“Is it normal to gain weight while on an insulin pump?”
My daughter has type 1 diabetes and she just started to be on an insulin pump. She's 14 years old. However, after she started to be on an insulin pump, I noticed that she almost immediately started to gain weight. Like, 10 lbs. Is this normal?
5 Answers
Insulin is a growth factor and a hunger stimulus. It is not uncommon for patients to gain weight any time they are started on insulin (pump or injection) if they are not warned about it and watch what they're eating.
Yes, some weight gain is usual. Before the pump, she has not been using all her calories, but with the pump & better control she is using them and any excess is stored in the fat (weight gain). If she is not overweight, I wouldn't worry about it, but if she is becoming overweight for her height, then you may need to cut down on her calorie intake a little. Discuss this with your doctor & a dietician.
Good luck. I hope she likes her pump. I have worn one for 25 years & wouldn't take it off for anything. All the best.
Good luck. I hope she likes her pump. I have worn one for 25 years & wouldn't take it off for anything. All the best.
Side effects of insulin:
Insulin is a vital peptide hormone that controls blood sugars. When there is lack or absence of insulin a metabolic state known as diabetes takes place. Patients with type 1 diabetes have an absolute need for insulin not only to control blood sugars but also for survival. When insulin is deficient the body can not utilize its own glucose. When blood sugars are elevated >180mg/dl, they spill in to the urine (glycosuria)
Currently insulin is the only therapy for type 1 diabetes. All insulin treatment modalities can control blood sugars to a reasonable degree but can not mimic pancreatic insulin, because insulin is mainly given under the skin and is different in time, dose and place than the way the pancreas delivers insulin. Since insulin is given in the wrong place at the wrong time and in the wrong dose (that is under the skin) it is common to see high and low blood sugars in patients with type 1 diabetics on regular basis. There is no perfect blood sugars when some one is using insulin under the skin regardless of the mode of insulin delivery.
Before the diagnosis of diabetes or in poorly controlled diabetes the blood sugars are high and some of the blood sugars spill in to the urine. The kidneys are the major site of reabsorption of glucose so we do not lose calories. But when the blood sugars are above the kidney's reabsorption ability the remaining blood sugars is excreted in the urine.
The kidneys reabsorb glucose if blood sugars are <180 mg/dl. The 180mg/dl is the maximum threshold of kidneys ability to reabsorb the blood sugars. When a persons blood sugar is 380 mg/dl, the kidneys reabsorb 180mg/dl and the remaining 200 mg/dl is excreted in the urine. Therefore when blood sugars are poorly controlled the kidneys will only reabsorb up to 180mg/dl assuming that person is well hydrated. The extra sugar that spills in the urine is extra calorie the body loses. In the long run poorly controlled diabetes or diabetes before diagnosis, the person can lose significant weight.
When sufficient amount of insulin is given or diabetes is well controlled the kidneys stop spilling glucose and weight gain is common in the beginning. Once blood sugars are stable weight gain should not be an issue. This is also true with new onset type 1 diabetics. They lose weight before diagnosis and gain back the weight they lost in 2-3 months there after they will not have an issue with weight gain unless they are experiencing many low blood sugars and are eating more to correct the blood sugars or if they are defensively eating more to to prevent low blood sugars.
Patients on insulin pump are generally better controlled than the patients on injection. They may gain more weight until the blood sugars are stable. They may also experience more low blood sugars and they may be eating more to correct the low blood sugars. It is also possible some patients may eat more defensively to prevent low blood sugars. when extra calories are consumed for various reasons weight gain should be expected.
There are 4 different ways why some one on insulin therapy may gain extra weight:
1) When blood sugars are well controlled. If a poorly controlled person gets better control or when a new onset diabetes person starts insulin therapy, the kidneys spilling glucose in the urine stops. That may cause initial weight gain since the calories are no longer wasted in the urine. But eventually the weight gain should stop as blood sugars become stable, unless the person is eating more calories for various reasons.
2) Frequent hypoglycemia. When low blood sugars occur more frequnetly, more calories are consumed to correct the low blood sugars. This will cause excess calorie intake than what the body needs for normal growth. Weight gain is therefore common, if there are frequent low blood sugars reguirng frequent consuption of carbohydrates.
3) Defensive eating to prevent hypoglycemia: Many patients with type 1 diabetes fear of low blood sugars. Since they may have bad prior experience with the symptoms of low blood sugars they may defensively eat more snacks to prevent low blood sugars. This excess injestion of carbohydrates eaten defensively to prevent hypoglycemia may lead to extra weight gain.
