Long time Type1 with new problems

[TooSweetForDiabetes]

Hi Everyone,

I have been a member for a while but usually do more reading than posting, however I would now like some direct advice.

I am 23 and have been Type1 since age 6. I take Lantus and novorapid and my HbA1C isn't great, been around 10 for the last 5years. Slowly over the last 5 years they just kept increasing my insulin dose so I was up to 46 lantus a day and about 26 novorapid. Over the last 12months as it has continued to go up so has my weight and I was told that if I actively tried to bring my weight down I may be able to reduce my insulin (never ending cycle). This did not work and my weight continued to increase as did my insulin despite eating healthy and exercising regularly.

I was advised recently that this was due to insulin resistance because I'm overweight (gaining 4stone in 12months) and a bit rubbish at carb counting. So in October 2012 I went on a DAFNE course. I thought this would reduce my HbA1C and help me to lose the weight gain from the last 12months....unfortunately it did not. So in January I was put on to metformin. At the same time it was suggested to me that my rapid weight increase may be influenced by being on the depo provera contraceptive injection so at the same time they put me on the implant.

So now I'm waiting to see the effects of both but the difficulty is I don't know which is helping exactly and I am getting some pretty rubbish side effects. My daily blood sugars are coming down although not following a great pattern and in three weeks I have lost 1stone. However I am also getting severe stomach pains, so bad that my food intake has dropped massively, I can't exercise as I feel constantly uncomfortable and my mood is all over the place with some very dark days. My GP told me last night that I should 'wait and see' as it was still early days but I'm worried.

Has anyone else had similar experience? Or can generally offer advice?

Thanks
Kate

 

[trophywench]

Hiya

Well - hard to tell - but metformin can cause upset tums, wind, diarrhoea .... is it 'SR' or ordinary release met, has the label got eg Glucophage SR on it? You ought to discuss this with your doc if it carries on, but usually if it is that it settles down after the first month-ish. And if it does, great, and you have the bonus of the weight loss, so capitalise on it!

I wouldn't stress too much about how much insulin you take TBH, you need whatever you need.

Once you have your tum sorted, then you probably need (well definitely) to do a basal test to make sure you are on the right dose of Lantus, and if you are or once you are, then you can start making headway with your carb ratios.

But tum first cos if you have a bug or something, then your BG will be all over the place, won't it?

 

[Caroline]

can't advise on most of it, but metformin is known to reduce your appetite and cause upset tummies for a while. If you are having too many problems or having too much discomfort it might pay you to ask for slow release metformin as it helps some folks.

I hope you getthings sorted and feel better soon

 

[Pumper_Sue]

Lot's of people say Lantus increases peoples weight, So perhaps worth researching that side of things as well. If you think that is the cause of your problems then consider asking for a different basal insulin.

 

[DeusXM]

However I am also getting severe stomach pains, so bad that my food intake has dropped massively, I can't exercise as I feel constantly uncomfortable and my mood is all over the place with some very dark days.

As others have pointed out, Metformin can cause (hopefully temporary) 'gastric distress'. It might also be worth considering the impact of the implant as well though. My girlfriend initially went on the implant but had it removed because she found it affected her mood and also gave her bad stomach aches (which were a prelude to menstruation issues). Not saying this is what is happening to you but it's worth remembering that not all issues will be directly correlated to diabetes.

What is your diet like, if you don't mind me asking? What many dieticians call a healthy diet for diabetes almost always tends people towards weight gain.

 

[everydayupsanddowns]

Lot's of people say Lantus increases peoples weight, So perhaps worth researching that side of things as well. If you think that is the cause of your problems then consider asking for a different basal insulin.

That was my thought too. Lantus has that reputation certainly, but obviously (this being diabetes) it doesn't work that way for everyone.

It would be interesting to see if you got the same (or possibly even better) results with 2 injections of Levemir a day (added flexibility of 2 insulin profiles), and what that did to your weight.

 

[bennyg70]

Hi Everyone,

I have been a member for a while but usually do more reading than posting, however I would now like some direct advice.

