Type 1 diabetics insulin dosage

[JoeJOns]

Hi,

I'm just wondering how much insulin you guys take per meal? I know it changes day to day but on the average day. At the moment I take about 6-7 units per meal as I am 20 pounds underweight and I was advised to eat more.

Also, I read that high amounts of insulin can also cause physical health problems? Is this true?

Thanks guys.

 

[Kaylz]

That completely depends

Are you still on set doses of insulin or do you adjust to suit the amount of carbs your eating in a meal?

most of us carb count and adjust to suit but then not everyone has the same insulin to carb ratio so will vary widely, I'm 1U:10g at the moment and the most I take for a meal solely is 4 units as my highest carb meal is 40g carbs but I may require half a unit more if I'm above my target or half a unit less if I'm sitting a bit low or have been pretty active

What physical health problems are these exactly?
xx

 

[JoeJOns]

I started off on 4 units of insulin to 40 grams of carbs, but I soon had to increase that to gain some weight.

That was pretty similar to the original plan that I was on. The problem was before going to hospital I lost so much weight and I have to put some back on so for the moment i'm doing about 5 units to 60 grams or 6 units to 70 grams because I am quite active at the moment.

Well I read about an association between high insulin, obesity and some forms of cancer etc. Now this might be total baloney but it concerned me slightly. Although I'm sure to develop these problems from high amounts of insulin it would have to be years of high insulin?

 

[Kaylz]

I was underweight too, my lowest being about 42kg, at 5ft 5 it wasn't great and I then suffered an eating disorder after diagnosis so was underweight for well over a year

Carbs doesn't have to be used as a way to gain weight as adding more may increase spikes in blood sugars if you don't manage to time the insulin correctly, instead why not try adding fats and proteins? if your not experiencing spikes then that's fantastic

insulin alone should not lead to weight gain if you have a healthy balanced diet and an active lifestyle, I think your reading a bit too much into it to be honest, if you were to go without your insulin because of what you were reading you would be here far less time than taking it, there are many people gone on to live 50+ years with Type 1 taking daily insulin xx

 

[Bruce Stephens]

Well I read about an association between high insulin, obesity and some forms of cancer etc. Now this might be total baloney but it concerned me slightly. Although I'm sure to develop these problems from high amounts of insulin it would have to be years of high insulin?

It's basically the food (and drink) that causes weight gain. There's an association with obesity and insulin because someone who eats a lot will need to produce more insulin, and also because excess weight is associated with insulin-resistance, and so (sometimes) with Type 2 diabetes.

It's not relevant to someone with Type 1 trying to regain a bit of weight, though. You can just eat a bit more, balancing that with insulin as necessary to keep your BG in range. (If you're eating more fat, protein, rather than more carbs, you'll likely not need much insulin for that.)

Our goal is to keep BG within range, and we have to use whatever insulin is required for that.

For what it's worth (and it's not worth much, since we're all different, and I'm at least borderline overweight), I take 15 units twice a day (so 30 in total) basal insulin and about 10 units bolus for each meal (about 5g for 1 unit, but it varies by time of day and depends on walking and things).

 

[JoeJOns]

I was underweight too, my lowest being about 42kg, at 5ft 5 it wasn't great and I then suffered an eating disorder after diagnosis so was underweight for well over a year

Carbs doesn't have to be used as a way to gain weight as adding more may increase spikes in blood sugars if you don't manage to time the insulin correctly, instead why not try adding fats and proteins? if your not experiencing spikes then that's fantastic

insulin alone should not lead to weight gain if you have a healthy balanced diet and an active lifestyle, I think your reading a bit too much into it to be honest, if you were to go without your insulin because of what you were reading you would be here far less time than taking it, there are many people gone on to live 50+ years with Type 1 taking daily insulin xx

Yes I tend to look into things a tiny bit much haha.

You were probably in a similar situation to what I am in now, how did you go about gaining some more weight? I will try add more fats and protein into my meals, just at the moment I'm having a few hypos a week so the carbs are keeping my blood sugars steady

 

[JoeJOns]

It's basically the food (and drink) that causes weight gain. There's an association with obesity and insulin because someone who eats a lot will need to produce more insulin, and also because excess weight is associated with insulin-resistance, and so (sometimes) with Type 2 diabetes.

It's not relevant to someone with Type 1 trying to regain a bit of weight, though. You can just eat a bit more, balancing that with insulin as necessary to keep your BG in range. (If you're eating more fat, protein, rather than more carbs, you'll likely not need much insulin for that.)

Our goal is to keep BG within range, and we have to use whatever insulin is required for that.

For what it's worth (and it's not worth much, since we're all different, and I'm at least borderline overweight), I take 15 units twice a day (so 30 in total) basal insulin and about 10 units bolus for each meal (about 5g for 1 unit, but it varies by time of day and depends on walking and things).

