You may have heard more than once from different people that insulin causes weight gain. Because of this, some people believe that taking insulin to manage their diabetes will automatically cause their weight to skyrocket. Let's see where this idea comes from and whether it really is true.
- Author: Lyudmila Panchuk, editor
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It is well known that one of the main functions of insulin is to facilitate fat storage. Of course, this should only happen when there is enough energy to store. When calories consumed exceed the nutritional needs of the numerous physiological processes our body performs every day, the excess energy is stored as fat.
We must remember that every person and animal on earth needs insulin to survive and thrive. In people without diabetes, the pancreas efficiently releases the amount of insulin needed to maintain normal blood glucose levels around the clock in response to numerous variables such as food intake or stress.
Is there something special about using exogenous insulin, as opposed to what your body makes, that predisposes people with diabetes to unwanted weight?
Type 1 diabetes and insulin
In people with type 1 diabetes, insulin-producing cells are destroyed and body tissues no longer receive nutritious carbohydrates to function adequately. This is why undiagnosed patients often lose weight. Once they start taking insulin through injections or infusions, it makes sense that they might gain weight, or at least get it back into the normal range.
Sometimes weight gain occurs. However, just like a person who naturally produces their own insulin, weight gain is likely the result of lifestyle factors and, in particular, consuming too many calories.
Shockingly, a recent report states that
“Although it was traditionally thought that patients with type 1 diabetes (T1D) had a lower BMI, modern research has shown the opposite. The trend toward increased prevalence of obesity increased at a faster rate in patients with T1DM compared with the general population. Currently, about 50% of patients with T1D are overweight or obese, meaning they exhibit clinical signs of type 2 diabetes, such as obesity and, often, insulin resistance.”
Experts from the Department of Diabetes and Endocrinology at the Royal Surrey County Hospital, UK, suggest several potential reasons why people may be more likely to gain weight on exogenous insulin study
“Insulin-associated weight gain may result from a decrease in blood glucose levels below the renal threshold without a compensatory reduction in caloric intake, a protective or unconscious increase in caloric intake caused by fear or experience of hypoglycemia, or the “non-physiological” pharmacokinetic and metabolic profiles that follow by subcutaneous administration [although this is largely theoretical]. ”
Taking too many calories (and corresponding insulin), which may or may not be caused by fear of the possibility of hypoglycemia, or suboptimal doses of insulin that cause hypoglycemia (and corresponding carbohydrate adjustments), may be at the center of the problem.
Experts note several possible strategies that can help reduce unwanted weight gain for patients with type 1 diabetes, including adjusting diet, increasing physical activity and exercise, adjusting insulin therapy, adding other diabetes medications that have a positive effect on body weight, or adding medications for obesity.
Insulin and body weight: myths and reality
Each of us strives for our own ideal of external beauty. One way or another, in the modern world, the concept of attractiveness is often associated with the compliance of a person’s body parameters with certain criteria, the main of which is body weight. And if for a healthy person, excess weight up to a certain point is only a cosmetic defect, then for a patient with diabetes, maintaining normal body weight affects the course of the disease and the likelihood of serious complications.
Many patients, starting insulin treatment, notice an increase in body weight, mistakenly believing that the hormone itself causes fat accumulation. This leads to fear of its use in some patients. It’s difficult to judge them: it’s unlikely that any of us are willing to consciously gain weight and become less attractive to others. The problem is that for a patient with type 1 diabetes, insulin is vital to provide tissues with glucose, and stopping its administration or administering it in insufficient quantities can lead to a worsening of the disease and even death. Why does weight gain actually occur in patients and how can you combat it? Let's try to understand the existing myths about insulin therapy and decide how to achieve ideal forms.
Myth one: taking insulin leads to weight gain.
This opinion is based on the own observations of many patients: as soon as they begin intensive insulin therapy, body weight begins to increase. Insulin in adipose tissue actually inhibits the breakdown of fats and stimulates the production of complex fats and their accumulation. It must be remembered that this process is physiological and necessary for the normal functioning of the body. In the absence of insulin, there is an increase in the concentration of glucose in the blood (that is, hyperglycemia), and large amounts of it are lost in the urine, since it cannot penetrate the cells. If there is not enough glucose to provide energy to the cells, this leads to the fact that body weight not only does not increase, but even decreases (which is one of the symptoms of type 1 diabetes). The presence of insulin prevents the above-mentioned glucose losses and promotes the proper use of glucose. The reason for the increase in body weight in the case of external administration of the hormone lies not in the action of insulin as such, but in a change in the ability of tissues to capture glucose from the blood and in the ways in which cells use it. With improved glycemic control (that is, with a sufficient decrease in blood glucose levels under the influence of injected insulin), tissues acquire the ability not only to use more glucose to carry out their functions, but also to store more carbohydrates and fat. Accordingly, if for some reason too much insulin is administered, it will stimulate the accumulation of energy sources “in reserve” and, possibly, in excess quantities. It is important to emphasize that with a sufficient and correctly calculated amount of insulin, this will not happen.
