Most people have a fairly good understanding of the healthy options in the foods they eat – meat with the skin on or off, low fat versus full-fat dairy, and so on – but do you know your food basics well enough to make the healthy choice when faced with a supermarket full of options? For example, are any fats better or worse than other kinds of fats for your health? What is a "low G.I. carb" and what kinds of food can you find them in?
DIETS AND WEIGHT LOSS – MANAGING THE MAZE
FOODS, DRINKS, DIABETES AND LIFE 
COMPLEMENTARY AND ALTERNATIVE THERAPIES
Written by Administrator
Type 1 Weight Matters
Type 1 Weight Matters is proudly supported by Novo Nordisk as a Platinum Sponsor 
Type 1 diabetes diagnosis and insulin use 
The period of diagnosis can mark a difficult time in the lives of people with type 1 diabetes and the impact can extend to the loved ones, work colleagues and peers of those newly diagnosed. Adjusting to living with type 1 diabetes can often lead to a struggle with insulin intake, particularly as changes take place in diet and exercise.
Issues of control over blood glucose and diet can lead to concerns about body image and management of diabetes. The sudden and extreme weight loss in the period prior to diagnosis, followed by weight gain as the body becomes healthy again following insulin commencement, can be hard to manage for some.
Type 1 diabetes can be particularly hard to manage as it is usually diagnosed in childhood or young adulthood (although it can occur at any age) , impacting on one of the most exciting and dynamic points of a person’s life. It is at this time that other areas of life are key focuses; including work, education, relationships and travel. Therefore, learning to manage a newly diagnosed medical condition can often seem like a daunting task.
Some weighty issues facing Australians with type 1 diabetes
Living with type 1 diabetes and its impact on lifestyle, can often be difficult to accept for many people newly diagnosed with diabetes.
With the current focus on the growing number of Australians who are overweight or obese, and with body image stereotypes portrayed with increased frequency in the media, people are suffering complexities and pressures around body image. Just like anyone else, particularly in the teenage years, people with type 1 diabetes have complexities and concerns around self-esteem, image and body weight. Along with this they have diabetes to deal with.
While we’ve all heard of fad diets and nightmare exercise regimes, the key point of difference for people with type 1 diabetes is that there is a powerful but risky weight loss tool – the omission of insulin.
The relationship between insulin and weight gain
Insulin is a hormone that affects metabolism and other body systems. It enables most of the body's cells to take up glucose – the body’s energy source - from the blood, storing it as glycogen in the liver and muscle.
Managing blood glucose levels requires a balance in the amount of food consumed, the level of physical activity undertaken and the amount of insulin absorbed. Blood glucose levels can also be affected by stress, infection, illness, medications and alcohol.
Exercise is a difficult area for people with type 1 diabetes. Often people exercise to stay fit and to help lose the weight they gain through insulin intake. However, exercise - especially when excessive - can lead to hypoglycaemia (low blood sugar or hypos) that in turn require glycogen. It is a cycle with which many people with type 1 diabetes struggle.
Skipping insulin to lose weight – survey results
In September 2008, an online survey conducted by Diabetes Australia – Vic and the Centre for Adolescent Health revealed that one in three
respondents with type 1 diabetes who were specifically asked about whether they were living with eating disorders and diabetes, were regularly skipping or manipulating their insulin dose to gain control over their weight.
A total of 243 Australian people participated in the survey, including 201 with type 1 diabetes, revealing information about eating patterns and weight concerns in the resulting Insulin Misuse for Weight Loss research report.
Skipping and abusing insulin – the facts
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One in three (32.9 per cent) of the respondents to this survey about eating disorders and type 1 diabetes said they have skipped insulin as a way to help them lose weight;
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Almost half (48.5 per cent) of those respondents with type 1 diabetes who skip their insulin say they do so on a daily basis;
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Almost two in five (37.7 per cent) of those respondents with type 1 diabetes surveyed say they have taken less insulin than they required as a way to help them lose weight.
