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[IP] gaining weight (long)

Pat asked the doc (which I am NOT, nor do i play one on tv)

> A1c went from 8 to 6.0 on the pump, so that isanother reason I 
> probably gained weight, but I justcan't understand that the MORE 
> careful I am the MOREweight I gain!!! I just keep slowly gaining! 

In MY experience, this is what I have LEARNED:

Basically, when you are on a your body gets USED to the insulin being there 
on a regular basis.  You have probably tweaked you basals and your carb to 
insulin ratio and think you have it down pretty good, and you must be doing 
something sorta right in someone's mind if your A1C is lowering...more 
importantly, I would ask, what are your daily numbers?  Are you going low, 
and I don't mean shaky, pass out, dont drive low...I mean, just that subtle 
feeling of UT OH, here I go....THOSE are the weight killers.  That may be 
when you are eating extra calories....and then you may even be bolusing a 
little to cover some of the carb you take in, if it is more than your low 
requires.  I know there are times (NOT RECENTLY) when I have eaten a package 
of Oreos to take care of a low (ok, i was depressed too, but that is a 
different story), and then had to take a billion units to keep my blood sugar 
from sky rocketing..I COULD have done it the old fashioned way and let my BG 
climb, pee out all those unwanted calories and not gain weight, but the 
taking of the insulin made it possible for the body to take what it needed 
and STORE THE REST AS FAT....now a package of oreos is a little extreme of an 
example, but hopefully you get my point.

Another idea is that your basals may just SLIGHTLY too high...and before you 
scream "my basals are good, i have basal tested," I would like to repeat, 
that your body gets USED to having insulin...if you are, on a daily and 
regular basis, giving yourself, say, 2 more units of insulin a day than you 
need, your body will adjust to that.  It will automatically REMEMBER that you 
ran a little low yesterday at about this time, so it will spit in a little 
more counter regulatory hormones which raise blood sugar, and so on and so 
on.  If your insulin to carb ratio is even slightly off, say you USE 15 carbs 
to 1 unit of insulin, but you are REALLY 17 carbs to 1 unit, you will be 
slightly over bolusing yourself at EVERY meal...You HAVE to eat up to that, 
or your body will get used to it and dump in hormones to keep it up.

The proof to me was in the execution.  I, too, felt my basals were damn near 
perfect, yet could not lose weight.  My CDE suggested some thoughtful cuts in 
my basal rates...not drastic, but going from .7 to .6 in some places, .6 to 
.4 in other places.  She also suggested I be very diligent (and not 
math-lazy) about bolusing at a 17:1 rate instead of the easier 15:1 rate.  
She said for about 2 weeks I might experience some higher blood sugars but 
that I shoudl treat them VERY conservatively  - ie not dropping the BG more 
than 40-50 points an hour...really sneak it down so the liver doesn't freak 
out by the huge drop and dump glycagen....So I did, and DID have higher blood 
sugars for a while...but stuck with the lower basal rates (MAINLY CUZ I 
be darned but my blood sugars went back to their normal range with the lower 
basal and more more accurate boluses

I even lost a couple of pounds!!!  I wrote down everything I ate and drank 
and every thing I did...when you are writing it down, it is hard to write 
"ate bag of fritos, while I watched Law and Order" - and you can't lie to 
yourself...I found it easier just to not eat the Fritos...or at least eat 
them on the life cycle WHILE i watched Law and Order...SINCE, of course, I am 
back to my lazy, slovenly 15:1 ways and my weight has crept back to its 
stable point (where i have been for 10 years) until i am once again 
motivated.....and today's fashions are NOT motivating me....

but anyway...just a thought, some experience and some suggestions...as always


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