Myth two: Using insulin, I will never be able to lose weight.
As we have already found out above, the optimal amount of insulin administered does not lead to weight gain. Accordingly, first of all, to maintain normal body weight, a high-quality and accurate calculation of the dose of the drug is necessary. Among other things, there are a number of ways to reduce the need for insulin in tissues, as a result of which the administered dose can be reduced without losing the therapeutic effect. However, this fact, if interpreted incorrectly, can lead to another misconception.
Myth three: in order to lose weight, I need to take an incomplete dose of insulin.
This statement is extremely unfair: administering insufficient amounts of insulin simply will not lead to normalization of blood glucose levels, which means that such treatment in itself is absolutely useless. As a result, instead of normalizing weight, you can get all possible complications of diabetes, including life-threatening ones. Reducing the amount of insulin administered is only possible when steps are taken to improve the uptake of glucose into tissues, resulting in less insulin being required to absorb the same amount of glucose. The best way to achieve this effect is physical activity. Are they allowed for patients with diabetes?
Myth four: exercise is dangerous for patients with type 1 diabetes.
Thoughts about the dangers of physical activity in patients with type 1 diabetes mellitus may be due to the fact that hypoglycemia can occur during many exercises. Fear of hypoglycemia forces the patient to avoid excessive physical activity and lead a sedentary lifestyle. Meanwhile, during active muscle work, a unique mechanism of glucose uptake is implemented, which does not require the presence of insulin. In addition, the contractile muscle secretes hormone-like substances that can increase tissue sensitivity to insulin, as well as increase the intensity of fat breakdown and reduce its production. All this, one way or another, leads to a decrease in the need for insulin. This means that smaller doses of insulin can be used without losing its beneficial effects. However, we should not forget that it is impossible to simply reduce the dose of the drug without changing your lifestyle to a more active one. This will not only not improve the situation with body weight, but will also lead to a worsening of the disease.
Myth #5: To lose weight while on insulin therapy, I must stick to a strict diet.
Type 1 diabetes and insulin treatment do not require adherence to any specific diet. In fact, the patient can afford to eat anything in any quantity, as long as the dose of insulin administered before meals is sufficient to maintain glucose at an acceptable level.
Thus, general recommendations for weight maintenance in patients with type 1 diabetes are as follows:
First of all, it is necessary to ensure adequate glycemic control: the dose of insulin must be sufficient. An “overdose” of insulin leads to increased glycogen synthesis and can subsequently provoke large fluctuations in blood glucose levels. In addition, exceeding the required amount of insulin leads to an increase in “reserves” of energy sources in the form of fat. Insufficient insulin does not allow glucose concentrations to decrease to the required level, which threatens the development of complications of diabetes mellitus. It is fundamentally important that with a correctly calculated dose of insulin, no undesirable effects will be observed.
Physical activity is not only not contraindicated for patients with type 1 diabetes, but is also vital for them. Regular physical activity increases the ability of tissues to absorb glucose and, therefore, reduces the amount of insulin required for administration.
If the dose of insulin is selected correctly, and each meal is accompanied by the introduction of an adequate amount of the hormone, the patient does not require a special diet. Of course, following the so-called “Mediterranean” diet is much healthier than eating fast food, but for patients with type 1 diabetes, the range of food choices is much wider than for people with metabolic syndrome or obesity.
Type 2 diabetes and insulin
For people with type 2 diabetes, weight gain after starting insulin therapy can also be a problem. For people with type 2 diabetes, insulin resistance is a major factor. Additionally, the use of other medications to compensate for diabetes or related conditions may play a role in excess weight gain.
Interestingly, research shows that insulin therapy itself does not cause weight gain in patients with type 2 diabetes. Another study noted that insulin-related weight gain in type 2 diabetes is associated with increased sedentary behavior.
Additionally, a recent publication describes that
“By the time insulin was started, high baseline insulin dose requirements were independently associated with greater weight gain as well as lower baseline BMI. Insulin use alone was not a predictor."
Experts also note that
“Several factors are associated with weight gain and more intensive therapy: failure to compensate for calorie losses due to glycosuria, consumption of excess calories to treat more frequent episodes of hypoglycemia, excess body water due to periods of poor glucose control, and habitual overeating. In general, increasing calorie intake leads to weight gain and increased insulin resistance, which then worsens the progression of diabetes.
