Sorry for not being in touch but I’ve been busy with out-of-control diabetes, weight gain, exasperation and a frantic search for a way forward. On the latter, I think I found one.
My use of insulin used to be predictable. I used a similar amount of long-term insulin morning and night. The routine was reassuring, giving me a sense I was in control of T1 diabetes. But then something changed, and over the past year my body’s glucose has gone up and up, and I’ve required more and more insulin. This increase in insulin has been closely followed by my weight.
If you didn’t know already, insulin causes weight gain. The injections lower the glucose in the body by removing it from the bloodstream and converting it into fat. Diabetic people can get fat from insulin injections — how unfair is that?That’s why I resisted taking the long-term stuff for so long, preferring to get by on frequent doses of fast-acting insulin, which isn’t so bad for poundage. But then in February 2023 I landed in the intensive-care unit DKA, diabetic ketoacidosis. This is a condition that occurs from a starvation of insulin, and the body becomes too acidic. The doctor at the ICU said he understood my concerns about insulin-induced weight gain. He said that, yes, excess weight can lead to high blood-pressure, heart disease, sore joints and other ills. “But your body needs insulin and every other health concern you have comes second.”
With that, they injected me with the very insulin I didn’t want to have, and I cried. Over 18 months I gained 30 lbs and a chronic feeling of helplessness. If using insulin will keep me safe from complications of diabetes, what can I do to ward off all those other things that can kill me? Plus, I’m saddled with a sense of self-loathing, a result of growing up in a family where being fat brought shame and a sense of worthlessness. The message was always “being thin makes you worthy of love.”
Aside from that, my body decided to vary its glucose levels in a way that has had me increasing the insulin dose up and up and then having to drop it down and down. I’m faced with hypoglycemia and hyperglycemia. Neither is healthy. Neither makes for an A1C the endocrinologist will like to see.
When I started on the long-term insulin, I was on 24 units a day. Two weeks ago I was using 80 units a day, and I’ve gained at 30 lbs. I’m the heaviest I’ve ever been. I already eat low carb, but have occasional bouts of carb loading (emotional binging). I wear elastic-waist pants and baggy tops. I avoid looking in mirrors. I hate my body.
My options are limited. The insulin is required to keep me alive. I understand going without insulin will kill me within a week. But I doubt that would happen, since the good doctors at hospital will get a hold of me and stick me with needles. So how do I lose weight and regain a sense of control that I so desperately seek? My only choice is to return to fasting, something that has helped me so much in the past. Fasting never made me sick. I just have to watch my glucose levels like a hawk.
Fasting results in the increase of ketones, a kind of exhaust created when the body burns fat. Ketones and high glucose are a bad combination, and can lead to ketoacidosis. So I started fasting with the realization that I’ll be raising ketones in my body, so I have to keep my glucose levels low. Fortunately the Dexcom meter allows me to monitor my glucose, and I hear alarms that warn me of spikes.
So my fasting experience over the last two weeks has been different from the past. I’ve had to chew candy to keep the lows manageable, and occasionally inject fast-acting insulin to compensate for too much sugar. The weight loss has been slowish, but after a couple weeks I’m down 7.5 lbs. I’ve cut my required long-term insulin dose by half. It’s a start. Every marathon begins with a single step.
I stopped drinking alcohol one day 5 1/2 years ago. The reason I drank was an excess of shame, and the tool I used to stop was avoidance of that shame. It’s much the same with weight gain/loss. I know deep down people who care about me don’t judge me by my weight. It’s only me that does that, and I don’t know if I can ever change that. But losing a little bit of weight like I’ve done gives me a path forward through a diabetic maze that at times seems impossible to navigate. I see a glimmer of light at the end of the tunnel.
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