Losing weight in diabetes

Insulin concerns

It is very common in patients with diabetes to gain weight once they start insulin pump treatment. Unfortunately, it is also very often that at the same time blood glucose levels improve marginally.

Why does this happen to patients using  insulin?

Insulin is an anabolic hormone, thus it promotes uptake and storage of amino acids, glucose and fat within insulin-sensitive cells such as muscle and fat cells regardless of the way it’s delivered (injected, pumped or released naturally).

Insulin therapy is associated with fat mass gain in people with type 1 and type 2 diabetes.  While lowering your blood glucose with insulin, your body stores all the calories instead of losing excessive amount of glucose with the urine like in hyperglycaemia. Some people tend to limit their insulin treatment or even skip its administration in order to lose weight. This is an incorrect practice as it can lead to excessive muscle mass loss or life-threatening condition such as diabetic ketoacidosis (DKA).

What can be helpful when the weight gain effect from using insulin occurs, is to increase your physical activity levels. It should effectively promote balancing your body weight and keep your overall insulin levels lower. The calculation is as simple as that the less insulin you need to take the easier it will be to lose weight.


What to eat

One of my patients was doing frequent dosing with her insulin pump as she noticed that by doing so she could eat more without a need to have to take an extra injection with the needle.  Although insulin can make it easier to eat an extra cake or other „forbidden”  foods, it does not mean that you should be doing that.

There are loads of diets considered to be appropriate for patients with diabetes, such as very-low-carb diets, vegan diet and so on. From my personal experience it shows that none of these diets are for everyone and what works best is always a balanced and personalized diet. For example, the fact that a person is on a low-carb diet does not necessarily mean that this person will lose weight, even though the need for insulin is much lower than for someone on a regular-carb diet. This is because once you remove carbs from your diet you need to replace it with another source of energy like for example much denser in calories fats.

My recommendation is not to completely avoid carbs but making smart choices – for example eating carbs which are gradually absorbed and don’t cause spikes in blood glucose as this can prevent you from matching big insulin doses which usually cause hypoglycaemia later.

In the next article I will talk about how to treat lows with diet in diabetes and how physical activity may be beneficial for that. 



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Alexandra Jagiello

Gloucester Road, SW7 London

07761 894 500

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