Over the years, I have had many people with diabetes ask me why they’re gaining weight instead of losing it.
There are two possible answers to that question. One answer, which is more applicable to people new to exercise, is that muscle weighs more than fat (for an equivalent amount).
Consequently, if you are gaining muscle while losing some fat weight due to your new exercise regimen, then your scale weight is likely not reflective of the positive changes in your body composition (i.e., less fat, more muscle).
The second possible answer is more applicable to people who are not new to exercise, especially anyone who may have recently changed the amount or intensity of training that they’re doing.
I first ask them, “Have you been treating a lot of low blood sugars recently?” When they invariably reply, “Yes,” then I know to tell them that they have simply been taking in too many extra calories while treating hypoglycemia.
Of course, you have to treat a low if you have one! However, every calorie counts, even the ones that boost your blood sugar back to normal (and beyond).
People with diabetes often reach for candy, cola, juice – or other high-calorie, high-fat, and high-sodium foods – to correct lows, which can lead to rebound high blood sugars, unhealthy eating, and weight gain.
What you use to correct a low is often just extra calories not accounted for in your daily meal plan.
What can you do to avoid gaining weight when you have to treat frequent lows? The best advice is to treat them with something low in calories, but with enough glucose to bring your sugars back to normal.
When you have a hypoglycemic reaction, do not binge on candy bars, cookies, and other high-calorie, high-fat foods. These “treats” take longer to raise your blood sugar than pure glucose and usually contain calories (like ones from fat) that do not raise blood sugar levels effectively.
You are almost certain to eat too much of them waiting for your blood sugar to rise and consume unnecessary extra calories that will cause weight gain – and excess weight gain can lower the ability of your insulin to keep blood sugars in check.
You can also end up with rebound hyperglycemia, which may increase your insulin needs and promote fat storage.
I’m going to sound like a walking advertisement for glucose products from here on out, but I fully understand from both professional and personal experience how critical making smart choices is when you want to keep exercising regularly and avoid weight gain.
Using fast-acting glucose to raise your blood sugars is likely to contribute the fewest extra calories. Why? Pure glucose contains only 4 calories per gram, so a 15-20 gram treatment has 60-80 calories, and every single calorie goes directly to rapidly correcting your blood sugar levels.
Hypothetically speaking, if you’re correcting just two lows per week with 15 grams of carbs, you will take in an extra 6,240 calories a year, or the equivalent of almost 2 pounds of body fat (one pound of fat is 3,500 calories).
By way of comparison, getting 15 grams of carbs from other foods usually results in your consumption of way more calories, especially if any of the foods contain calories coming from fat (9 calories per gram) or protein (4 calories per gram), neither of which will rapidly correct a low blood sugar.
Here are just a few other food comparisons:
- A 2-ounce bag of Skittles candy contains almost 60 grams of carbohydrates and four times the calories of a 15-gram glucose dose. Likewise, just one ounce of Smarties contains 25 grams, which if you consumed them all would probably raise your blood sugar too much and cause you to take in extra calories.
- A candy bar like Snickers contains about 100 extra calories for every 15 grams of carbs. Correcting lows with Snickers or other candy bars adds another 3-pound weight gain a year.
- A regular soda that contains high-fructose corn syrup may take longer to correct a low (fructose has to be converted into glucose first), and it’s easy to consume more than 15 grams – which is the amount in only 4 ounces of a soda (one-third of a 12-ounce can).
- Even choosing orange juice or a banana to correct a low is less effective because the fructose (fruit sugar) is much more slowly converted into glucose. You probably won’t be able to stick to only 4 ounces of juice or half of a medium banana (15 grams of carbs) while you wait for your low to be corrected, and end up consuming more calories than necessary.
There is nothing worse than exercising and trying to lose weight, but ending up gaining some instead due to all the extra calories you eat to correct low blood sugars.
If you can prevent lows with diet and medication changes before, during, and after exercise and avoid taking in those extra calories in the first place, certainly do that! But when you do have to treat an occasional low, keep in mind that using food rather than pure glucose can add a lot of calories to your total yearly intake and your lows may take longer to correct.
In short, pure glucose is always best for rapid treatment of lows, although pure sucrose (table sugar, as found in hard candies) is second best.
For prevention of lows during longer bouts of exercise or overnight, however, consider taking in a low-calorie bedtime snack with a balance of carbs, protein, and fat that will keep your blood sugars stable for longer.
