#580 Diabetes Variables: Weight Change

November 19, 2021Scott Benner

Diabetes Variables: Weight Change

Scott and Jenny Smith, CDE share insights on type 1 diabetes care

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello, everyone, and welcome to episode 580 of the Juicebox Podcast.

Hey guys, welcome back to another diabetes variables episode with me. I'm Scott and Jenny Smith. Jenny, of course, works at Integrated diabetes. And you can hire if you'd like at Integrated diabetes calm. The diabetes variable series has been going over listener submitted variables for type one diabetes, and today's topic is weight change. Maybe put on a little tick off a little gain muscle lose muscle, that's a variable for diabetes. And in a moment Jenny and I are going to talk about all of that. But for now, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan are becoming bold with insulin. My friend Jenny Smith has had type one diabetes for over 30 years. She holds a bachelor's degree in Human Nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator and a certified trainer on most makes and models of insulin pumps and continuous glucose monitors. And if that's not enough, she's one of the kindest people I've ever met.

This episode of The Juicebox Podcast is sponsored by trial net. Are you wondering what trial it is? I will tell you trial on it is a risk screening for type one diabetes. It is available at no cost to the relatives of people who have type one diabetes. Here's who's eligible are you between the ages of two and a half and 45. And have a parent brother sister or child with type one you are eligible? Are you between the ages of two and a half and 20 and have an aunt, uncle cousin grandfather, niece, nephew, half brother half sister with type one, then you're eligible? Have you tested positive for auto antibodies outside of trial net? Now then you're eligible trial net.org forward slash juicebox. Now once you get the you go to the website there, right you do a little typing you do everything. You have options about how to get screened, you can do an in home test kit. This free kit provides everything you need to collect a fingerstick blood sample from the safety of your home. And then you can just ship it back in a free FedEx envelope. Contactless pickup, ooh. You can use contactless pick up with FedEx contact less means no talking to anybody. Okay, sorry. So no test get I've got a little away from I saw, I was like fancy, I could just leave it outside, I'll come get it. In home test kit, you could also use a lab test kit, which would mean you would take the free screening kit that trial that sends you to a Quest Diagnostics or LabCorp lab, and they'll handle the blood draw and take care of everything. Or if there's a trial in that location near you, you could just go there. And no matter which of those processes you choose, this is what happens next, you get your results, you will receive your screening results in four to six weeks. If your results show that you are an early stages of type one diabetes. Trial net, we'll schedule a follow up visit to see if you're eligible for a prevention study. And remember what all this cost you nothing. It's free. It's really free. I swear to whatever you swear to put up your hand, hold your hand on something else. I swear to tell the truth the whole truth about Tron it's free trial net.org forward slash juicebox. Here's the thing. If you want them to know that you came from me, there's a checkbox while you're going through the process. You have to tell them I heard about this through the Juicebox Podcast it's I think it's just a drop down box, you choose Juicebox Podcast, then you have to follow through and send in your test. So don't just get the kit from them and sit on it and think Oh, I hope the podcast you didn't they need to get your test back before I get credit for you as a participant trial net.org forward slash juicebox. My family use trial net many years ago for my son and we've always been grateful for the information that is sent back to us. If you're not sure if you want to do it or not, I understand. But I would check it out trial net.org forward slash juicebox. Alright, I appreciate you listening to all that I'm really trying to help try and like get the word out about what they do and of course that they're free. So I appreciate your listening. And now we'll get to the episode with Jenny and I no ads rest of the way. I'm gonna start with weight change as everyone knows by now, you know listen to the podcasts and in like 150 different variables that they find that impact their blood sugar's weight change was one that was brought up by a number of different people. And I think it's something that gets lost that people don't don't see. I see it mostly when people are talking about Children, because their kids gain weight. And they don't notice it. But doesn't everybody gain weight? not notice it? Really? You don't I mean, like, you know, I'm saying like, colloquially like we don't, most of us don't know when we put on five pounds at

Jennifer Smith, CDE 5:15
first. True, yeah, unless you're really the person who is very much on top of like, I weigh myself every single Friday morning when I get out of bed with no clothes on.

Unknown Speaker 5:26
Like, I have to have this weekly, weekly weight sort of check in.

