Losing weight is hard for the non-diabetic body; adding type 1 diabetes to the challenge of weight-loss can be overwhelming and make the whole thing seem impossible.

Nonetheless, losing weight is possible. 

Don’t throw in the towel because past efforts haven’t worked, I recommend clearing your slate and starting over. 

When you’re juggling blood sugar levels, insulin doses, nutrition, and exercise, it can get messy. The secret to preventing the mess is learning some of the finer details that improve blood sugar management during exercise and make weight-loss possible.

Exercising first thing in the morning or before dinner

Old-school diabetes education has told us to exercise after eating in order to prevent low blood sugars, but this will drastically prevent your body from burning fat for fuel. Why would it need to? You just ate 400 calories — your body can burn that up instead.

When you exercise first thing in the morning — before eating, and with a stable in-range blood sugar — you’re actually going to burn fat for fuel because your body is still in a “fasted state.” 

The moment you consume calories, your body will switch over to burning glucose for fuel. 

This is something bodybuilders have been doing for decades in an effort to burn body fat without sacrificing muscle mass. 

If you can’t exercise in the morning, you can create a “fasted” environment by not eating past 3 p.m., and exercising at 6 or 7 p.m. before dinner. 

The fast-acting insulin you took for your last meal at 3 p.m. will be largely out of your system. As long as your basal/background insulin is properly fine-tuned, you should be able to do a cardio workout (walking, jogging, etc.) without seeing any significant change in your blood sugar.

Strength-training workouts can sometimes spike in your blood sugar. If you see that happening consistently, then you know you may need a small bolus of insulin at the start of your strength-training workout. 

When I used to lift weights in the morning, I took 1 unit of insulin to counter the glycogen breakdown from my muscles and liver.

What if you wake up in the morning with high blood sugar? Or you’re high at 6 p.m.? 

No problem. Take a very small dose of insulin to correct the blood sugar (start with no more than 25 percent of your normal correction dose) and continue with your workout. If you’re over 250 mg/dL, consider waiting because the stress of exercise with super highs can lead to ketones.

Simply walking 3 to 5 days a week for 30 minutes in a “fasted state” will lead to weight-loss. 

Be patient, though. It takes easily 30 or more days to see the scale budge.

Adjust your insulin doses sooner than later

Even though you won’t see the scale budge significantly for 3 or 4 weeks, you will see your insulin needs decrease quickly the moment you start trying to lose weight.

Cutting or reducing junk food, alcohol, and processed carbs can lower your insulin needs after merely a couple of days (if you stick with it, of course).

Getting daily exercise when you were not exercising before can lower your insulin needs almost immediately!

And then, when you drop those first couples pounds (even if it doesn’t show up on the scale, but you can feel that your clothing is looser), you’ll see another reason to reduce your background insulin doses.

How will you know? Low blood sugars. 

If you don’t react quickly to your body’s demand for less insulin, you’ll exhaust yourself trying to prevent and treat the lows. 

Then you’ll be frustrated with how often you have to eat unplanned snacks to treat the lows. 

And you’ll want to give up.

But, don’t give up!  

Be proactive and make slight reductions in your background insulin dose during that first month. And by slight, I mean never reducing your doses by more than 1 to 2 units per day — and remember to give a few days to see the full effects of that reduction. 

Don’t obsess over cutting all the carbs

There is so much emphasis within the diabetes community on cutting carbs, eating a ketogenic diet, or following the Bernstein approach.  The pressure can feel overwhelming succeed at cutting carbs. 

You don’t, however, have to eat strictly low-carb in order to lose weight. It might feel like that’s the only thing that’s worked in the past — but if you’re still trying to lose weight today, then I’d argue that it didn’t actually work for you at all because you weren’t able to stick to it and you gained the weight back.

If trying to follow a strict low-carb diet hasn’t worked for you so far, let’s try something different.

1. Aim for a “medium” or “moderate” carbohydrate quantity. And instead of obsessing over every gram, simply east more whole foods. That means more vegetables, legumes, nuts, fruits, eggs, meat, and some grains.
2. When it comes to those starch-loaded grains, simply eat them thoughtfully and ideally not all day long. If you love pasta, then make room in your medium-carb diet for pasta and make less-starchy choices throughout the rest of the day.

The goal is to create an approach to nutrition you can sustain longterm, that doesn’t leave you feeling deprived, that includes a lot of whole foods — especially vegetables.

And what works well for you may not work well for your best friend who loves her ketogenic diet. That’s okay! This is your body and your relationship with food. Start experimenting, and let your relationship with food become an ongoing work-in-progress that is full of delicious real food!