It’s popular knowledge now in America that the obesity epidemic has given rise to an epidemic of metabolic syndrome and type 2 diabetes. In other words, (with the right genetic predisposition) being fat can make you a diabetic.
What is less appreciated is that being a diabetic can make you fat.
If I were to characterize my diabetes care, I would say I aggressively treat to range. If I see my blood glucose (BG) start to rise, I bolus early, rather than waiting until I am actually high and correcting. I admit it– I prefer to run a little low rather than a little high.
The benefit of this aggressive treatment is that I can prevent some degree of hyperglycemia. The downside? I frequently have to correct on the other end– eating to bring my BG back up because I too aggressively treated a high. I correct usually with 5 – 10 grams of carbohydrates, in the form of dry crackers, or straight sugar if I’m below 60 mg/dL. (I don’t like glucose tabs much, and I try not to correct with foods I actually like because, as a diabetic, my relationship with food is screwed up enough as it is.)
I am fairly insulin and exercise sensitive at this point in my life, so I end up needing to correct frequently. On average, I end up eating about 40 grams of corrective carbohydrates per day. That’s 160 extra calories (ignoring for simplicity any extra non-carb calories the crackers contain) a day.
One hundred and forty extra, totally non-nutritive calories. And not enjoyed, either– it’s medicine, not food. Ugh.
To gain one pound, on average, a person needs to eat an extra 3,500 calories. At 160 extra calories per day, I will gain a pound about every three weeks. Over the course of a year, I will gain 17 pounds.
The way I treat my diabetes is making me fat.
So what are my options? The first and most obvious is to use less insulin, treat less aggressively, correct less. I’ve tried that, and apparently I’m not patient enough or clever enough to do that and not be high too frequently for my liking.
The second is to cut the excess calories out of what I would normally be eating to maintain my weight. That’s what I do, and it works, but it’s lame. That means I eat less real food, and get far too much of my daily caloric intake in crackers.
Of course, complaining that I dislike my source of calories is pretty clearly a case of First World Problems. But I live in the first world, and I care about my health, and eating tons of carbs in sugar is not the best thing for me, I know.
So what’s the solution, other than a cure and/or artificial pancreas that takes the burden of insulin dosing out of my hands? I’ll take suggestions.
In the meantime, my diabetes and I will continue to lock horns, as it tries to make me blind and fat, and I do my best to resist. I hate that bitch.
So you refusing to eat less food is making you fat, not the damn crackers. Holy shit.
I had some neck surgery and was determined to get my blood sugars in check and heal quickly. I went on the dexcom sensor and made huge improvements. I’m all healed now but 30 lbs. heavier. I exercise routinely but still have the weight. I brought this up with my doctor and we reduced my daytime bolus. I guess the body tries to match the amount of insulin in your system with body mass. I’m very good with my diet and have started to see very small weight improvements. This bolus change has also made my mealtime carb ratio more… Read more »
Very good post, and something I’ve dealt with too. My issue is eating the same breakfast pretty much every work day and sometimes I’m 200+ and other times 60- by 0900. I try to bring a banana or small apple/orange and eat those on the low days. of course that sometimes leads to eating more than 5 servings of fruit per day, but I like it better than chocolates or candy (or crackers!). Thanks for this and you other posts, very informative and insightful.
I felt like you were speaking directly to me. i was diagnosed 16 years ago. I pump, I’m aggressive. I eat very low carb. Â My reward is an a1c of 6 . But I’m FAT!! There seems to be no help in store for that.
I struggle with this constantly. I wanna go do a workout, but I’m too low, so do I eat something to raise my sugar so I can go on that bike ride or just say forget the exercise? Not too mention you overbolused for that meal and are having to eat something at 1am to bring your numbers back up. I work out roughly 6 days a week and eat better than the majority of America and still struggle with losing weight.
I’ve had a similar conversation with my endo because I cannot lose weight (fat) no matter what I do. I’m about 15 pounds overweight and can gain & lose muscle fairly easily. But it’s so irritating that being overweight is the price you pay for treating aggressively. Thank you for writing this post. The topic has been very frustrating for me for quite some time.
I hate that bitch, too! And I totally hear you on the diabetes weight bullshit. I was just calculating that I had ingested 600 extra calories via glucose tablets in a week and a half — and like you say, that hardly counts as enjoyable food. What’s more, I find it frustrating that insulin is essentially a message to your body to store fat . . . so it isn’t just that you ingest more calories to treat lows, it seems that the insulin itself that caused the low might also cause additional fat storage. (I asked my endocrinologist once… Read more »