I have type 1 diabetes and am on the verge of being overweight. I exercise 30 to 60 minutes a day at least four times a week and watch what I eat. I seem to have a rise in my blood sugars after I eat breakfast and dinner so, then, I take extra insulin. Is the extra insulin making me fat? Could I have possibly developed type 2 diabetes?

You certainly should not hesitate to bring your concerns and questions to your own doctor and diabetes team.

You did not indicate your insulin dosages or your overall glucose control or other potential health issues or pertinent information. So, it will be difficult to best answer your question.

In broad general terms, exercise typically does LOWER glucose levels, in the longer term. Acutely, however, exercise can initially raise glucose levels. You may be “chasing” your glucose levels. Are you experiencing hypoglycemia? Do you chase lows with extra food? If so, do you pace yourself (for instance, by using the “Rule of 15:” give 15 grams of carbohydrates and then recheck in 15 minutes)? Tight glucose control and extra insulin can lead to weight gain.

People who are heavy can also become resistant to the effects of insulin. This insulin resistance commonly leads to more insulin requirements, which can lead to increased weight gain, etc., etc., and the cycle goes on. So, type 1 patients can acquire a “type 2-type picture.

In the largest picture of all, diabetes management requires the balance of insulin dosing-to meal planning-to exercise. Work with your diabetes team.

DS