I am 23 and have been Type1 since age 6. I take Lantus and novorapid and my HbA1C isn't great, been around 10 for the last 5years. Slowly over the last 5 years they just kept increasing my insulin dose so I was up to 46 lantus a day and about 26 novorapid. Over the last 12months as it has continued to go up so has my weight and I was told that if I actively tried to bring my weight down I may be able to reduce my insulin (never ending cycle). This did not work and my weight continued to increase as did my insulin despite eating healthy and exercising regularly.

I was advised recently that this was due to insulin resistance because I'm overweight (gaining 4stone in 12months) and a bit rubbish at carb counting. So in October 2012 I went on a DAFNE course. I thought this would reduce my HbA1C and help me to lose the weight gain from the last 12months....unfortunately it did not. So in January I was put on to metformin. At the same time it was suggested to me that my rapid weight increase may be influenced by being on the depo provera contraceptive injection so at the same time they put me on the implant.

So now I'm waiting to see the effects of both but the difficulty is I don't know which is helping exactly and I am getting some pretty rubbish side effects. My daily blood sugars are coming down although not following a great pattern and in three weeks I have lost 1stone. However I am also getting severe stomach pains, so bad that my food intake has dropped massively, I can't exercise as I feel constantly uncomfortable and my mood is all over the place with some very dark days. My GP told me last night that I should 'wait and see' as it was still early days but I'm worried.

Has anyone else had similar experience? Or can generally offer advice?

Thanks
Kate

What is your diet like? One persons healthy is anothers not so. What is a couple of typical eating days in the life of Kate?

I went throught the same and believe a lot of the problems go hand in hand, Like you I was diagnosed young and had not great control for many years.

My Diet was terrible as was my lifestyle and I put on weight. My control was also out of the window.

However by truely changing my diet (Cut out all chocolate crisps, cakes biscuits and snacks. Started eating low GI foods, cut carb intake from 250g per day to 150g & Also my calorie intake overall from around 2500 to 1500 - 1800, cut down on drinking plus smoking - A real overhaul) and adding a little exercise (Mainly walking) I got a) My BG under control - Therefore making me feel more healthy, less mood swings, Less worry & Stress. And B) I lost 3.5 stone In little over year which has helped my blood pressure, my self esteem and my insulinr resistence and control even further.

 

[everydayupsanddowns]

What is your diet like? One persons healthy is anothers not so. What is a couple of typical eating days in the life of Kate?

I went throught the same and believe a lot of the problems go hand in hand.

My Diet was terrible as was my lifestyle and I put on weight. My control was also out of the window.

However by truely changing my diet (Cut out all chocolate crisps, cakes biscuits and snacks. Started eating low GI foods, cut carb intake from 250g per day to 150g & Also my calorie intake overall from around 2500 to 1500 - 1800, cut down on drinking plus smoking - A real overhaul) and adding a little exercise (Mainly walking) I got a) My BG under control - Therefore making me feel more healthy, less mood swings, Less worry & Stress. And B) I lost 3.5 stone In little over year which has helped my blood pressure, my self esteem and my insulinr resistence and control even further.

That's pretty inspiring stuff Benny. Hat's off to you!

 

[TooSweetForDiabetes]

Wow thank you everyone for the amazing feedback, all very helpful. Just amazing to not feel alone with this.

I had considered the side effects of metformin as there is a warning of stomach pains on the pack but I just felt that this was more than a bit of discomfort and wanted some other perspectives on how bad I should expect it to be. I am already on the Glucophage SR so maybe I'm being a bit sensitive, although had considered that the implant may be causing some sort of cramping which was mixing in and making the pain seem worse. I'm feeling more confident to stick it out for a bit and see if things settle and meanwhile look at the other stuff.

I had never been told about the influence of lantus on weight, (to be honest for years I was just told it was me being greedy and needing to do more exercise) so I will bring this up with my consultant. I do currently have lantus on spilt injection, at the moment it is 20 in morning and 18 in evening but not sure if levemir would be better. I have been advised that levemir may be useful due to how my blood sugar reponds after exercise as I end up changing novorapid ratios all day the day after exercise.

