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From West Virginia, USA:

I'm 25 years old and recently diagnosed with Type 1 diabetes. During the past four months I have gained fairly tight control of my blood glucose levels through diet, exercise, and insulin injections. Prior to my diagnosis, I weighed 105 pounds. I am 5'4" tall. During the first three months of insulin injections, I gained close to 20 pounds. I now weigh 130 pounds and feel very uncomfortable and confused about this weight gain. I am eating a low-fat diet and exercising daily. Is this weight gain normal and is it possible for me to lose about 10 pounds?


It is very common for people newly diagnosed with IDDM to regain lost weight and sometime to increase beyond their previous levels. However, there's no doubt that insulin plays a key role in getting fatter and that, to same extent, our shape is genetically programmed. Your current weight is quite fine for your height and I would discourage you from eating a self-made diet or, perhaps worse, to attempt to lose weight without medical advice.

You didn't mention exercise and, although this has primarily very important benefits in terms of body fitness and psychological well-being, it obviously burns calories and therefore, at least in theory, you are more likely to increase your weight if you eat more after exercise or even normally. Speak to your dietitian at the diabetes clinic to ensure that you are currently eating the correct things - it would be a real mistake simply to eat a low fat diet.


Additional Comment by Dr. Lebinger

It is not uncommon to unexpectedly gain weight when improved control is obtained. The average weight gain in the DCCT study (Diabetes and Complication Trial) was 11 pounds in the intensively managed patients.

This can be very frustrating. I would suggest discussing with your physician whether or not it would be OK to slightly decrease your insulin dose. If your blood sugars increase, you could then try to decrease your diet or increase your exercise to lower the blood sugars.

You may be able to decrease your insulin dose if you decrease the proportion of calories from carbohydrate and increase the proportion calories from protein and/or fat even if the total calories remain the same. (Don't increase the total calories). This is because calorie for calorie, carbohydrates require more insulin than protein and fat. Too much insulin promotes weight gain.

Please make sure that you first discuss any possible change in insulin or diet with your physician.


Original posting 29 May 97
Additional comment added 8 Jun 97


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