The wider implications and what this means
These statistics reveal an alarming trend for some people with type 1 diabetes who have problems with their weight and body image to use insulin to manage their weight - and highlights the need for an increased awareness amongst people with type 1 diabetes of the important role of insulin and how to manage this effectively to maintain healthy diabetes control and weight management.
While it is disturbing to think about, skipping or abusing insulin can lead to an earlier than expected onset of diabetes complications and an increased risk of death.
Complications of diabetes can include:
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Feet and eye problems, including amputation;
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Heart and blood problems;
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Erectile dysfunction;
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Nerve damage;
The research also highlights the need for people with diabetes to talk with their General Practitioner (GP) or healthcare professional about their current therapy and how they can best manage their diabetes.
Diabetes and the potential for eating disorders
If a person with type 1 diabetes has an issue with insulin misuse, it can be a symptom of an underlying psychological problem or concern. Insulin misuse is sometimes carried out as a means of controlling deeper psychological disorders, including depression.
Eating disorders are a very real danger for many people, particularly for teenage girls and young women, without even factoring in the increased risk of skipping or taking less insulin. The Insulin Misuse for Weight Loss research report revealed that one in four girls with type 1 diabetes who responded to the survey, had developed some sort of eating disturbance in their teenage years. We know from other research as well that eating disorders are twice as likely to occur in teenage girls with type 1 diabetes than in girls who do not have diabetes.
If you think that things have gotten out of control and perhaps there are issues with an eating disorder, you need to speak to someone in your health care team about seeking help. This can include both an eating disorder specialist and a diabetes management team working togethor with you. You can access counselling via email on our online counselling pages here personal counselling.
I have type 1 diabetes - what does this mean for me? 
Developing a healthy relationship with food and insulin can help prevent dangerous behaviors such as insulin misuse and restriction. It is important for people to embrace a balanced, flexible approach to eating. Whereas type 1 diabetes used to be about what you couldn't eat, it is now more about learning that food is not the enemy and that it is possible to eat a wide variety of foods, maintain a healthy weight and balance this with appropriate insulin use.
If your diabetes, insulin use and/or weight, are areas of concern or confusion, there are people you can talk to, including family, friends and healthcare professionals.
It is important not to feel ashamed and to ask for help if you need it.
Healthcare professionals and GPs are equipped to help with these issues and are able to offer advice on the best way to lead a happy life, whilst effectively managing your diabetes. It is also important that you communicate openly with your healthcare team and inform them of any changes or concerns you experience in your management of type 1 diabetes.
Stay informed and understand the different options that are available. Most of all, it is important to have the courage to face up to, and completely understand, the risks and health implications associated with skipping or manipulating insulin.
I know someone with type 1 diabetes who may manipulate insulin intake – what can I do?
If you know someone who might be at risk of insulin manipulation, it is important to appreciate that it is a sensitive and difficult topic. It may well be frustrating and difficult for you to fully understand the issues; however offering support to a friend or family member can often make all the difference.
It is important to recognise the signs of insulin misuse and to understand that if it’s something you are concerned about, you are not alone. While insulin manipulation may be difficult to come to terms with, it is a common cause of concern for people with type 1 diabetes, their loved ones, work colleagues and peers.
Warning signs of ongoing problems with insulin misuse can include:
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changes in eating habits (eating more but still losing weight)
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unexplained weight loss
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unexplained hyperglycemia (high blood sugar)
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low energy levels
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frequent urination
While insulin abuse can be an uncomfortable and disturbing topic for many, misusing insulin for weight control is a very real health concern that requires further media awareness and public education.
Remember....
| Insulin misuse is dangerous and common |
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Offer support to loved ones and seek support yourself if concerned or unsure
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You are not alone |
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It can and does get better
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Further support and information
Check our Your Stories Page
Go to the Talking Type 1 pages, for more information and stories about these topics
Hop across to our forums to share with others and seek advice here Type 1 Weight Matters Forums
Download a copy of the NDSS Booklet re Type 1 diabetes and Eating Disorders here: NDSS_Eating_Disorders_Booklet
The Type 1 Diabetes and Eating Disorders Online Survey was supported by an unrestricted grant from Novo Nordisk.
