What to Know About Type 1 Diabetes and Weight Loss

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Losing weight with type 1 diabetes is not a simple task. The juggling act of simply living with type 1 diabetes could sell a few hundred tickets at the circus. Adding weight loss to that impressive performance is worthy of applause. Here are 10 need-to-know facts and tips to help you with your weight-loss endeavor.


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Insulin isn’t the only crucial hormone you’re not producing

The other hormone people with type 1 diabetes don’t produce is called amylin. Along with insulin, beta cells secrete amylin, a hormone that regulates the rate at which food digests. Without amylin, it means the carbohydrates you eat are being broken down far more quickly — and raising your blood sugar more quickly. That, in turn, means you require more insulin for those carbs. This makes weight management more difficult, too.


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Nutrition is key!

This is true for everyone but it’s especially true for those of us with diabetes: the largest contributor to your weight loss or weight gain is what you eat. Going to the gym regularly can’t compensate for a diet that is full of junk or too high in calories overall. You don’t need to follow an extreme diet to get results. Just start with the basics: real food, real cooking, and lots of vegetables. Look for resources on “clean eating” to get started. Like they say, “Abs are made in the kitchen!”


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Don’t try to eliminate all carbs

If diving headfirst into a ketogenic diet appeals to you, give it a whirl. But if you find yourself struggling and binge-eating carbs at night after the first week, it might be more effective to focus on a reduced-carb diet rather than an extreme low-carb diet. Reducing your carb intake from 200+ grams a day down to 100 grams per day will undoubtedly help your weight-loss goals without leaving you feeling deprived and desperate.


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Walking burns the most fat and the least sugar

You don’t have to go nuts at the gym to get results. People often think intensity is what determines fat loss. Jogging actually burns more glucose than body fat because your heart-rate is consistently above 130 bpm, making it impossible to get oxygen to fat cells. When walking, with a heart rate below 130 bpm, your body is able to better utilize fat for fuel. Tip: Try walking in the morning before breakfast when your body is still fasting and thus still burning fat, not glucose, for fuel.


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“Intermittent Fasting” can be done safely with type 1 diabetes

The daily fasting schedule that suggests skipping breakfast and not eating lunch until 1 or 2 p.m. is actually ideal for type 1 diabetes. You’ll only go low if your insulin doses aren’t accurate and need fine-tuning. By fasting, your body continues to burn fat for fuel. Ideally, you’ll wake up and start your fasted morning with an in-range blood sugar. Monitor your numbers closely the first few days you try it to determine if your basal insulin needs adjusting.


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Your insulin needs will drop immediately—before you’ve even lost a pound

The moment you start to eat healthier foods and getting more exercise, your basal insulin needs will need a reduction. What you eat doesn’t just affect your meal insulin doses, it affects your entire day’s worth of insulin. Switching from regular pizzas to lean meat and vegetables will mean your body isn’t working so hard to digest incredibly heavy, greasy meals that cause a great deal of insulin resistance. You’ll see the results in your insulin needs quickly.


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Your insulin needs will continue to drop, with every few pounds you lose

Even losing three or four pounds can mean your basal insulin doses need to be reduced (with the help of your CDE as needed) by one unit or two. If you notice you’re suddenly having a lot of low blood sugars at different times of the day, this is a sign that you’re making progress, and it’s time to reduce your insulin. It’s a good thing, but it requires some tedious fine-tuning and patience. Your body is simply becoming more sensitive to insulin.


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Fix the lows, then fix the highs

The hardest part of losing weight with diabetes is balancing your blood sugar. Every time you’re low, you have to eat. Every time you have to correct a high, you’re taking more insulin that may be storing that extra glucose as body fat. The more balanced your blood sugars are, the more effective your weight-loss efforts will be. Start by reducing the lows you’re having, suggests Gary Scheiner, CDE. Once you’ve adjusted your insulin to prevent frequent lows, then focus on preventing the highs.


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Plan your “treat day”

You’ve probably heard it before: willpower is not an unlimited resource. If you try to be 100 percent perfect all the time, the result may be more damaging to your goals than simply planning for some imperfection. Depending on your current relationship with food, eating one treat in moderation might be an everyday goal or a once-weekly goal, for example. Think about what feels like the right schedule for you now. As your new lifestyle becomes easier, that “treat” schedule can change, too.


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It can take a while to lose the weight

Weight loss isn’t easy for anyone, so adding type 1 diabetes onto that challenge only makes it trickier, and, sorry to say, sometimes longer, too. Because of everything you’ve just read, weight loss for those of us with type 1 is simply a slower process. Remember to think about this journey as taking months, not days or weeks. Sometimes avoiding the scale and just focusing on your actions and habits is the way to go.