Just started Insulin

[Pugfugly]

Hi, I’m on Metformin but have just started injecting Insulin. I have successfully lost four stone and am still trying to lose a little more. I weigh 10st. 11 pounds but since starting insulin I am struggling to lose any more. I am staying the same weight over four weeks. I need to be around 10st. 7lbs (still in the overweight category) but I’m happy to maintain at that weight. Has anyone else struggle on insulin?

 

[Lucyr]

Insulin doesn’t cause weight gain it just means your body can use and store the food you eat.

If you have a driving licence (even if not driving at the moment) make sure you inform the DVLA and familiarise yourself with the rules of driving on insulin.

 

[Pugfugly]

Insulin doesn’t cause weight gain it just means your body can use and store the food you eat.

If you have a driving licence (even if not driving at the moment) make sure you inform the DVLA and familiarise yourself with the rules of driving on insulin.

I already informed the DVLA.

 

[Pugfugly]

I’m guessing I’ll have to cut down on the carbs. I have weetabix and blueberries with skimmed milk for breakfast and a wholemeal sandwich for lunch. Maybe I’ll try cutting out the bread at lunchtime.

 

[saffron15]

I have read recently that when you are older, I am the same age as you, a little extra weight is good idea. I'm female and weigh 11stone 4. I was heading for 14 stone when diagnosed. I do intend to lose more. The article I read was someone who was very slim and was hospitalised having become dehydrated on a walking trip abroad. I think the rational was to having something in reserve in case an illness causes weight loss and fragility.
I like bread too much. I will have a sandwich if I'm in a café. When I've made sandwiches for myself I like smoked salmon on cream cheese and make it as an open sandwich ie one slice of bread. Could you sometimes have one slice rather than two? For breakfast I have a mushroom omlette or full fat Greek yoghurt with berries and nuts or seeds. Perhaps every other day you could have this and if you have more than one weetabix maybe reduce to one or crumble one on the yoghurt.
I'm thinking calories as now you are using insulin the carbs don't matter.
When I was diagnosed last July I realised I had gone low carb around 120 a day and was very pleased that I was losing weight, for me it was the upside of the diagnosis.

 

[rebrascora]

Hi and welcome.

Can you tell us a bit about your diabetes?

Things like how long ago you were diagnosed (roughly) and how that came about? ie. Was it discovered via a routine blood test or were you symptomatic and if so which symptoms?

It is unusual to go from Metformin straight to insulin. Did they try you on any other medications with the Metformin before starting you on insulin?

Which insulin are you taking and when do you take it?
How long have you been using the insulin?

I assume you are testing now that you are on insulin. What sort of results are you getting when you test?

Losing 4 stones is fantastic, so well done! How long did it take you to lose it and what sort of diet were you following?

It can be dangerous to reduce carbs if you are on insulin and particularly if you are using a mixed insulin, so the more info you can give us about your situation the better we can advise you.

I am also wondering, if your diabetes came on quite suddenly and your levels were quite high at diagnosis and you had symptoms like thirst and weeing a lot and lost weight quickly, if perhaps you might actually be a late onset Type 1 like myself and many others here who developed Type 1 in our 50s and 60s rather than Type 2.

 

[saffron15]

@Pugfugly I see @rebrascora has asked about your diagnosis, i had assumed that insulin had been added to the metformin and assumed you had been diabetic for some time. A friend's husband was type 2 in his forties but now in his seventies also uses insulin. @rebrascora will give great advice in relation to insulin.

 

[Pugfugly]

I think I’ve filled in most of the details except when I started on insulin, which was 14/3/2025
Just eaten a tuna sandwich. I was really hungry so I had two slices of wholemeal bread.
I follow Slimming World, which is how I lost four stone.

 

[Pugfugly]

I’m type 2 by the way and I’m 71…. That always shocks me as I feel younger, until I look in the mirror!

 

[Pugfugly]

I have attached my readings.
I found out I was diabetic in 2012 when I had a pre-op test for a hip replacement. I had lost about 2 stone prior to that op without really trying and I gave up smoking at the same time. I gained that two stone back during my recovery and compensating for not smoking, I guess. I feel much better losing four stone since then. All my sisters were diabetic and my father too. They were Type 2 but on insulin.

 

[rebrascora]

Thanks for all that extra info. So you are on 10units of Glargine a day. Interesting that you were having hypos with Sitagliptin and so they changed you to insulin Glargine, which would generally be considered more likely to cause hypos than Sitagliptin.

Glargine is what we call a basal or background insulin. It provides a slow trickle of insulin to deal with the glucose released from your liver and it is not particularly intended to use to cover the glucose released from the food you eat, however if it is not used in conjunction with a fast acting (bolus) insulin which is designed to cover the glucose from food then your Glargine is likely covering both jobs to some extent, ie covering your liver output and also helping to cover your food.
Your results look really good although a 4.4 before lunch today is perhaps a little close to hypo land for a more senior person (even if you don't feel it) so I would be a little cautious about reducing your meal time carbs without having the ability to reduce your insulin dose for that meal, which you can't really do with Glargine, because it works over almost 24 hours, but it might be worth discussing a very slight reduction in your glargine with your nurse which might then give you the ability to reduce your carb intake a little more.