As for my diet it is pretty boring, I have 2 crumpets everyday for breakfast with margerine and then I have wholemeal ham and salad butty, a yoghurt, piece of fruit and crisps for lunch, then I have a tea which consists of 50-60g of pasta or rice with 200g protein and a portion of veg in dishes like chilli, curry, spaghetti bolognese, and tomato pasta dishes, then sometimes if I fancy supper I have soup. Weekends are a little different as I have more soup, salad or pasta dishes for lunch and usually have big Sunday Roast. I do have a weak spot for crisps and often might have extra bag between meals. However since starting metformin in Jan I have had crumpets, only sandwich and not managing full evening meal with no snacks due to reduced appetite and stomach discomfort. Is there any improvements I could make? I know cutting snacks is helpful but I don't really understand the whole when not to eat bread and stuff like that, so any advice would be great.

Thank you again for the help and your stories are very inspiring, hopefully I can see some improvements with a bit of guidance.

 

[bennyg70]

My initial advice would be if you have a smart phone get an app like my fitness pal.

You can look up foods on there / And scan barcodes and keep track of what you are eating through the day. Keep track of calories, fat etc consumed.

I did this and was surprised when adding up all those "Crisps between meals" and the odd slice of bread etc through boredom. How much I actually had. When I had an average figure. I challenged myself to reduce my intake by 10%. When I did this the hunger pains soon went, and I enjoyed the challenge. It also let me input exercise and this will deduct calories from your target. So if I got to the end of the day and Id hit my target but was gagging for a bag of crisps, I would get outside and go for a long walk, deduct the calories (Which it has preset in there) and then could have them and be under my target.. and If i felt good for having the walk and now felt i didnt need the crisps... Bonus. It e ncourgaed me to exercise, so I could "buy" more food credits in a way lol

So now the hunger pains have gone, and im eating 10% less.

Now I cut another 10%. And repeat the process.

It worked for me,a nd i enjoyed the challenge. It helped me cut out the snacks and all thoses added extras that really stack up through the day. I also learnt a lot about the values of foods, what was in them and what was better for me and worse.

For this to work you have to be commited, to entering all the data and not cheating.

 

[Northerner]

I would find an alternative to the crumpets for breakfast as they are quite high carb and most people have a particularly bad problem with insulin resistance in the morning, exacerbated by dawn phenomenon (the liver releasing extra glucose as you wake).

I would suggest trying Burgen Soya and Linseed bread, maybe for toast for breakfast and also for your sandwiches. It's lower-carb than most breads due to the soya flour content, and most people find it is kinder to their levels - it's also very tasty! 🙂

 

[LeeLee]

A quick comment about depo provera... I was on 12-weekly injections, but they changed me over to Cerazette (same drug but tablet form) when I hit 45 because the long-lasting versions can cause bone thinning. No side-effects or problems with the tablets.

 

[DeusXM]

Lot's of people say Lantus increases peoples weight

I'm intrigued to know where this claim comes from. I'm not disputing it but I'm wondering if it's come from a common misconception attributable to Levemir marketing.

When Levemir was introduced, Novo Nordisk made a massive deal about how Levemir was a new basal that didn't cause weight gain. Because it was released after Lantus, there was a perception that Lantus must cause weight gain. However, the studies from where Novo drew their claims from never involved Lantus at all. The comparison was with Insulatard. The irony is that Levemir actually has more of a peak than Lantus so on paper, Levemir should actually cause greater weigh gain because it has a peak that needs feeding whereas Lantus doesn't.

I know cutting snacks is helpful but I don't really understand the whole when not to eat bread and stuff like that, so any advice would be great.

From my perspective, you are eating a lot of carbs. What you need to remember is that all peaks in your blood sugar that aren't used as fuel immediately ie. through exercise are turned to fat. That's what insulin does - it removes harmful excess sugar from your blood by converting it to fat. A diet such as yours (where it looks like easily at least half of your daily calories come from carbs) will be very hard to lose weight on without a significant amount of exercise regularly throughout the day. Your evening meal is particularly problematic - it sounds like you're basically having either rice or pasta with something every day. This is a lot of glucose to dump on your body when presumably you won't be moving around a great deal. Better options would be things like grilled steak of chicken with plenty of things like broccolli and spinach, or salad. What you need to remember is that although they don't look it, bread, potatoes, cereal etc. are as far as your body's concerned, nothing more than bags of sugar.