Jennifer Smith, CDE 5:31
So yeah, I would say even five pounds is kind of hard to feel a difference on your body. I think the biggest shift in terms of noticing is like how your clothes are fitting. And that also then means that it's kind of where did the weight goal to go more around your waist? Your pants are harder to button now? Did it kind of get distributed evenly through the course of your whole, like all the fat cells in your body? And maybe you're really not visually seeing the five column weight gain. But we changes affect diabetes? As a general statement? Yes.

Scott Benner 6:07
So where do you think it affects first Basal is that

Jennifer Smith, CDE 6:13
from a if we're talking true weight change in terms of fat weight gain, right? Not muscle fat, not muscle weight gain, but fat weight gain, then metabolically, you would think you would see the change in Basal first. Now if you're somebody that hasn't really had much precision around like mealtime, dosing or whatnot, you might also start to see more excursions around meal time than you did before. But also that could be that there's not enough Basal behind it too. And so your Bolus is just are covering as well as they were before too. So Basal first,

Scott Benner 6:55
I was just delighted that you use the word excursions for oh, I don't know why. I just she means when things get upside down at mealtime. Why is my blood sugar 240 All of a sudden? Yes. I love the use of that word, it really took me by surprise. Are you saying that if I like yoked up and put 20 pounds of muscle on it, the impact would be different or different

Jennifer Smith, CDE 7:25
how because remember, the more muscle that you have on your body, typically speaking, the more muscle you have. Muscle needs to be maintained by the body. And as such, muscle gain means a higher metabolic turnaround. It means that you use energy more efficiently that somebody who weighs the same amount, but is more fat weight than muscle weight. So typically, we would expect that the more muscle gain you have, you would have more sensitivity to insulin. To maintain that weight, you also probably have a pretty regimented exercise plan, both some cardio, some resistance, some, you know, weightlifting, whatever is in the mix. So all around heavier weight increase in the body, whether it's toning and definition and muscle build or like body building muscle, you would expect that your insulin needs may metabolic Basal wise go down because you're burning things and using insulin better.

Scott Benner 8:32
Okay. So just being healthier, in general, can require less insulin, because of what it infers not only the way your muscles work in your body, but you're probably eating differently or working out differently than even a person at your same weight. Who's more sedentary? Correct, got it. Okay.

Jennifer Smith, CDE 8:55
And I think along with that, you can kind of, you can actually see a pretty quick turnaround in difference. Let's say that you're a person who exercises pretty much every day, like at least 30 to 45 minutes of some type of movement that is designated in a time period, right. And let's say you have a week where you are not sick, but just things have gotten so busy that you literally just can't even get out the door and go do what your normal thing is mid to end of that week, you may definitely notice the difference in no exercise compared to the sensitivity you were seeing when you were regularly day after day or every other day, moving your body

Scott Benner 9:38
and that'll you'll notice that by your blood sugar's rising in general,

Jennifer Smith, CDE 9:41
right and less response to insulin in the way that you had been experiencing comparative to in a more sedentary, okay, setting.

Scott Benner 9:51
So, so more I guess let's look at kids for a second is the similar idea with kids gain weight. Then as their growing parents kind of don't notice. And then they suddenly nothing's working. So there's nothing really different here. Right? If your child gaining weight or or an adult, I mean, is it that the similar?

Jennifer Smith, CDE 10:12
Well, I guess not so much. But in a kid, remember, if it's healthy weight gain because of normal growth pattern, it's what would be expected in terms of where they are, in age or in life, their gain is for a, for a real reason, they're growing. So they may be growing right, gaining weight, and then they may grow in height as well. Kids usually grow out, grow up, grow out, grow up. And so with growth, usually, you'll see those typical things which we've talked about in terms of like, increase in insulin during those growth periods and whatnot. But then usually with growth, that has been a weight gain, and the increase in insulin need will be sustained. Because they've gained some weight. I mean, kids usually don't go from one week weighing 42 pounds to the next week weighing 52 pounds. I mean, that's, that's excessive gain, right? There's something wrong.