4) Life style that promote more processed food consumption and sedentary life style: The general population is getting over weight. Children are also gaing more weight due to excess calorie consumption and lack of regular physical activity. Over 30% of children are over weight. Type 1 diabetics are not an exception. They follow the obesity trend of thier none diabetic counter parts in the general population. Regular planned moderate to vigorous physical activity and healthy balanced diet are vital to maintaining an ideal weight.
Prevention of Weight Gain: To prevent weight gain the following step can be taken as applicable.
1) Prevent frequent low blood sugars from occuring. Understand your nutritional requirements to only gain appropraite weght. Adjust your insulin and carbohydrate requirents to prevent low blood sugars and to avoid etra weight gain. Discuss your dietary and blood sugars goals with your nutritionist and diasbtetes educators.
2) Do not over correct low blood sugars. When blood sugars are low only it the amount of carbs that will correct the low bloood sugars. Consuming excess calories will lead to extra weight gain.
3) Avoid defensive eating to prevent low blood sugars. If eating excess carbohydrates defensively to avoid low blood sugars is done habitually, it will eventually lead to extra weight gain .
4) Do not skip meals: Skipping meals is not a good practice. Especially skiping breakfast is not a good idea. People that skip a meal tend to eat more in thier next meal. This will eventually lead to extra weight gain.
5) Excercise regularly: Reglar physical activity is recommendaded for all able children. Atleast 1 hour of moderate or vigerous physical activity is recommended for healthy cardiovascular system. Performing the recommended physical activity will also help maintain ideal weight. Diabetic patients should avoid sedentary life style and perform the recommended sports activity routinely.
Going back to your daughter:
Your daughter is gaining excessive weight after starting insulin pump. Insulin pump can lead to a better glycemic control. When blood sugars are better controlled little glucose spills in the urine. This may lead to some weight gain in the begining. However when blood sugars are well mantained the weight gain should not be an issue. On the other hand gaining 10 pounds in a short time is unusual, especially, if she is not newly diagnosed with type 1 diabetes.
You should look in to other possibilities why she is gaining excessive weight in a short time. You may consider the following senarios.
1) She may be experiencing frequent low blood sugars that require frequent eating to correct the low blood sugars. The consuption of extra calories to correct low blood sugars can lead to etra weight gain.
2) The insulin program in the pump may have been set higher than what the body needs. That is she may be getting more insulin than what she needs. If insulin is set higher in the pump, more carbohydrates will be consumed to minimize hypoglycemia. This can lead to extra weight gain. The insulin infusion pump basal, bolus and correction programs should be adjusted to prevent unnecessary hypoglycemia and extra carb consumption.
3) Defensive eating (snaching) to prevent hypoglycemia (low blood sugars): If she may be eating more carbohydrates as a defence against hypoglycemia from happening, she may be consuming more calories that may lead to extra weight gain. Defensive eating should be discouraged if possible.
4) Overcorrecting low blood sugars: Low blood sugars should only be corrected to a safe or desired range with out over-correcting them. Over-correction means eating more carbohydrates. These extra calories will lead to extra weight gain.
5) Skipping meals: Skipping meals especially breakfast is not a good practice. When meals are skipped we tend to eat more in the next meal. This can lead extra weight gain.
6) Consumption of more calories like the rest of the population: Obesity is on the rise. 30- 40% of children are overweight. This is becuase we are eating highly processed fiberless foods and food products. Most of our diet is fortified with high fructose syrups. Try to look in to this issue seriously. Make sure she is eating healthier natural foods high in vegetables, whole gain and fruits with some high quality proteins in moderate portion. You can look in to the Myplate method dietary guide recommended by the USAD.
7) Sedentrary life style: This life style generally leads to excessive weight gain. Children should have a planned daily physical activity. The physical activity should be over an hour a day with moderate to vigorous sports activity in a safe environment under an adult supervision. Performing the recommended physical activity routinely will prevent extra weight gain protect the cardiovascular system.
you should carefully consider the above senarios. There may be some other more causes of weight gain. You should discuss these essues with her nutritionis, diabetes educators and physician to figuire the cause of the excessive weight gain and get a solution to fix the problem. Gaining this much weight in a short time is not sustainable. The insulin or theinsulin pump is not a problem or the cause of any of this weight gain. Absolutely not. The problem is in the management of the diabetes. Focus on the management the diabets, dietary recomendations and physical activity. The pump is the best insulin delivery system available todate or until there is a cure for diabetes in the future. If the diabetes management is followed correctly weight gain should not be an issue. Please discuss these issues with your diabetes care team.
Good Luck.
