Disclaimer : Not a physician or giving medical advice or recommendations. Just giving a clearer picture of where my little T1er is. Certainly would not apply to all. Consult your physician with any questions. 😉
I wanted to be clear or maybe explain something that I probably didn’t word the best or made some unconscious assumptions on my readers’ knowledge of us that might be misleading regarding Ryan’s weight gain. Here’s what I wrote in my previous blog about our endo visit and Ryan’s gain:
“. . . which partially explains Ryan’s weight gain. Yes, he has gained a little too much weight. Dr. W warned us about that back in Sept when we were talking about the pump. The freedom allows him to eat more, and he has. But he also said that the more he is below 180, the less calories he is peeing out. More control, means less peeing of sugar and calories. And with a more controlled bg, the more likely the chances that when the sugar swings, like we know it does, it can go low. And when we go low, we treat with sugar carbs. The two together can easily equal Ryan’s weight gain. Not enough to diet. But enough to consider lower carb snacks. I think that when spring hits and especially with summer, he’ll even out. It’s just the timing of pumping and winter and controlled sugar. I’m opting for a little belly and more glucose control. ”
For a year, Ryan has gained weight on and off. Upon diagnosis on December 17, 2009, his ketones were >14, yes, GREATER THAN FOURTEEN! He had lost 7 pounds (about 18% of his total body weight) from his previous well visit months prior. And I, in total ignorance, assumed that he was growing taller than he was putting on weight, like a disproportionate growth spurt. His brother, five years older, was similar when he was Ryan’s age, but he wasn’t losing weight, just growing super tall. So the first couple visits post diagnosis, the weight gain was exciting, showed he was getting healthy, his body was going back to normal; well, normal aside from d. By the time his weight was beginning to level off, summer was almost upon us. He was outside every day trying to keep up with his older brother and chase his little one. And when summer did hit, we went swimming almost six days a week (the pool is closed on Mondays). My boys are fish! So the activity level was very high and consistent.
But when the end of August hit, we battled highs all the time. Highs between 250-325, too often higher, consistently. I don’t know what was going on. It didn’t matter what we did, how we changed things, his numbers were just HIGH (remember, we were still on MDI too . . . it’s hard to control things when they get out of whack like that on shots). We’d have good weeks or good several days here and there, but those numbers persisted through Sept, Oct and most of Nov . . . thus an 8.8 A1c on November 16. And what I also noticed was his CONSTANT peeing. Peeing like he did pre-diagnosis. To the point of my panic. I kept asking Jason if it was normal, if we should be concerned, and his reply was always, “Amy, he already has diabetes.” I kept asking Ryan if it hurt when he used the restroom making sure it wasn’t kidney infection or something like that. It just never dawned on me that it’s just part of dealing with high blood sugars. But I am telling you, the nearly three months prior to pumping, the child was on a peeing frenzie, so much so, he would get ticked off when he would have to pee at times because it was intrusive and interrupting! So, the “more control, means less peeing of sugar and calories” makes perfect sense considering how abnormal and frequent the trips to the restroom were. So, since we have been keeping his sugar under control, he has been retaining all his sugar intake.
Dr. W also mentioned how good control can contribute to weight gain. Before we started pumping, Ryan almost never had lows. Yes, he would hit the 70s or so but rarely ever fell below. We almost never treated lows with sugar carbs. But in the last few months of pumping, Ryan has hit more lows than he has in nearly whole year prior. And because we weren’t used to that, we didn’t treat them conservatively. So he really has had a lot more sugar than normal. And he’s keeping it because he’s not peeing it out with crazy highs.
Also, the TIMING of going on the pump can contribute to the weight gain. There is so much more freedom to eat with the pump. I have let Ryan eat much more freely because we can. I don’t know if it made Ryan feel more “normal” but it sure did me ( I know, that is a flaw in my thinking). But it was also in DECEMBER! Ryan was dx’d a week before Christmas last year. It made for a very hard, very sad Christmas. I was determined to do all the baking and cooking that I did not do last year and let Ryan partake in it all.
So, I think that maybe all these factors combined has been the collective cause of his weight gain. You can look at his picture and see that he is not overweight, but he is developing a bit of a belly (which is why his jeans are very long, we have to have a little bigger size to have a pleasing “comfort level,” according to Ryan, around his mid-section; should probably break down and buy a few huskies). I do think that once summer hits or we have spring-like weather consistently, he’ll slim down easily with increased activity. Dr. W was not in any way suggesting a diet, but throwing out things to consider that might be contributing so we can be as aware and educated as possible.
I’m hoping that as pumping settles in a little more and we get all things adjusted and leveled out that Ryan won’t have these issue anymore. We all live in a unique environment with a unique chemistry make-up d and non-d related. And there is always at least a million factors to consider. Ryan’s little body has been through a lot of adjustments in a year’s time and hopefully, with little effort, we can get it all leveled out for him.