I have type 1 diabetes and have gained about 8 kg (17.6 pounds) in the last four to five years. Controlling my diabetes was quite easy the first few years, but after the third/fourth year, it became a lot more complicated. Since then, the way my body reacts to insulin is quite different from week to week and sometimes even from day to day. I started to need more insulin, but also experienced more hypoglycemic reactions, which is probably the reason why I gained weight. I am now on a diet, exercise seven days a week, have decreased the amount of insulin intake, but lose very little weight. I also have the feeling I have gained quite a few muscles and start thinking it is a bit too much. I have two questions: Do type 1 diabetics develop muscles more easily when exercising? I want to lose the fat, not convert it into muscles. Is it safe to exercise just after eating in order to be able to reduce the amount of insulin needed?

It is probably safe to exercise after eating so as to bring your blood sugar down, but it might be a bit uncomfortable. I would be concerned that the variability of the food you take in is contributing to the variability in the blood sugars. Are you counting your carbohydrates? If so, this will allow you to give your insulin as a ratio (1 unit for so many grams of carbohydrate) and allow you to consistent match insulin with food. Another thought is that your injection sites might vary a great deal. Use of the abdomen, with its large surface area and lack of change with exercise, is probably the best option for your injections. Just make sure you do not have any hard sites over the injection areas. Finally, muscle is more dense that fat. It weighs more than fat per unit volume. Most patients on an intense insulin regimen do have some degree of trouble with weight because the insulin has effects to lay down more muscle and fat as one of its hormonal effects. However, the alternative is to lose weight, have poor muscle function, and poor long-term glucose control.

JTL