Tuesday, 22 July 2014

Nearly 4 stone gone in under 11 months. 2014-07-22

I was diagnosed with type 1 diabetes in 1988 after suffering the usual symptoms for about ten weeks.  Not good but quickly sorted with regular insulin doses and blood glucose monitoring.  But over the years my weight steadily grew and grew, from about 13 stone in my pre-diabetes form to 19 stone 2lbs in August 2013.

I had tried many ways of losing weight, two of which had resulted in some improvement.  One was having my heart broken which helped me lose a stone by not eating much at all.  Not very sustainable and not much fun!  The second method was by going on a DAFNE course in 2007 (Dose Adjustment for Normal Eating) which I would strongly recommend to any type 1 diabetics.  It teaches you to adjust your insulin to match the food your are going to eat, which doesn't sound revolutionary to me now but went against the teaching of the time when I was told to eat similar amounts of carbs at the same times of each day.

In the weeks after this course I lost over a stone but I found that as time went on the effort to maintain the rigid monitoring of blood sugars and carbs became difficult.  I got down to 17 stone 2 lbs but could not get any lower, partly due to losing the will to keep going when I was no longer losing any weight.

So my weight slowly rose and rose until it reached its peak in August 2013 at 19 stone 2 lbs.  Oh, the shame!  But what to do about it?  I had tried all the things I thought would be sustainable without success.

Me at my peak in August 2013 with George and Harry

Oh yes, I have to admit that exercise has never figured highly in my weight loss plan.  I always found that if I went to the gym or did a long bike ride I would burn off, say 150 calories, but my blood sugar would drop and I would need, say 200 calories worth of sugar to get it back to normal.  This was incredibly demoralising and resulted in me trying to do gentle exercise rather than vigorous.

So how to lose all this extra baggage?

I had heard that insulin was linked to weight gain and being particularly resistant to insulin meant I was taking very large quantities to keep my blood sugars stable.  At this stage I was taking around 30 units of fast-acting insulin per meal, with more to adjust as necessary, and 60 units of background insulin in two doses.  So this was probably an average of around 160 units per day.  So if I could reduce my insulin intake then I might reduce my weight.

The obvious way to do this was to reduce my carb intake.  I was only taking so much insulin to match the carbs I was eating.  Cut down the carbs and the problem should change.

Of course I couldn't have done this before going on the DAFNE course.  Previously I was advised to take a fixed amount of insulin for each meal and eat the right amount of carbs to match it.  Although I never stuck to it rigidly, DAFNE gave me the knowledge to vary from it.

So I cut out most of my carbs.  This meant eating basically the same food as before but skipping the carbs.  So meat, potatoes and veggies were just meat and veggies.  This really suited me- if I needed to eat more I just had a larger portion of meat and veg.

So at the end of August 2013 I started on this new regime and the weight just seemed to fall off without much effort.  I dropped from 19st2 to 15st12 by mid February 2014.  It felt so good!

I lost a further couple of pounds but then found that I wasn't losing weight any more.  As far as I was aware I hadn't changed my routine but I stayed at 15st10 to 16st1 until I realised the problem was that my carbs had crept back up.  I had been eating the occasional bit of fruit, the odd roast potato and the odd small bag of crisps.  And as my weight came down my requirement for my background insulin was dropping but I hadn't reduced how much I was taking, meaning I needed to take in more carbs to adjust my blood sugar levels.

So I started again in June at 16st0, this time trying to keep to the Atkin's Diet guidance of 25g net carbs (carbs less the fibre content) per day, but of course taking in extra carbs to balance my blood sugars as needed.  I didn't worry about keeping track of the actual number of net carbs as I felt that it was best not to hold back on salads and veggies as long as I avoided the higher carb ones (sweetcorn, potatoes, etc.).

Today (22 July 2014) my weight is 15st3.  That's a loss so far of 3stone 9lbs, 55lbs or about 25kg.  I had a glitch when I wasn't losing any for a couple of weeks but I realised that my background insulin needed to drop again.  Now I take 14 units twice a day and no fast-acting insulin.  From 160 units to 28 units per day!

At the moment I am still obese, apparently (BMI>=30).  At 14st13 I become just overweight (BMI<30) and at 12st6 I become a 'normal' weight (BMI<25).  This is my provisional target but what I really need to get to is a waist measurement of half my height.  I find it difficult to measure my height accurately but I seem to be 178cm high (5'10") nowadays so my waist measurement needs to get down to 89cm, which is 35".  That's what really matters!  So far I'm down to about 45.5" so have quite a way to go, especially as I think my waist was about 52" at its peak.  But it seems that the weight round the middle is the hardest to shift.

So all is going well so far.  Let's see how it goes from hereon!