Insulin resistance is one of the things I am quite concerned about. But as a 130 pound, 5 foot 11, newly diagnosed, slightly malnourished man I am hoping that insulin resistance won't apply to me for a while! My main goal at the moment is to keep my blood sugars steady, ketones low, and to gain about 20-25 pounds

 

[Thebearcametoo]

I think at the moment the priority is to be in target for your glucose as much as possible and look at slowly adding some weight. The long. Term health issues with well managed T1 diabetes are much reduced with intense insulin therapy. There will be challenges through your diabetes journey but at the moment focus on your targets for next 3 months (or even just the next week) rather than worrying about beyond that.

 

[trophywench]

I lost a stone before I was diagnosed, so that was 12.5% of my body weight and I actually found that most of it just went back on as I gained proper control of the diabetes, so it took between 2 and 3 months, about the same length of time over which I lost it. Everything back then was full fat anyway be it the milk in drinks, or yoghurt and no low carb stuff on offer anyway - so I just carried on eating normally, which I still do.

I've always rather assumed that every 'diabetic complication' known to medical science will arrive together one day but if it does, I'll just have to deal with it then same as I've dealt with everything else life has chucked at me since I was born, rather than waste energy worrying about it in the meantime.

Much more productive and fulfilling using that energy to do stuff that interests me!

 

[Kaylz]

Yes I tend to look into things a tiny bit much haha.

You were probably in a similar situation to what I am in now, how did you go about gaining some more weight? I will try add more fats and protein into my meals, just at the moment I'm having a few hypos a week so the carbs are keeping my blood sugars steady

it took me over a year as I didn't have the mindset to add more carbs as that's what my eating disorder was, a fear of carbs after a fellow Type 1 said the problems I was going through were my own fault as I'd been eating carbs, I began snacking on low carb foods that didn't require insulin, so a boiled egg every morning, some cheese in the evening etc, these pictures were taken at my worst point around the middle of 2017 and I felt so weak but building the fats really helped me xx

 

[TheClockworkDodo]

Well I read about an association between high insulin, obesity and some forms of cancer etc. Now this might be total baloney but it concerned me slightly.

I suspect it's total baloney, like most things you will read about diabetes on the internet if you google enough 🙄 Or it might be that it's the other way round - insulin does not lead to obesity, but obesity can lead to high insulin resistance and this can lead to all sorts of other illnesses, but as an underweight type 1 this is not relevant to you at all.

There is certainly a myth going round that insulin use causes weight gain - this is not true. Taking fixed doses of insulin and then eating up to the insulin can cause weight gain (from eating too much), but when you are on MDI you can eat the amount you need to reach/stay the weight you want to be, and adjust your insulin doses to fit in with what you eat. You should not gain weight just by taking insulin (and in any case at the moment you need to gain weight, so you need enough insulin in order to eat as much as you need to get back up to a healthy weight - not doing this could lead to the sort of eating disorder @Kaylz had).

The amount of insulin you need is the amount you need - there's not a dose that's too high or too low or anything like that, there's just the right dose for you personally. The doses they put you on at first are a "best guess" and you may well need to ask your diabetes team about adjusting them over the first few months - after a while you'll learn to do this yourself whenever you need to. The doses you need will vary with lots of things - not just food, but exercise, time of day, changes in the weather, stress, whether you've had a hot bath, whether there's a b in the month ... . So only newly diagnosed people can really say "I'm on this dose" - most of us can only say "At the moment I'm on this ratio of insulin to carbs at this time of day". For me, this means I could end up taking anything from 2.5 units to 11 units, and it wouldn't bother me either way, I just take what I need for that meal on that day.

 

[DaveB]

Hi. I agree with much of what has been said already but when you say you are 20 pounds underweight is that thru following weight charts which are probably best ignored or by looking at yourself in the mirror and deciding how you want to look which makes sense.

 

[silentsquirrel]

I don't think many people would think 5'11'' and not much over 9 stone anything other than underweight!

 

[JoeJOns]

I don't think many people would think 5'11'' and not much over 9 stone anything other than underweight!

I agree with you. I am a walking anatomy chart at the moment but putting on weight quick enough

 

[Bruce Stephens]

at insulin use causes weight gain - this is not true.

My guess is that people with T1 are less likely to be overweight or obese. We're always on a diet, for one thing (though not usually a diet aimed at lowing weight). (Actually, weight loss diets tend not to work long-term, so maybe the diet thing isn't that important.) But we're necessarily a bit more aware of what we're eating, and we know we're going to be weighed and otherwise examined regularly.

More generally, there used to be a factoid that doctors with diabetes had a better life-expectancy than doctors without. (Maybe because doctors are more likely to abuse drugs, especially alcohol, but also maybe there's something about regularly seeing a doctor for your own health.) (I've no idea how true this factoid was (or is), but it seemed plausible.)