# Really struggling with insulin and weight gain



## Christie11 (Jan 20, 2022)

Hi everyone. I'm new here and looking for some advice if possible please. I'm type 2, taking 100 units lantus per day, and 1.2ml victoza. My bloods are still crazy high - last Hba1c was 95!! The insulin I'm injecting just isn't touching the sides in terms of blood sugar control but what it is doing is piling weight on me. I have ballooned by about 3st since I started on it. My diabetic nursing team keep telling me to crank up the dose to control the bloods and are not listening to me about the weight gain. I'm consistently eating well, always in a calorie defecit, exercise generally every day, tried low carb, low cal, keto, slimming World, weight watchers but since I went on the insulin nothing is working. I'm at the stage where I'm ready to chuck the insulin in the bin and deal with the high bloods but I know that's not sensible. I seem to be very intolerant of other meds (tried metformin, empagiflozin, gliclazide, ozempic and all very bad side effects) hence I ended up on insulin, but given its a growth hormone its presumably blocking me from losing weight and encouraging me to gain it instead. Is there anything people can recommend at all that could help me? I'm really struggling mentally, I don't want to eat or take meds any more because I hate how I look and feel and this is all totally damaging my relationship with food in that I am analysing every little thing I eat. Its becoming all-consuming and I'm exhausted with it. Honestly any help would be amazing!


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## Inka (Jan 20, 2022)

Sorry to hear that @Christie11 I guess that you have a fair amount of insulin resistance so having to go on insulin has created a bit of a vicious circle. I know you say you’ve tried all the diets but have you tried a very low fat plant-based diet? It improves insulin sensitivity. I’m Type 1 so it’s a bit different for me but even then the diet improved my already good insulin sensitivity.


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## Inka (Jan 20, 2022)

You could consider trying a different insulin too. Not every insulin suits every person, so it’s worth considering a swap.

Are you able to post an average day’s food and blood sugars for you at the moment?


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## Christie11 (Jan 20, 2022)

Thanks for replying. I haven't considered low fat plant-based actually - do you have any examples of the kinds of meals you'd eat? I didn't realise it could help with insulin sensitivity. I'll check about a different type of insulin - I assumed they'd all be fairly equal but it's worth trying alternatives I imagine. 

In terms of blood sugar, I'm usually in mid to high teens. I've got a libre sensor so will see if I can post a screenshot. Meal wise, a typical day is maybe something like:
9am - plain Greek yoghurt with nuts and chia seeds, sometimes have a handful of Raspberries or Strawberries 
12.30 - soup (veg or lentil usually), or a Tuna salad
3pm - a snack like carrots and hummus/ 2 Babybel/ almonds/ small apple
6pm - usually lean meat like chicken with veg. If I have a carb it's generally no more than 2 tablespoonfuls
8pm - cup of tea and small snack like a fibre one bar/ packet of lentil Crisps/ couple of rice cakes

I'm not eating any of this in massive portions either. I feel like I'm being super restrictive and I'm seeing no benefit and just feeling totally miserable. 
Dietitian has said she sees no issue with what I'm eating and it seems balanced so I'm not sure what to think!


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## Inka (Jan 20, 2022)

Your diet does look really moderate @Christie11 I can understand why you’re so frustrated. As you’re in the high teens, I really wonder whether you might be better off on a basal/bolus regime. That would be a long-acting basal like you’re taking now, but also a fast bolus insulin to deal with your meals. I’m going to tag @Lucyr because she’s Type 2 on insulin and on a similar regime to what I’ve just described. I feel that big whack of Lantus might be worth replacing with a different basal, less basal and some fast insulin before each meal. You really aren’t over-eating so it must be so frustrating for you.

You’d have to check the meals because some of them contain pasta, etc, and might be too many carbs for you but most are veg and pulses. The amount of fat varies slightly in each. 

Will post some links later. Got an awake child calling.


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## Christie11 (Jan 20, 2022)

Thank you, this is so helpful! Honestly even just the acknowledgement that I'm not going mad and what I'm eating isn't crazy is great. I'm stuck in a cycle of blaming myself and finding it all so difficult and as much as I try to explain to family and friends they just don't get it! Any links would be great, thank you ☺️

I was always led to believe that more short-acting insulin was bad for weight gain so had avoided even considering that route but do you think the less basal would even it out?


