Gator Bill

Q:

I've been an insulin-dependent type 1 since 1969 and an having a difficult time with my weight. I watch what I eat and exercise, yet in the last 5 years I have gained nearly 15 pounds and now weigh 190 lbs., which is too heavy. I take about 60 units of insulin per day. Any suggestions?

Amy Campbell

A:

It’s actually fairly common to gain weight as we get older. Weight gain can occur for a number of reasons, but one of the main reasons is loss of muscle mass which, in turn, slows down the metabolic rate, or the rate at which we burn calories. So, unless we decrease our calorie intake and/or step-up our level of physical activity, the pounds tend to pack on over the years. Having diabetes and trying to lose weight can sometimes be tricky, because cutting back on food and/or increasing physical activity can lead to low blood glucose levels. You then have to treat that low blood glucose with carb (and that means calories). If you haven’t done so already, you might consider meeting with a dietitian who is experienced in diabetes management (look for the “CDE” credential, which means “certified diabetes educator”). He or she can help you determine the right amount of calories and carbs for weight loss, but also give you guidance on how to adjust your insulin to limit swings in your blood glucose. Then, the second part of the equation is to examine your level of physical activity. In order to help you lose weight and keep it off, you’ll need to aim to be active between 60 and 90 minutes each day. That sounds like a lot, but you can break it up into shorter segments, like two 30-minute sessions each day. Make sure your exercise program includes an aerobic component like walking, bicycling or swimming, as well as a resistance component, such as using hand weights, a resistance band or weight machines. An exercise physiologist, physical therapist or personal trainer can help you design an activity program to help you meet and stay at your weight goal.