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Question:

From Vernon, British Columbia, Canada:

My 20-year-old daughter has recently had unexplained weight gain. She has had type 1 diabetes since the age of 6 and has had an insulin pump since the age of 9. She is 5 feet, 7 inches tall. Her weight has gone from 126 pounds in december to 136 pounds. She is on a University track team, runs the 800 and 1500 meter and trains daily. Her last A1c was 8.2. She rigorously follows a strict diet of only about 1500 to 2000 cal per day. Her thyroid tests were normal (T3 slightly low). She is amenorrhic. She had this investigated by a OB/GYN two years ago and there were no concerns. She is extremely frustrated as this is affecting her performance on the track. Any thoughts?

Answer:

One of the frustrating things about diabetes management is the weight gain associated with good glucose control. Insulin is a drug that increases appetite and inhibits the breakdown of fat. While everyone would agree that good glucose control is important, there would be different opinions about the best way to get the weight to optimum levels. I would recommend seeing a dietitian that is familiar with diabetes and sees young people with type 1 diabetes. A food diary would be most helpful in quantitating calories, as well as reviewing healthy dietary practices. If intensive training is involved, it is possible to gain weight through increase in muscle mass. The dietitian would also be in a position to evaluate body composition and determine if there is an inappropriate increase in body fat. Since the goal is to have a happy, stable young adult, I would favor this approach over fad diets and crash programs that can result in loss of muscle mass and prove even more difficult with her athletic performance.

JTL

DTQ-20140321162950
Original posting 14 Apr 2014
Posted to Weight and Weight Loss

  
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Last Updated: Thursday May 01, 2014 11:28:09
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