Insulin is a vital peptide hormone that controls blood sugars. When there is lack or absence of insulin a metabolic state known as diabetes takes place. Patients with type 1 diabetes have an absolute need for insulin not only to control blood sugars but also for survival. When insulin is deficient the body can not utilize its own glucose. When blood sugars are elevated >180mg/dl, they spill in to the urine (glycosuria)
Currently insulin is the only therapy for type 1 diabetes. All insulin treatment modalities can control blood sugars to a reasonable degree but can not mimic pancreatic insulin, because insulin is mainly given under the skin and is different in time, dose and place than the way the pancreas delivers insulin. Since insulin is given in the wrong place at the wrong time and in the wrong dose (that is under the skin) it is common to see high and low blood sugars in patients with type 1 diabetics on regular basis. There is no perfect blood sugars when some one is using insulin under the skin regardless of the mode of insulin delivery.
Before the diagnosis of diabetes or in poorly controlled diabetes the blood sugars are high and some of the blood sugars spill in to the urine. The kidneys are the major site of reabsorption of glucose so we do not lose calories. But when the blood sugars are above the kidney's reabsorption ability the remaining blood sugars is excreted in the urine.
The kidneys reabsorb glucose if blood sugars are <180 mg/dl. The 180mg/dl is the maximum threshold of kidneys ability to reabsorb the blood sugars. When a persons blood sugar is 380 mg/dl, the kidneys reabsorb 180mg/dl and the remaining 200 mg/dl is excreted in the urine. Therefore when blood sugars are poorly controlled the kidneys will only reabsorb up to 180mg/dl assuming that person is well hydrated. The extra sugar that spills in the urine is extra calorie the body loses. In the long run poorly controlled diabetes or diabetes before diagnosis, the person can lose significant weight.
When sufficient amount of insulin is given or diabetes is well controlled the kidneys stop spilling glucose and weight gain is common in the beginning. Once blood sugars are stable weight gain should not be an issue. This is also true with new onset type 1 diabetics. They lose weight before diagnosis and gain back the weight they lost in 2-3 months there after they will not have an issue with weight gain unless they are experiencing many low blood sugars and are eating more to correct the blood sugars or if they are defensively eating more to to prevent low blood sugars.
Patients on insulin pump are generally better controlled than the patients on injection. They may gain more weight until the blood sugars are stable. They may also experience more low blood sugars and they may be eating more to correct the low blood sugars. It is also possible some patients may eat more defensively to prevent low blood sugars. when extra calories are consumed for various reasons weight gain should be expected.
There are 4 different ways why some one on insulin therapy may gain extra weight:
1) When blood sugars are well controlled. If a poorly controlled person gets better control or when a new onset diabetes person starts insulin therapy, the kidneys spilling glucose in the urine stops. That may cause initial weight gain since the calories are no longer wasted in the urine. But eventually the weight gain should stop as blood sugars become stable, unless the person is eating more calories for various reasons.
2) Frequent hypoglycemia. When low blood sugars occur more frequnetly, more calories are consumed to correct the low blood sugars. This will cause excess calorie intake than what the body needs for normal growth. Weight gain is therefore common, if there are frequent low blood sugars reguirng frequent consuption of carbohydrates.
3) Defensive eating to prevent hypoglycemia: Many patients with type 1 diabetes fear of low blood sugars. Since they may have bad prior experience with the symptoms of low blood sugars they may defensively eat more snacks to prevent low blood sugars. This excess injestion of carbohydrates eaten defensively to prevent hypoglycemia may lead to extra weight gain.
4) Life style that promote more processed food consumption and sedentary life style: The general population is getting over weight. Children are also gaing more weight due to excess calorie consumption and lack of regular physical activity. Over 30% of children are over weight. Type 1 diabetics are not an exception. They follow the obesity trend of thier none diabetic counter parts in the general population. Regular planned moderate to vigorous physical activity and healthy balanced diet are vital to maintaining an ideal weight.
Prevention of Weight Gain: To prevent weight gain the following step can be taken as applicable.
1) Prevent frequent low blood sugars from occuring. Understand your nutritional requirements to only gain appropraite weght. Adjust your insulin and carbohydrate requirents to prevent low blood sugars and to avoid etra weight gain. Discuss your dietary and blood sugars goals with your nutritionist and diasbtetes educators.
2) Do not over correct low blood sugars. When blood sugars are low only it the amount of carbs that will correct the low bloood sugars. Consuming excess calories will lead to extra weight gain.
3) Avoid defensive eating to prevent low blood sugars. If eating excess carbohydrates defensively to avoid low blood sugars is done habitually, it will eventually lead to extra weight gain .
4) Do not skip meals: Skipping meals is not a good practice. Especially skiping breakfast is not a good idea. People that skip a meal tend to eat more in thier next meal. This will eventually lead to extra weight gain.
