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RE: [IPk] Turned Down!

At 06:13 PM 17/03/2003, you wrote:
>insulin on a pump and therefore there is some element of
>weight loss even without a reduction in food intake.  The
>main factor in my losing weight was however fewer hypos, the
>ability to skip meals (I often skip lunch or just have fruit)
>and the fact that it is so much easier to exercise.
>I know some people to gain weight.  This is thought to be
>because either they were used to having higher average blood
>glucose levels prior to the pump (which suppresses appetite)
>and therefore when they establish more normal blood sugar
>levels their appetite returns with a vengeance or that the
>ability to eat more or less what you want when you want is

While much of the above is true, I put on weight initially BOTH times I 
have gone onto a pump. This is because to get decent blood sugar control, 
you generally require more insulin; with more insulin and proper glycemia 
your body is able to process and metabolise foods properly, so you tend to 
add weight (previously you have had insufficient insulin and thus much of 
what you eat is not metabolised properly and is excreted as urinary sugar 
and other wastes). The article I referred you to previously does discuss 
this in more depth.

I would add, however, that once control is established properly, weight 
loss is very easy on a pump if you make a small effort, as you no longer 
have to "feed" your insulin, and you are able to adjust your insulin dosage 
so very quickly that you can maintain control while (theoretically at 
least!) not having multiple hypos!

One study I read about a few days ago (and can't find now!) looking at 
weight gain/loss with the start of CSII showed that about 60% of people put 
on weight, 10-20% remained stable, and the other 20-30% actually lost 
weight ... so it is by no means "inevitable" that you will gain weight! If 
you are motivated to test frequently (and by this I mean *around* 8 
times/day - I personally test anywhere from 6-16 times daily) and are 
capable of adjusting your basals and boluses appropriately, there is 
absolutely no reason you should gain weight at all. Studies and sites that 
will support your claim include:
http://www.geocities.com/Vienna/Strasse/5726/input/pumpreview/ (INPUT .. 
thank you John!)

Therre are lots more out there if you're prepared to search; I hope some of 
those are helpful!

I've recently lost 6.5kg in about 8 weeks, simply through testing, 
adjusting my food and exercise patterns, and varying insulin rates as 
appropriate. If *I* can do it, anyone can! And I can assure you that 
despite repeated attempts on MDI, I couldn't do it then, no matter how hard 
I tried.

Best of luck, Graham.


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