 

[TooSweetForDiabetes]

Thanks guys, think I am feeling a bit more reassured. I know what to look out for and can get a big of a plan together so I'm not just worrying.

I'll try to get on top of tracking my food intake and exercise as well as bloods and injections and then I can give all that information to my consultant.

I'll wait out the pain, maybe just question if the implant is related and if there is anything I can take to relieve it a bit without interfering.

I'll let you know how I get on and if I find out anything useful which I can reflect back.

Thanks again everyone.

 

[TooSweetForDiabetes]

Sorry, more comments popped up whilst I was typin, I haven't ignored comments. So in response to extra ones, I wanted to add that I was considering better options for breakfast as I need something fast but filling, I'll try the alternative breads and see if that helps.

As for trying to reduce the heavy carb basis of my meals, I have always been a bit wary on this- daft I know but just the old diabetic in me still scarred by the repetitive advice that 'diabetics need carbs'. I think I need to be brave and try less carby meals. My only thought is that I often feel less full after these meals, so do you have any advise on how I avoid that (e.g. bulk out meals with veg?) or is it just in my head and something I need to get used to because my body will feel different with reduced carbs?

Also do you all think I should make one change at a time (e.g. change breakfat one week, then evening meal the next) to see effects or just go ahead with big change as it should be for the better?

Thanks 🙂

 

[DeusXM]

Also do you all think I should make one change at a time (e.g. change breakfat one week, then evening meal the next) to see effects or just go ahead with big change as it should be for the better?

Small gradual changes, every time. Not only are you more likely to stick with them, it means you'll be able to tailor your diet to YOU. Not to someone who gets all their info off a chart of averages, or a medical textbook that's ten years out of date. To YOU.

Plus, where a lot of people get caught out on this is by making too many changes, not accurately altering their insulin and then having massive hypos, so they get discouraged. Make your life as easy as possible!

I have always been a bit wary on this- daft I know but just the old diabetic in me still scarred by the repetitive advice that 'diabetics need carbs'. I think I need to be brave and try less carby meals.

It's perfectly rational for you to feel like this. If you've had diabetes for what, 17 years, you've probably been on mix insulins and something like Insulatard at one point in your life. These insulins DO need you to eat plenty of carbs. Lantus and Levemir are far more of a revolution in diabetes treatment than most people realise and the majority of medical training still teaches this idea that hypers aren't as bad as hypos (they are, just in a different and more long term way) so this info doesn't get filtered down properly.

You also have to remember that since the 1970s, diet advice has been focused on low-fat. Yet since we all started worrying about being low-fat, everyone seems to have suddenly got fatter far more quickly. There are many, many reasons why this is but a focus on low-fat diets and replacing fats with carbs may have a role in this, which brings me to my next point....

My only thought is that I often feel less full after these meals, so do you have any advise on how I avoid that (e.g. bulk out meals with veg?) or is it just in my head and something I need to get used to because my body will feel different with reduced carbs?

Add more fat.

I know, crazy, huh?

But fat and protein fill you up for longer. If you cut down on the carbs, unless you want to be starving all the time, you'll have to up your fat intake. Go with what's comfortable for you and remember, dietary fat does not automatically store as body fat. Worried about cholesterol? That's a reasonable worry, but there is a compelling theory that LDL and triglycerides levels (the bad stuff in cholesterol) decrease when there is less insulin circulating around. I'll level with you, I'm still not sure on this. I'm currently experimenting on myself - I've got my latest cholesterol results and at the moment I'm on a fat/protein/carb split of 60%/30%/10%. When I next get my bloods done I'm going to be interested to see what changes happen.

Another thing to remember is that your body likes carbs in same way an alcoholic likes a drink. They are theorised to be addictive and cutting back can shock your body (again, another reason to do this in stages). You also may have false signalling for appetite. A high carb meal will spike your blood sugar and it's this spike that can cause you to feel full and possibly lethargic. Cut out the spike and your body can get confused because it's not got what it was expecting. Once you've done this for long enough, your body is encouraged to go into ketosis (which is NOT DKA) and you'll start to feel fuller again. Don't feel you have to cut out all carbs and don't feel like you need to rigidly stick to this stuff 24/7 or you'll just go mad. Find what works for you and just keep an open mind about everything.

