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February 8, 2005

Type 2, Weight and Weight Loss

Question from New York,USA:

I've had type 1 diabetes for 45 years. Several years ago, I was also diagnosed with type 2 diabetes: Double Diabetes. I've been on an insulin pump for 10 years. Until recently, I had good diabetes control. I have no complications at this time. After being ill for almost a month, with two doctors not able to find out what was causing the illness (no infections, etc.), I suddenly became extremely insulin resistant. I now take one unit of insulin for each 5 grams of carbohydrate I eat. My one doctor suggested that I just continue to take more insulin. I'd like to find out what caused the extreme insulin resistance and then see if it can be reduced, so I don't have to take so much insulin. I also have had celiac disease for four years. I exercise every day, but still am unable to lose any weight, even doing 100 to 120 total carbohydrate per day. So, I need answers for getting the weight off and what I can do to beat the insulin resistance. My thyroid is fine. My doctor says eat lots less and exercise lots more. What do you think?

Answer:

In addition to what your doctor has told you, it would be important to make sure that there are no other medical issues causing the insulin resistance. This would include any additional medical problems such as infections, worsening celiac disease, or medications that cause insulin resistance. You need to make sure that your subcutaneous insulin injections sites are okay. Any lipohypertrophy or problems at the injection sites can cause a problem with efficient absorption of the insulin. Exercise causes glucose to be taken up more efficiently. In addition, weight loss will also improve insulin action. There are no painless ways to lose weight. It requires a plan and a way to see it through (with lots of support). I would suggest you see someone who is a diabetes educator to talk about some of these issues and for constructing your long-term goals toward weight loss with exercise and diet.

JTL