Hunger is a symptom of hypoglycemia, which in many cases can lead to overeating. The patient's fear of hypoglycemia may also lead to underuse of insulin or chronic overeating to try to prevent episodes of hypoglycemia. This so-called 'defensive snacking' can become a habit for many people with diabetes as they try to control or prevent episodes of hypoglycemia."
And in conclusion they say that
“Although insulin therapy carries a risk of weight gain, with careful management of diabetes-related therapy, weight gain is not inevitable. A variety of lifestyle interventions and targeted therapies are now available to achieve the smallest possible weight change while maintaining adequate glycemic control.”
Thus, as with type 1 diabetes, unwanted weight gain with type 2 diabetes is not inevitable. However, patients should be careful not to overindulge in calories and work with their healthcare provider to optimize insulin dosing and minimize incidents of hypoglycemia.
REGULATION OF INSULIN PRODUCTION
Insulin production can be basal or dietary:
- basal insulin is responsible for normal blood glucose levels, as well as anabolism between meals, at night. Its secretion rate is 1 unit/hour. Fasting and physical activity reduce this indicator;
- Dietary insulin production increases after eating certain foods that cause an increase in blood glucose. It accounts for up to 70 percent of the hormone produced per day, which serves the body to reduce the amount of glucose. At the same time, per 10 grams of carbohydrates, from 1 to 1.25 units of insulin are secreted, which is called one bread unit (XU).
Hormone production is also influenced by the time of day. The largest amount of the hormone is released after breakfast - up to 2.5 units per 1 XE. This is also due to the presence of cortisol, which has very high levels in the morning. Insulin production gradually decreases, and by evening the indicator drops to 1 unit.
Tips for achieving or maintaining an optimal weight while on insulin therapy
- Pay attention to your diet: consuming too many calories can lead to weight gain. Making sure you're getting enough protein, an essential building block that will help you feel fuller longer, can help you minimize excess carbohydrate and fat intake (all dietary changes should be discussed with your doctor!).
- Make sure your insulin doses are set correctly: Using too much insulin causes hypoglycemia and leads to excess carbohydrate (calorie) consumption, which can lead to unwanted weight gain.
- Exercise regularly: Exercise is beneficial for improving insulin sensitivity and can make it easier to maintain your weight.
- Drink water! Water is not only a defense for the body, but also a great way to eat less! Sometimes when we think we're hungry, we just need fluids!
PARTICIPATION OF INSULIN IN FAT STORAGE
Insulin is a protein hormone synthesized by pancreatic cells. When the amount of glucose increases, the hormone is released to activate proteins that transport it. They carry out the function of delivering glucose to the cells of adipose tissue, where it is directly involved in the formation of fat. Insulin also affects the interaction of carbohydrates and fats in the liver, increasing the amount of fat. They are stored in the capillaries of adipose tissue, that is, the hormone causes the process of fat deposition.
There are two types of fabrics. Insulin-dependent tissues are liver, muscle and adipose tissue. There is no dependence on insulin in blood cells, nervous system, and vascular endothelium. In the absence of the hormone, glucose is not able to penetrate insulin-dependent tissues, as a result of which cells do not store fat and muscle tissue does not receive energy. If glucose is not supplied and insulin is not produced, then the muscles begin to take energy from fat tissue. This is how the process of burning fat reserves begins. The conclusion is that low insulin levels lead to a decreased likelihood of weight gain. The body's activities will be carried out due to the old fat layer. However, constantly low levels of the hormone threaten the loss of muscle mass.
Tips to avoid weight gain
Calorie counting
People with diabetes try to eat less carbohydrates. However, it is just as important to track your overall calorie intake. Eating too many calories can lead to excess blood glucose levels and increased fat storage. Portion control and food journaling can prevent a person from consuming more calories than their body needs. Over time, people learn what portion sizes work best for them and no longer need to measure and track their food intake.
Regular training
Regular exercise keeps the body healthy and strong. They also help burn calories, regulate blood glucose levels and promote fat burning. WHO recommends that adults aged 18 to 64 get at least 150 minutes of moderate-intensity exercise each week. A recent review suggests that exercise can provide significant benefits for people with insulin resistance and type 2 diabetes.
The doctor's consultation
The researchers believe that “there is no one-size-fits-all eating pattern for people with diabetes, and meal planning should be individualized.” Dietitians can advise people on what foods they should eat and what they should avoid. They will also help you develop personalized meal plans.