Some examples are Balance bars, low-fat and reduced-sugar yogurt, or low-calorie ice cream.
An ounce of prevention is always worth a pound of cure, especially if a hypoglycemic episode leads you to eat everything in sight!
Suggested next post: How to Lose Weight When You Live with Diabetes
Zoe
Thanks for this information Dr. Colberg,
I don’t know if I have hypoglycemia, because I haven’t been back to the doctors after I was told that if physiotherapy didn’t work I would be put on medication (I don’t like the idea of relying on meds for the rest of my life). But my doctor assumed that I just have chronic migraines. The pain is always intense in the left side of my head, and often starts in my neck (sometimes spreading through my jaw). It usually feels more like neck pain. But after 2 1/2 years, I’m realising that I seem to self-medicate by eating… when I eat sugary foods, after about ten minutes the pain seems to subside (sometimes it almost completely disappears). Sometimes if I eat something fatty with cheese, followed by sugar (the cravings I seem to get when I’m in pain) that makes it disappear too.
So I’m thinking it might be something to do with my blood sugar. And after looking at symptoms on the internet, hypoglycaemia looks more like my problem.
The problem is though, is that eating so much sugar is damaging my teeth, and I can’t seem to lose weight. So this article has really helped. I’ll invest in some glucose tablets tomorrow and see if that helps!
Etienne
Well im new to low blood sugar..
In one year i have been piling up the pounds… Eating 3 meals a day dows not help.. I eat 5 meals and inbetween a day.. I was involved in an accident.. And inured my pancreas.. It wasnt treated the same time.. But 6 months after.. Most medical staff had me taken test wich shows sometimes normal sometimes low… Very tricky since im adviced to not eat or drink anything before i go for a sugar test… Then i get so hungry… My mouth become dry and i lose my balance then i eat… Then when i go to doctor my bloodsugar is normal.. Untill today i never got medical attention i just eat and eat.. I cant get medication because im not yet diagnosed… Even though i been admitted time after time for going into a hypoglycimia coma… Please mind my spelling
Christel Oerum
If you can I’d recommend you buy a blood sugar meter. You can get it in most pharmacies without a prescription. Then you can measure your blood sugar yourself and if you’re low you can treat it accordingly.
As for weight gain, the amount of meals you eat won’t be the determinating factor. If it’s not a medical issue that makes you gain weight (such as hypothyroidism) you’re gaining weight because you’re eating more calories than you burn. So for weight management, make sure that your hormones are balanced (a doctor can assist with that) and that you’re not overeating.
Janet
I believe the glucose tablets are just expensive glorified sugar. I keep a tube of frosting on hand a eat a small dab… (small as less than half inch dab) usually brings my bg up by 5 carbs. If that doesn’t work I go for the higher carb food, not calorie packed.
Leana Simione
Thanks alot!! This is always a struggle for me! And worse when i am low and hungry, such a bad combo! ..
Gayle Kirma
Excellent article! Thank you!
Christel Oerum
Thanks
Caralia
So what products do you suggest? Glucose tablets or the glucose gels?
Christel Oerum
I prefer glucose tabs since they are very easy to dose, don’t take up a lot of space and last forever. If you decide to go for a gel make sure that there isn’t any “bonus” stuff in the product, that you know how much you’ll need and how to dose it out
Judith
Goodness, that puts the weight gain into perspective! No wonder I’ve put on so much weight over the 40-something years I’ve lived with Type 1, never mind the wrong food choices I’ve been making apart from this. Thank you so much!!!!
Christel Oerum
Glad you found this helpful! Those lows and how we treat them can lead to some (sneaky) gains
Kelly
As a Type I Diabetic for 30 years, I know all too well the problem with trying to correct a low with food. However, I am not really concerned about weight so I treat at times with things that taste good instead of fast acting glucose. One product I have found works great, especially if I am seriously low and cannot lie down (like climbing Half Dome) is “Jelly Belly Sport Beans”. One package (28 grams) has 100 calories and 25 grams of carbohydrate. So half a package works well for most lows. Its almost like they are predigested. They just kind of melt.
Petrina Behlow
Great article. Thank you so much. I have always wondered what to do when I have los while working out
Deborah
Is it to late to join the challenge
Christel Oerum
Hi Deborah, The challenge has been running for a week, but if you email tobias@diabetesstrong.com, he can add you to the email list and facebook group.