5) Excercise regularly: Reglar physical activity is recommendaded for all able children. Atleast 1 hour of moderate or vigerous physical activity is recommended for healthy cardiovascular system. Performing the recommended physical activity will also help maintain ideal weight. Diabetic patients should avoid sedentary life style and perform the recommended sports activity routinely.
Going back to your daughter:
Your daughter is gaining excessive weight after starting insulin pump. Insulin pump can lead to a better glycemic control. When blood sugars are better controlled little glucose spills in the urine. This may lead to some weight gain in the begining. However when blood sugars are well mantained the weight gain should not be an issue. On the other hand gaining 10 pounds in a short time is unusual, especially, if she is not newly diagnosed with type 1 diabetes.
You should look in to other possibilities why she is gaining excessive weight in a short time. You may consider the following senarios.
1) She may be experiencing frequent low blood sugars that require frequent eating to correct the low blood sugars. The consuption of extra calories to correct low blood sugars can lead to etra weight gain.
2) The insulin program in the pump may have been set higher than what the body needs. That is she may be getting more insulin than what she needs. If insulin is set higher in the pump, more carbohydrates will be consumed to minimize hypoglycemia. This can lead to extra weight gain. The insulin infusion pump basal, bolus and correction programs should be adjusted to prevent unnecessary hypoglycemia and extra carb consumption.
3) Defensive eating (snaching) to prevent hypoglycemia (low blood sugars): If she may be eating more carbohydrates as a defence against hypoglycemia from happening, she may be consuming more calories that may lead to extra weight gain. Defensive eating should be discouraged if possible.
4) Overcorrecting low blood sugars: Low blood sugars should only be corrected to a safe or desired range with out over-correcting them. Over-correction means eating more carbohydrates. These extra calories will lead to extra weight gain.
5) Skipping meals: Skipping meals especially breakfast is not a good practice. When meals are skipped we tend to eat more in the next meal. This can lead extra weight gain.
6) Consumption of more calories like the rest of the population: Obesity is on the rise. 30- 40% of children are overweight. This is becuase we are eating highly processed fiberless foods and food products. Most of our diet is fortified with high fructose syrups. Try to look in to this issue seriously. Make sure she is eating healthier natural foods high in vegetables, whole gain and fruits with some high quality proteins in moderate portion. You can look in to the Myplate method dietary guide recommended by the USAD.
7) Sedentrary life style: This life style generally leads to excessive weight gain. Children should have a planned daily physical activity. The physical activity should be over an hour a day with moderate to vigorous sports activity in a safe environment under an adult supervision. Performing the recommended physical activity routinely will prevent extra weight gain protect the cardiovascular system.
you should carefully consider the above senarios. There may be some other more causes of weight gain. You should discuss these essues with her nutritionis, diabetes educators and physician to figuire the cause of the excessive weight gain and get a solution to fix the problem. Gaining this much weight in a short time is not sustainable. The insulin or theinsulin pump is not a problem or the cause of any of this weight gain. Absolutely not. The problem is in the management of the diabetes. Focus on the management the diabets, dietary recomendations and physical activity. The pump is the best insulin delivery system available todate or until there is a cure for diabetes in the future. If the diabetes management is followed correctly weight gain should not be an issue. Please discuss these issues with your diabetes care team.
Good Luck.
Hi!
I mostly treat adults with diabetes, but the basics would be the same. Insulin helps the energy from carbohydrates be used by the body by getting it into the cells instead of letting it sit in the bloodstream. In the bloodstream, extra glucose damages blood vessels, leading to the problems with neuropathy (nerves not getting good circulation get sick), and cardiovascular disease. Newer insulins and other medications and better understanding and monitoring have helped drastically reduce some horrible problems we used to see a lot more: blindness, amputations, heart attacks. So, getting the glucose out of the blood stream into the cells is a really good thing!
I mostly treat adults with diabetes, but the basics would be the same. Insulin helps the energy from carbohydrates be used by the body by getting it into the cells instead of letting it sit in the bloodstream. In the bloodstream, extra glucose damages blood vessels, leading to the problems with neuropathy (nerves not getting good circulation get sick), and cardiovascular disease. Newer insulins and other medications and better understanding and monitoring have helped drastically reduce some horrible problems we used to see a lot more: blindness, amputations, heart attacks. So, getting the glucose out of the blood stream into the cells is a really good thing!
Yes. Once diabetes gets better controlled, there is less sugar being excreted in the urine. If your kid's diet and exercise are not adjusted according to her sugars and insulin doses regulated in the pump, she will have weight fluctuations.
Thanks again for your email.
Dr. Sunil
Thanks again for your email.
Dr. Sunil