The end result of all of this (and it is a gradual process) is that you should hopefully reduce your insulin resistance, need to take less insulin AND you will lose weight. You'll also probably get a better A1C. That's the theory, anyway.

Your consultant will probably write this off as a fad diet. That's because they all assume reducing your carb intake means eating fry-ups all the time. It is not. It's about eating good quality meat and fish, fresh veg, avocados, olive oil etc. And for your breakfast, don't be frightened of eggs. If I make an omelette, I tend to not need to eat until late afternoon, which means by eating something that's supposedly bad for you, I actually eat less overall.

Make slow changes, adjust your insulin accordingly, test regularly. You'll find what works for you. Good luck!

 

[trophywench]

Well I always go back to this ..... I was 22 when diagnosed and had been watching my weight since I was aboiut 15. It was all about calories then, and balancing the 3 food groups.

Then I was diagnosed. They said What do you eat?

I told them. They went away and looked it all up (no puter progs then!) and the hospital dietitian pronounced my normal diet was properly balanced in all important areas. And included 110g carb. So they calculated my insulin regime round that and my height/weight. Because of the insulin in use then, I had to move a few carbs from mealtimes to in between meals as snacks.

When the modern insulins arrived and MDI I didn't have to have the snacks (unless I really wanted them ever) so basically I dropped 30g carb a day in one fell swoop. So I have 80 to 100g carb. I'm 5ft 4", about 55kg and size 10/12. Same as I was in 1972 give or take. I carb count in terms of what bolus I inject but otherwise don't really keep tabs on it that much.

I mean I saw some NHS guidelines that said I should eat 250g of carb a day. Well are they gonna buy me the size 16/18 clothes I'll need before Easter if I do that?

You NEED whatever you NEED. No more and no less!

 

[Music&InsulinSavedMyLife]

Hi Everyone,

I have been a member for a while but usually do more reading than posting, however I would now like some direct advice.

I am 23 and have been Type1 since age 6. I take Lantus and novorapid and my HbA1C isn't great, been around 10 for the last 5years. Slowly over the last 5 years they just kept increasing my insulin dose so I was up to 46 lantus a day and about 26 novorapid. Over the last 12months as it has continued to go up so has my weight and I was told that if I actively tried to bring my weight down I may be able to reduce my insulin (never ending cycle). This did not work and my weight continued to increase as did my insulin despite eating healthy and exercising regularly.

I was advised recently that this was due to insulin resistance because I'm overweight (gaining 4stone in 12months) and a bit rubbish at carb counting. So in October 2012 I went on a DAFNE course. I thought this would reduce my HbA1C and help me to lose the weight gain from the last 12months....unfortunately it did not. So in January I was put on to metformin. At the same time it was suggested to me that my rapid weight increase may be influenced by being on the depo provera contraceptive injection so at the same time they put me on the implant.

So now I'm waiting to see the effects of both but the difficulty is I don't know which is helping exactly and I am getting some pretty rubbish side effects. My daily blood sugars are coming down although not following a great pattern and in three weeks I have lost 1stone. However I am also getting severe stomach pains, so bad that my food intake has dropped massively, I can't exercise as I feel constantly uncomfortable and my mood is all over the place with some very dark days. My GP told me last night that I should 'wait and see' as it was still early days but I'm worried.

Has anyone else had similar experience? Or can generally offer advice?

Thanks
Kate

Hiya, I can't help much as I'm new to all this haha, but I would suggest going on the implant.

I am on Lantus and have been for over a month and *fingers crossed* I haven't gained any weight, unless I've lost it without realising! But I have been on depo injection for 3 years now, and I gained over 3 stone from it, unfortunately I can't go on the implant so have just had to stick with it, but definitely stick with the implant as personally I think it works best when you have diabetes - it gives you the most control from the two 🙂 From others, I know that it will be different form the injection, and may take a while to adjust, so I can understand him saying about waiting and seeing from that point of view. I haven't had good experiences with doctors, but if I was you I would stick with your guns and make them do something about it. It could harm you in the long run if they don't do something about it!