First we need to understand what insulin does to the body:
After you eat a meal, the food is broken down into glucose, which is the simple sugar that creates the main source of energy for the body’s cells. These cells cannot use glucose without the help of insulin, which is a hormone produced by the pancreas. Insulin helps glucose to enter the cells and convert it into energy.
However if the pancreas does not make enough insulin or the body is unable to use the insulin that is present, the cells cannot use glucose.( In Type 1 diabetes the pancreas no longer works at all after the first few months of diagnosis. ) If no insulin is produced by the body excess glucose builds up in the bloodstream, resulting in high blood sugar readings.
Ordinarily a person who does not suffer with diabetes can overeat and their pancreas produces all the necessary insulin required to deal with the extra intake of food. I am a Type 1 diabetic and if I overeat I need to match the insulin I inject to my food intake to prevent high blood sugar readings. Too little insulin and my readings are high, too much insulin and I might have a hypo.If I didn’t inject enough insulin, then not all the food can enter the cells (to store in the liver and muscles, with the excess stored as fat). So a percentage of the glucose from the meal just stays in the blood.
We all worry about weight gain, and since I was diagnosed two years ago, my weight has steadily risen by about 10lbs. Was the insulin making me fat? Directly after diagnosis my regime was two injections a day of NovaMix pre-mixed insulin. But as my blood sugar began to go haywire I went on to four insulin injections a day. (Levemir and Nova Rapid)This was when I started to put on weight.
Research has shown that some diabetics who were controlling their blood sugar with insulin did gain weight. Of course, as we already know, ideal weight, eating a balanced diet and exercising are the keys to controlling diabetes and decreasing the risk of heart disease and stroke etc. On the other hand using insulin to control glucose in the blood is essential, even if it means gaining some undesirable weight. It was discovered during this research that the average weight gain of the diabetics they studied was around 10-14 pounds.
Overeating may be the problem
Once a person gets used to controlling their blood sugar with insulin, they may feel that an extra treat of ice-cream or cake is OK and can be easily remedied with a few extra units of insulin. When I looked back through some of my food diaries I could see that I had started to eat slightly larger meals once I was on four injections a day, especially the evening meal. In turn I had increased my insulin dose to match the extra food intake. Maybe it was not so much the insulin that was making me fat, as much as the extra food I was eating purely because I knew that the insulin would take care of controlling blood sugar levels.
It’s a sad fact that if you are overeating and not getting enough exercise then you will gain weight because the diabetes medication is supporting your excess food intake. In other words the insulin itself did not cause weight gain, but all the excess calories did. It does appear that people on insulin might be prone to gain more weight, rather than those on oral medication. Careful diet and exercise, will help in controlling weight.
What should you do to help control the amount of insulin you need every day?
- Cutting down your calorie intake will be good. I have an acquaintance who is diabetic. She can not control her desire for cakes and pastries. When tackled about it she just says not to worry, as she will inject a few units of insulin to cover it. She probably blames the insulin for making her fat! She already has a huge ulcer on one leg.
- A brisk walk or an hour in the gym will enable glucose in your blood stream to be used for energy and not stored as fat. A healthy planned diet together with exercise will have a beneficial effect on your insulin levels.
- Experiment with a Mediterranean type diet, which is high in vegetables, fruits, fish, nuts, olive oil and whole grains and low in sugar. This is a healthy diet plan for everyone. And eat whole foods which will help to keep insulin levels stable.
- Do not eat things like biscuits, cakes, candy, potato chips, all white sugar and other refined foods which cause insulin levels to rise much too fast. Never include white flour and processed foods in your diet. These foods will cause massive swings in your insulin levels.
- If you are overweight to the point of obesity, losing this fat will often bring insulin levels under control.
So, does insulin make you fat? Well we are all different and quite possibly some diabetics do have this problem. Research is ongoing into all aspects of the effects of medication on diabetes. It’s always wise to mention any worries you might have regarding your insulin regime to your diabetic team.
I think the lesson I’ve learned over the last few months, is to keep my appetite in check. Nibble a few nuts and seeds when the carrot cake in the fridge is tempting. I have to be truthful and say that quite probably it wasn’t the fault of the insulin that made me put on weight – it was eating too much food and injecting bigger amounts of insulin to control my soaring blood sugar levels. Calories and more calories, they soon add up to disaster.