References
Type 1 Diabetes, Diabetes Australia http://www.diabetesnsw.com.au/about_diabetes/type1diabetes.asp
Balancing Food, Activity and Insulin, Diabetes Australia Fact Sheet http://www.diabetesvic.org.au/Portals/0/BalancingFoodActivityInsulin_FactSheet.pdf
Insulin Misuse for Weight Loss, Diabetes Australia - Vic
Diabetes Australia – Vic, http://www.diabetesvic.org.au/LivingWithDiabetes/Complications/tabid/100/Default.aspx
This page has been sponsored by our Platinum Sponsor - Novo Nordisk
Written by Administrator
What is Weight Matters?
"Weight Matters" is our online weight management programme. This includes a series of groups and other resources relating to issues including weight, body image and healthy management of diabetes and weight; and wellbeing and mental health.
The programes includes:
- Online weight management groups for people with type 2 diabetes - we have completed our 3 pilot groups and plan to call for a new series of groups later in 2010 - stay tuned for more on this
- Online weight management groups for people with type 1 diabetes - pilot has been completed and we plan a second group later in 2010 - stay tuned. In partnership with Novo Nordisk - see our "Type 1 Weight Matters" pages.
- Casual peer chat sessions around weight matters - Wednesday nights at 7.30 pm EST - please check local times. No counsellor or formal programme. All welcome! Moderated by Christina who has been through our type 2 weight matters groups programme.
- Weight matters buddies programme - part of the group programmes
- Fact sheets about weight management, diabetes, wellbeing, mental health, diet and exercise - some are available here now
- Access to a dietitan online - part of our online groups. We are working on this as part of the general website - stay tuned!
- Our Food Matters pages
- Access to counselling - available now - go to the online counselling area Diabetes Counselling - Online Diabetes Counselling
- Our "Online Cooking School" - available now
History of the programme
In 2007 we held a survey to find out your thoughts, wishes, needs and problems with weight, food and everything connected to these things – in other words your “weight matters” and what matters to you. 78 people completed this survey. This formed the background to the development of our Weight Matters group programmes.
Some of the results were:
- Forty- nine percent of respondents felt that diabetes made is harder to loose weight.
- More than 90% reported attempting to loose weight and of those people, more than 80% reported using exercise and diet as weight loss strategies
- 39% reported using a diet programme with support such as Weight Watchers, Jenny Craig or Tony Ferguson but 58% of these people reported not being able to stick with the programme for the long term.
- 72% reported having a family member who is over weight.
- 69% reported binge eating and the most common triggers for bingeing were: feelings about self, mood, depression and stress
- More than 80% of people reported eating take away food only once a week or less
- 58% reported needing more support to lose weight
Who can join?
Currently, we have completed our pilot groups for both type 1 and type 2t - we hope to run some more groups later in 2010 - we will keep you informed here.
You can now register interest to go on the waiting list for future groups later in 2010 for both type 1 and type 2. Just email us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it to join the list
These programmes are not diet or exercise programmes, but rather support programmes to help you to learn more, identify problems and barriers to healthy weight management, help you to stick at managing your weight in the long run and increase your wellbeing. The focus is on weight management, mental health and wellbeing.
However we do have access to a dietitian and an exercise physiologist and we are currently working out the best way of using them to your advantage. More to come....
What happens next?
Once you contact us, if you are suitable to join the programmes, we will ask you some questions and get you to fill out an enrolment form prior to starting the programme and we will send an enrolment/resources pack. We will include things like questions about your eating habits; exercise; diabetes management; wellbeing; your weight and BMI (body mass index) – we will help you with all of this.
The type 2 programmes are 8 weeks and the type 1 programme is 6 weeks. At the end of the group programmes we will ask you to do these questionnaires again, and again 6 months later. We will also ask you some evaluation questions. Questions will be around:
- What you are doing to manage your weight;
- How confident you feel in managing your diabetes;
- Your wellbeing; and
- How satisfied you were with the programme.