Scott Benner 11:14
What about, let's, let's say we have an adult who's, generally speaking, is that a weight that they they wish wasn't so and there, they go about losing weight, but they do it? Let's just for an example, let's say they do it in an unhealthy way. It's not, it's not about exercise, they just stopped eating or something crazy, okay, and then they're losing weight, will they see it? Will they see a decrease in their insulin needs, because you're not adding exercise, you're not adding good food, you just just the dwindling of body mass?

Jennifer Smith, CDE 11:46
Absolutely, they'll see a difference. I mean, their mass their body mass has gone down, they will metabolically require less insulin, unless the weight loss is such a stress on the body. Enough of a stress kind of like an illness, they stress that the body is really like, bothered by this loss and struggling through it, especially in I mean, you brought up like just stopping eating or dwindling, the amount that comes in to a considerable amount. Again, that could be a significant enough stress that while insulin needs will go down, because of the weight based shift, they the stress on the body may make it look less significant. Again, these are like assumptions around a scenario,

Scott Benner 12:29
right? No, I just wanted to paint a picture because I because I'm a little afraid that this episode really should be, hey, when your weight shifts, your insulin needs are going to shift shift. Yeah, yes. And then the music plays at the end. And we say goodbye, like so. Yes. Yeah. I just wanted to

Jennifer Smith, CDE 12:45
I mean, that's in a nutshell. Absolutely. That's it? Yes.

Scott Benner 12:50
I just wanted to give some contextual ways that people might see it in their real life. So that it's not just so simple as hey, if your weight shifts, because I think it's possible people don't notice that as much even great stunning when you don't notice it on your own kid or yourself. I mean, especially on yourself, if you're a person living with type one. I mean, or if you're, you know, you don't notice people you live with people you live with are the last people to ever notice that you've gained because they see you every day, there's no way for him to tell whatsoever. I will like walk down stairs, sometimes I'll be like, Yo, anybody want to notice like, but I look better? If you notice how, like, flatter my chin is or like anything and like, No. So then you think, well, what's the point? They just seem to be the same

Jennifer Smith, CDE 13:35
point should be for your own self benefit should have nothing to do with others. Right. But I think you know, as a variable, which is what this really is right? weight change as a variable. I think you bring up a good point in terms of excuse me, if you've looked at so many other things, as Why are my insulin needs so much higher? Why does it look like I'm so much more sensitive? Maybe is it? Have you stepped on the scale lately?

Scott Benner 14:03
Yeah, maybe you just don't know what happened. What's happening, right. Okay. All right. Great. Thank you.

Yeah. Let me thank Jenny. And I'd also like to thank trial net for sponsoring this episode of The Juicebox Podcast. go to trial net.org, forward slash juicebox. To get started right now, don't forget to tell them that the Juicebox Podcast sent you when they ask on the forum online, they'll be like, Where'd you hear about this, you say Juicebox Podcast, and then you get the kit and then send it back. And don't forget trial net is 100% free for you. Trial net.org forward slash juicebox. Couple things I'll let you out of here. Don't forget, if you're looking for a community, try the Juicebox Podcast private Facebook group with over 17,000 members. It is a private Have it in supportive community that you should check out Juicebox Podcast type one diabetes. I also want to remind you that the diabetes pro tip episodes begin at episode 210 and are available at diabetes pro tip.com, and juicebox podcast.com. If you're a part of the Facebook group, I think there's actually Spotify playlists in the announcement section. But if you're not listening through Spotify, you can see an entire list that will help you understand the Pro Tip series at diabetes pro tip.com. While you're there, you should check out the defining diabetes episodes as well. If you're a US resident, go to T one D exchange.org. Forward slash juice box. Fill out the brief survey that helps people living with type one diabetes, super simple questions. Completely HIPAA compliant, completely anonymous takes less than 10 minutes, you can do it right on your phone, right on your sofa. You're going to help people living with type one, you're going to support the podcast. I'm trying to get to 2000 completed surveys by the end of diabetes Awareness Month. So one month from now. Go go go. If you all stopped and did it right now. Just based on how many people I know are listening to this episode. Not only would there be way more than 2000 but you might you might hear a pop like an audible out in the world. That would be the minds of the people at the tea when the exchange just blowing. They just be like oh, I can't believe that happen. Maybe he won the exchange.org forward slash juice box. Thank you so much for listening. I'll be back soon with another episode of The Juicebox Podcast.