I just turned 17, have had type 1 diabetes since I was 11, and recently I switched from a very, very low carbohydrate diet (mostly protein, sometimes greens) to eating a balanced meal plan (fruits, vegetables, etc.). I am concerned because I have gained 15 pounds and my insulin dose is about five times what it was. Is my weight gain related to taking more insulin? Do I just need to work out a good meal plan? Are there general averages of how much insulin teenagers use?

Most teens at the end of their growth period need approximately 0.8 units per kilogram of body weight per day. Exact individual needs are very varied and depend a great deal on daily exercise, body build, type and quantity of carbohydrates and total calories. You should ask your diabetes team this question since they know you the best, and can give you an individual answer.

If calories are greater than expenditure over time, you will gain weight. This could happen if you suddenly improved your overall glucose control and did not cut back on the calories previously being wasted from high sugars (and glucose spillage). You should need more insulin if you go from a low carb to a high carb meal plan, but should be able to balance your overall control without weight gain.

SB