Please contact us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it if you are interested or have any questions.
The programmes include:
- Information pages: This is available here to all members of diabetes counselling online (not just Weight Matters participants) and includes information about nutrition; mental health and wellbeing; exercise and activity; common barriers and facilitators to weight management. See the links to fact sheets below -we will be adding more information soon;
- The blog, available to all members of Diabetes Counselling Online, in which Weight Matters participants are encouraged to write entries regarding weight management and their ups and downs, like an online diary - all members can access this area, just register to create an account and you can join in with the chat rooms and blog whether you are in Weight Matters or not;
- An 8 week structured group programme of online group sessions held in a chat room for type 2 and 6 weeks for type 1;
- A weight support buddy programme for recruited participants – you will be matched up with someone else from the group;
- Access to a private chat room at any time to meet;
- You can also use the rest of the site at any time;
- Open group chat for all people is available now on a Wednesday night in the Weight Matters chat room - you will need to register for the chat room to access this and let us know you need access to the Weight Matters rooms Diabetes Counselling Chat
The group programmes are weekly online meetings, at a set time, in the Weight Matters chat room at the website. Topics are around weight management with a focus on mental health and wellbeing, such as the different types of problematic eating; depression; body image; stigma etc. One or two of our counsellors run each session and guide the group, just like in a face to face group.
After the formal groups programme you will be encouraged to keep using the blog, forums, chat rooms and link with your buddy and other group members. We are aiming for the support to be long term, as weight management is long term.
Check in here for updates! If you have any questions contact us on This e-mail address is being protected from spambots. You need JavaScript enabled to view it
FACT SHEETS
DCOFactSheet-DiabetesEatingGuidelines.pdf
DCO Fact Sheet - Carbs and Diabetes
DCO Fact Sheet - Facts on Fats
DCO Fact Sheet - Glycemic Index
DCO Fact Sheet - Healthy Eating not Dieting
DCO Fact Sheet - Emotional Eating
DCO Fact Sheet - Motivation and taking the steps
DCO Fact Sheet - Weight Matters useful links
Lift for Life
The Lift For Life program is a progressive weight training program designed for people with or at risk of Type 2 diabetes based on comprehensive research by the International Diabetes Institute proving the positive effects weight training has in managing Type 2 diabetes.
Lift For Life aims to improve diabetes control, decrease body fat, increase strength, and enhance general health and well-being through a structured approach to strength training.
Baker IDI have a unique operating model integrating research, education and clinical care divisions, dedicated to making a difference for people with diabetes and those at risk of all ages and fitness levels.
EFM Health Clubs has been chosen by Baker IDI and Fitness Australia to deliver this program nationally as the EFM culture, environment and personalised Fitness Coaching structure is well suited to deliver this type of program and the Lift For Life program is essentially a weights only program with a Fitness Coach to member ratio of 1:12. Four simple assessments are provided over the 6 month program and EFM offer a free trial session to Lift For Life participants.
Throughout a Lift For Life program, participants can work at their own pace, with plenty of help and encouragement along the way from an EFM coach to help achieve your goals.
EFM offers personal Fitness Coaching at all sessions to provide you with a tailored program to help you manage your diabetes.
Lift For Life members can do a program via one of the LIFT FOR LIFE weights program cards which can be regularly updated. Lift For Life members can also join in regular EFM weights focused sessions if they wish, and if Lift For Life members wish to do extra cardiovascular exercise, they are able to do so as long as they have first completed their resistance training exercises for the session and/or for the week.
At the end of the Lift For Life program Lift For Life members are very welcome to continue with their EFM membership without the Lift For Life assessments and training will still include a significant weights focus for diabetes management.
Lift For Life enquires can be made online at www.efm.net.au or by calling 1300 336 348.
Weight Matters has been made possible through grants from Eli Lily and Mazda Foundation in 2008
And in 2009
Novo Nordisk
And The Ian Potter Foundation
See our type 1 weight matters pages, sponsored by Novo Nordisk, for more information about type 1 diabetes
