I am a 45 year old male who has type�1 diabetes, and even though my hemoglobin A1c went from 11.2 to 8.3% in six months on the insulin pump, I am having trouble getting my sugars below 220 mg/dl [12.2 mmol/L] and with weight gain. I have increased my both my basal rates and my boluses with no change. Where can I find a diet that will work?

Prior to pump use, I took my injections in the stomach area for 15 years. Where are some alternate insertion sites?

One of the reasons for the blood sugar not going below 220 mg/dl [12.2 mmol/L] may be your injection sites. If you have lipohypertrophy in these areas, your insulin will not be absorbed normally. You can use areas on the hip. I have had patients use the legs or arms but these are tough areas to use. Have your physician or diabetes nurse check your skin sites and see if they are acceptable to continue to use.

If weight gain is a problem, I would suggest having your sugars reviewed so that any excess insulin can be eliminated from your regimen. There are no magic diets. It takes discipline and hard work over the long haul to have a positive effect. Exercise will have the effect to decrease your insulin requirements.

JTL