It doesn't seem like you are eating too much though. Are you able to exercise a bit more to counteract the weight gain? As said, insulin doesn't specifically cause weight gain, it just allows your cells to access the glucose from your food which was previously making your levels high.

Were your levels very high when you were losing the weight?

When was your last HbA1c of 69 because your current results look like it is likely much lower now that you are on insulin.

 

[helli]

Your results look really good although a 4.4 before lunch today is perhaps a little close to hypo land for a more senior person (even if you don't feel it)

My parents would be offended by such a comment and they are older.
Age should not be treated as a number alone. It is what you do (and are able to do) which should dictate medical treatment not the number.
This happens at all sorts of ages - I am in my 50s and was very angry when told the fix to my broken arm would be “good enough for my age”.
That said, as I have no medical training, I do not feel qualified to tell someone of any age whether 4.4 is too low for them. It is not something I would be concerned about for myself.

Please be careful of any age discrimination.

 

[rebrascora]

I appreciate what you are saying @helli and I struggled with how to word it but the truth of the matter is that as we get older the risk from a fall whilst hypo becomes greater than the risk from a slightly higher BG and often slightly higher targets are suggested. When that happens should absolutely be individualised. The point I was really trying to make was, regardless of whether or not the OP was comfortable with a 4.4 before lunch, was that reducing her carbs at lunchtime when levels are that low pre lunch could risk dropping lower into a hypo after lunch, simply because the Glargine dose may well be covering some of the carbs from the meal.

@Pugfugly There was absolutely no offence intended and I am very sorry if I caused any.

 

[Pugfugly]

I do Aquafit twice a week and walk whenever I can. Do you think I should up my exercise level even more? I have lumbar spondylosis and an under active thyroid. I do get quite tired but always do my Aquafit as I realise it lowers my blood glucose. I take two Biscoff biscuits to have after my classes and before I drive home as I know I can’t drive if my blood glucose is under5.

 

[rebrascora]

That certainly sounds like a decent amount of exercise. I think if your weight is stable and you are not putting the weight back on that you have lost, then you have to decide how much you really want to lose those last few pounds and is it worth limiting your diet further for a relatively small gain, but if you do decide to reduce your carbs then you will need to consider insulin reduction, especially as your levels are getting towards borderline at times already.

 

[Leadinglights]

I do think it seems an odd decision to change your sitagliptin which induces the pancreas to produce more insulin for insulin if you were getting low blood glucose. Have you tried a regime with just metformin and diet as it is possible that you are being over medicated.
There are newer NICE guidelines that suggest a personalised approach to blood glucose management for more mature people where acceptable levels are more lenient as the risk of other problems like falls from too low blood glucose.

 

[louisew]

My parents would be offended by such a comment and they are older.
Age should not be treated as a number alone. It is what you do (and are able to do) which should dictate medical treatment not the number.
This happens at all sorts of ages - I am in my 50s and was very angry when told the fix to my broken arm would be “good enough for my age”.
That said, as I have no medical training, I do not feel qualified to tell someone of any age whether 4.4 is too low for them. It is not something I would be concerned about for myself.

Please be careful of any age discrimination.

My parents would be offended by such a comment and they are older.
Age should not be treated as a number alone. It is what you do (and are able to do) which should dictate medical treatment not the number.
This happens at all sorts of ages - I am in my 50s and was very angry when told the fix to my broken arm would be “good enough for my age”.
That said, as I have no medical training, I do not feel qualified to tell someone of any age whether 4.4 is too low for them. It is not something I would be concerned about for myself.

Please be careful of any age discrimination.

Yes I agree. I’m 60 type 2 on low doses of insulin, basal and bolus and I’m usually in the 4s before eating, which is also the within the range shown on the diabetes.co.uk website My diabetes nurse is very happy with my hbac1 of 5.3 and my TIR. I obviously make sure I’m at 5.5 before driving, but don’t drive much so not usually something I have to consider

 

[harbottle]

Hi, I’m on Metformin but have just started injecting Insulin. I have successfully lost four stone and am still trying to lose a little more. I weigh 10st. 11 pounds but since starting insulin I am struggling to lose any more. I am staying the same weight over four weeks. I need to be around 10st. 7lbs (still in the overweight category) but I’m happy to maintain at that weight. Has anyone else struggle on insulin?

It's a common side effect, the NHS has this info about it:

When you first start taking insulin you may notice that you start to put on weight. This is because of the way insulin works to use glucose from food to produce energy and store any extra as fat.

You might have also lost weight before your diagnosis, and so you might put some weight back on once your blood glucose is back within target.

If you're concerned about putting on weight, talk to your healthcare team who can advise on diet, lifestyle and adjusting your insulin dose as you change your diet.

Having a healthy weight and eating a balanced diet can help with symptoms of type 2 diabetes and gestational diabetes.

Common questions about rapid-acting insulin

NHS medicines information on common questions about rapid-acting insulin.

www.nhs.uk