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## Lucyr (Jan 20, 2022)

Basal and bolus is the regime i'm on, it gives you more flexibility with your meals because you can take insulin to cover them. It only leads to weight gain if you eat more calories than you're using up, because the insulin bringing your blood sugars down means you can use calories properly.

The other thing is that it is possible to be taking too much lantus, and to be having high bgs because your body pumps out extra glucose to meet the lantus dose. How long have you been on that dose? I'd think less lantus and adding a bolus insulin like apidra would be the next thing to try.


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## Christie11 (Jan 20, 2022)

Ah okay, that's good to understand. No one has ever taken the time to explain these things in any detail so I appreciate the help! I've been on that particular lantus dose about 2-3 months, prior to that was on 80 units a day and had been for about 2 years I think. I will definitely ask about the change of regime!


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## Lucyr (Jan 20, 2022)

You could also try a different basal if you wanted, to see if something else works better for you than lantus. However i often find drs only want to change one thing at once, so i'd personally ask for the mealtime fast insulin first and see how that goes and then ask to change lantus if still having issues. 

One thing you might come up against is a "mixed insulin" which for some reason Drs can often put type 2s onto. This is one insulin taken twice a day that includes both your long acting and fast acting insulin. I'd suggest deciding how you feel about this before asking for mealtime (fast acting) insulin, just in case it is suggested, so that you have your opinion ready. 

The "benefits" of a mixed insulin is that its only 2 injections a day instead of 4. The disadvantages are that you have to eat the same amounts of foods at the same time every day with very little flexibility. Personally that doesnt fit my life at all, and i'd rather have the extra injections and the extra flexibility that gives me to eat different foods at different times each day.


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## Inka (Jan 21, 2022)

Great advice from @Lucyr above @Christie11 I hope it’s helped you to hear from another Type 2. 

More short-acting insulin would only be bad if you ate too much. Short-acting would be more targeted to your meals rather than having a great ‘lump’ of Lantus sitting there that’s has to do two jobs. I think this is the problem - you have to take more than you need to enable it to attempt to control your after-meals blood sugar too.

I use an insulin pump, and when I went on it, I was told I’d probably lose weight. As I was slim anyway, I didn’t believe this, but I did lose weight. Apparently, this is because pumps only use fast-acting insulin and that insulin is targeted precisely.

The idea of the very low fat plant-based regime is that it’s animal fat mainly that causes insulin resistance, and thus cutting fat and in particular animal fat, improves insulin sensitivity. Some of the whole food plant-based regimes do allow occasional low fat meat and fish, but most don’t. Some are stricter than others with the fat, but they’re all low fat. 

There are a number of proponents and they’re mainly American so be prepared for that US style of writing, and for some awful pre-change diets full of processed foods. Take a look and get the general idea. There are studies that suggest a whole food plant-based diet is good for diabetes and other conditions. 

Forks Over Knives is a well-known one. You don’t have to pay as there are a number of recipes online. Also, your local library might have the book for you to borrow for free. You’ll see there’s lots of veg. There are a number of Diabetes Success stories.

How Not To Die by Michael Greger. One of my favourites. I’ve got his book and also his cookbook. Again, they should be in your library. The recipes are nice and he also has a Daily Dozen of things you should be aiming for. I believe there’s an app too. He runs a website called Nutrition Facts with free resources.

Joel Fuhrman He allows some low fat meat and is slightly less strict. He has a variety of books eg Eat To Live, and also has recipes on his website.

The Esselstyns - father (Caldwell) and son (Rip). Esselstyn senior is famous for promoting a very low fat diet to reverse heart disease, but has also got some information about diabetes. Esselstyn Junior is/was a firefighter and has his own range of books about plant-based eating and health. This success story gives an idea of what the diet involves.

Whatever diet you choose, I think a change of insulin and insulin regime could help. Obviously exercise is good too as that improves insulin sensitivity. I presume you’ve had checks to rule out other causes of your weight gain eg thyroid checks?


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## Christie11 (Jan 21, 2022)

Amazing, thank you to you both for the advice. I'll do my research on plant-based to see if its something that I could do, I appreciate all the info. I had no idea re. the fast-acting insulin not causing weight gain unless you eat too much so that makes me feel more comfortable looking at this option. Yes, had the usual tests like thyroid etc. and nothing untowards flagged up although was a while back so I'll maybe ask to get them repeated to check. Pretty sure it's the lantus though as I can see how my weight has gone up directly in line with when I increased my doses! It's trying to get medical professionals to listen that's most infuriating.


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