? That would help if not.

 

[Inka]

Type 1 is a condition where you have to become your own expert. It does get easier with experience. Two great books about Type 1 are:

Think Like a Pancreas’ by Gary Scheiner.

And Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas (ignore the title - it’s great for adults too)

Once you get more confident with using your insulin, I think you’ll find that your weight stabilises at a good level for you because you’ll be able to use the Humalog to eat what you need. In the meantime, eating things like cheese, nuts. oily fish, etc can help.

 

[Ian67]

Yes I have and I have tried that if I carb count I would plummet all the time my diabetes is strange one . If I’m running at 8 and I have my treat for the week say fish and chips one slice of bread with 2 units of humalog I will go down to about a six .
But if I have a chicken salad sandwich and a pack of plain crisp I will shoot up to a 13-14 ?

 

[Inka]

@Ian67 Be reassured your diabetes sounds perfectly normal not strange at all 🙂 Lots of Type 1s are sensitive to insulin. Also, during the honeymoon period, it’s very common to be on small doses and to have to deal with some of your own insulin coming in late and randomly and putting your blood sugar down,

Do persist with carb-counting. It can’t ‘not work’ because, put simply, it’s having the right amount of insulin for that meal. That is, you carry on until you’ve got your ratios sorted for breakfast, lunch and evening meal (they’ll probably be different), then you add further adjustments based on what you’re about to eat and your current blood sugar. Often Type 1s find two meals of the same carb amount need slightly different insulin amounts or split boluses.

Your fish and chips is high fat so many people find a split bolus is needed (some insulin before the meal, some a time after). If you’re still in the honeymoon period, you might find you can get away with a smaller bolus and then wait until your own insulin kicks in to deal with the rest.

Your chicken sandwich and crisps is a higher GI meal so that why your blood sugar went up to 13/14. You might need to have your bolus earlier to stop that spike. In addition, some people find bread and/or crisps need slightly more bolus than other foods of the same carb amount. That’s not a problem. All you do is remember or note it down. Then when you have the same meal again, you’ll know how far in advance to bolus and how much insulin to have.

If you find that your own insulin is kicking in between meals, then all you do is have a snack. That’s not unusual during the honeymoon - and it’s to your advantage too as it will help you put on weight. Again, experimentation is everything. You might find you need a 10g carb snack mid-morning but a 20g carb one mid-afternoon. Just to be clear, you eat the snack without any Humalog.

If you’re thinking this is all sounds a pain - it is. This is what I found hardest to get my head round about Type 1. You don’t take the ‘right dose’ of insulin and you’re sorted - it’s a constant process of balancing and daily work.

I hope that all helps you and reassures you that you don’t have a freaky kind of Type 1. If you keep your blood sugar controlled so that you can properly use the food you eat, and get a feel for how your body is working currently, then you should gradually put on weight. You have to a) eat enough on a consistent daily basis; and b) take enough insulin to keep your blood sugar in range, which is an ongoing process of learning, juggling and balancing.

 

[Ian67]

Thank you so much for your advice you have told me more then my doctors or nurses. I will now try and get everything in balance and I have also bought that book off Amazon you told me to read .

 

[rebrascora]

A "like" just isn't enough for @Inka's post above.... Really great post!

@Ian67 You will slowly become the expert in your own diabetes (you will eventually know much more about it than your consultant) but it takes time and trial and improvement, learning to understand how your body responds to different foods and exercise and insulin and a whole host of other factors and the honeymoon period makes it all even more unpredictable because your own insulin production occurs in fits and starts when you least expect it. Hang in there!. It is a long, slow learning process and at times it is pretty frustrating but you will start to see patterns and understand why some things happen the way they do and other times you just have to shrug and say, "I did my best. No idea why it didn't work, but tomorrow is a new day!"

 

[chaoticcar]

I am a skinny type 2 so know absolutely nothing about type 1 and insulin but I wondered if you could up the good fats ? I add lots of butter to my vegetables and have a second breakfast of full fat yoghurt with double cream and berries ,lots of cheese and nuts to keep my weight up .I hope that you find a solution
Carol

 

[Inka]

Thank you so much for your advice you have told me more then my doctors or nurses. I will now try and get everything in balance and I have also bought that book off Amazon you told me to read .

You’re very welcome @Ian67 🙂 Type 1 is hard work but you gradually get a feel for it. Perfection isn’t something we can achieve, but we can keep it mainly under control and in its place while we get on with our lives 🙂

 

[Ian67]

A "like" just isn't enough for @Inka's post above.... Really great post!

@Ian67 You will slowly become the expert in your own diabetes (you will eventually know much more about it than your consultant) but it takes time and trial and improvement, learning to understand how your body responds to different foods and exercise and insulin and a whole host of other factors and the honeymoon period makes it all even more unpredictable because your own insulin production occurs in fits and starts when you least expect it. Hang in there!. It is a long, slow learning process and at times it is pretty frustrating but you will start to see patterns and understand why some things happen the way they do and other times you just have to shrug and say, "I did my best. No idea why it didn't work, but tomorrow is a new day!"

Thank you maybe I’m trying too hard at the minute and I want that straight line instead of the ups and downs .

 

[rebrascora]

Thank you maybe I’m trying too hard at the minute and I want that straight line instead of the ups and downs .

The best that you can hope for is slightly smaller mountains and valleys or if you are really lucky rolling hills (straight lines don't even happen for non diabetic people) but it takes time and effort to figure it out and sometimes when you try too hard you actually push it the other way, so it really is all about balance and what you can learn from each experience to perhaps improve it a bit next time.
Having reasonable expectations of what is possible is very important and some people seem to have bodies which have read the diabetes handbook and follow the "rules" a bit more than others. It really gives you an immense appreciation for the job a fully functioning little pancreas does. Even with all out modern technology it is still a massive challenge for us.

 

[Nick Cliff]

I am a skinny type 2 so know absolutely nothing about type 1 and insulin but I wondered if you could up the good fats ? I add lots of butter to my vegetables and have a second breakfast of full fat yoghurt with double cream and berries ,lots of cheese and nuts to keep my weight up .I hope that you find a solution
Carol

That's useful to know @chaoticcar - as a skinny Type 2 trial and error has also led to me increasing fats, despite the original advice to restrict them, and proteins. Consequently I keep an eye on my cholesterol levels, liver and kidney function, and remind the surgery to test for these when doing my HbA1c.
Sorry Type 1s if this is irrelevant to original post.
Nick

 

[chaoticcar]

My cholesterol levels came down when I upped my good fats and lowered my carbs
Carol

 

[rebrascora]

My cholesterol levels came down when I upped my good fats and lowered my carbs
Carol

I find the term "good fats" a bit misleading/confusing.

My cholesterol levels have lowered despite eating what many people would consider to be "bad" fats ie saturated fats from meat and dairy and eggs. I personally consider these natural fats as "good", but I think the general population and most health care professionals would see them as the opposite, so it would be helpful if you can clarify what YOU mean by "good fats".
I would add that I also use olive oil and eat nuts and seeds and avocados as other sources of fat. Sadly I am not a huge fan of fish so a piece of salmon once a fortnight is as much fish oil as I manage. I think most people would agree that fish oil fits the "good" description.