Doctors can advise patients on ways to improve their health while reducing their risk of developing diseases such as diabetes, obesity and cardiovascular disease. Doctors can check your glucose and insulin levels and their lipid profiles. These laboratory methods can give people insight into their overall health.
Food
Certain foods may help prevent weight gain. High-quality, unprocessed foods contain less sugar and fat. These foods increase your feeling of fullness and help you avoid overeating.
OBESITY, INSULIN AND CARBOHYDRATES
OR 12 STEPS ON THE PATH TO OBESITY
Since excess body weight is one of the determining factors in the development of diabetes mellitus, it would be useful to understand how this process occurs in the body and what provokes it.
The obesity algorithm can be presented as follows: 1. You think about food; 2. you begin to secrete insulin; 3. insulin signals the body to store fatty acids and not burn them, releasing energy; 4. you feel hungry; 5. blood sugar levels increase; 6. simple carbohydrates enter your blood in the form of glucose; 7. you begin to secrete even more insulin; 8. you start eating; 9. you secrete even more insulin; 10. fat is deposited in fat cells in the form of triglycerides; 11. fat cells become even thicker; 12. you are getting fat
Fats are constantly moving in and out of the body's cells. And we get better from the fats that remain in the body. Fat is stored in the fat cell in the form of triglycerides. Triglycerides are formed from three fatty acids linked by a single glycerol molecule inside a fat cell. They are too large to pass through the fat cell membranes, unlike fatty acids, which pass out easily. Those. the more triglycerides accumulate, the larger the cells become, the larger we become.
Carbohydrates are simple (fast) and complex. Fast or simple carbohydrates are compounds that consist of one or two molecules of monosaccharides, and they are the most harmful in terms of causing obesity.
Simple carbohydrates are divided into two groups:
- Monosaccharides (glucose, fructose, galactose);
- Disaccharides (sucrose, lactose, maltose)
Simple carbohydrates are instantly digested, releasing glucose into the blood. This in turn promotes the production of insulin.
Insulin is the main regulator of metabolism. Its level determines whether fat cells will be synthesized or broken down. When insulin levels rise, the enzyme lipoprotein lipase (LPL), which is responsible for the entry of fat into the cell, is activated. Those. The more insulin we produce, the more actively LPL pumps cells with fat.
So, the production of isulin is caused by carbohydrates. The quantity and quality of carbohydrates consumed will determine how much fat is deposited.
And this means
carbohydrates increase insulin -
- insulin promotes fat deposition
However, carbohydrates are different from carbohydrates:
The role of carbohydrates in human diseases through the regulation of unbalanced intestinal microbiota
On the topic, see also:
- Gut microbiome and type 2 diabetes
- Microflora and type 2 diabetes mellitus
- Dyslipidemia
- Metabolic syndrome
- Probiotics against obesity
- Antibiotics cause obesity
- Probiotics against childhood obesity
- How gut microflora can cause obesity
- Clinical studies "Bificardio"
- Preclinical studies of "Bificardio"
- Probiotics and Cholesterol
- High cholesterol. What to do?
- Cholesterol-metabolizing activity of intestinal bacteria
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Does insulin affect weight?
Insulin plays a role in regulating blood sugar levels and converting food energy into fat. Insulin also helps break down fats and proteins and stimulates muscle, fat and liver cells to absorb glucose during digestion. Cells either use this glucose for energy or convert it into fat for long-term storage. Eating more calories can lead to excess glucose levels. If cells do not extract glucose from the blood, the body will store it in the tissues as fat. When a person receives insulin as treatment for diabetes, their body may absorb too much glucose from food, leading to weight gain. If diabetes is left untreated, it can cause weight loss because the body does not properly convert food into energy. Taking insulin solves this problem. This is why people may notice weight gain when they start taking insulin.
WEIGHT LOSS DEPENDING ON INSULIN
There is a misconception among diabetics that they need to reduce their insulin dose. This is very dangerous; excess blood sugar harms the body, increasing its viscosity. Therefore, it is necessary to reduce the level of glucose itself by adjusting the quality of the diet. Eating foods with a high glycemic index (GI) has a direct link with the likelihood of developing type 2 diabetes. Such a diet also threatens the development of insulin resistance, that is, the body's cells become resistant to insulin and cannot use it fully. The occurrence of such diseases is also influenced by a lack of fiber, which slows down the absorption of glucose into the bloodstream, and a lack of physical activity. This is how obesity begins.
Low GI foods that are least likely to contribute to insulin production are needed. The glycemic index of pure glucose is 100; for other products it is indicated in comparison with this parameter. A low GI level indicates the product's ability to slowly raise blood sugar. The level of the hormone will also be low, which causes the body to lose weight. A healthy body increases insulin levels in response to a high GI. