Question:
From Atlanta, Georgia, USA:
I am 21 and have been diabetic for 19 years. I consider myself a very active
diabetic. I recently went on the insulin pump and found my sugars a lot
easier to control. My question involves the effects of the pump on hunger
and weight gain. I have gained 14 pounds and have a monstrous hunger that
cannot be abated. This concerns me because I have not changed my eating or
exercising habits.
Answer:
Intensive therapy, such as the use of an insulin pump, will improve diabetic
control. With this in mind you need to remember that calories previously lost
as sugar in the urine are now available for use as energy or stored as fat.
When intensive therapy is started and weight gain of 10 pounds or more is
noted (and it's not fluid retention often seen with improved diabetic
control), your food intake may need to be reconsidered and calories reduced.
With a reduction in calories, the insulin dose may also need to be lowered.
A possibility that may have occurred: if an intensive
insulin program has been improperly designed (too much insulin), you might be "eating to
feed the insulin." What this means is that the insulin may have been lowering
your glucose levels too much and you needed to eat to bring them back up. If
this is the case a dose reduction in insulin should help you cut back on your
consumption of food.
Whichever the case may be, take time out to discuss your concerns with
your diabetes team in order to figure out
what is the best approach for you and your diabetes care.
PL
Original posting 26 Jul 97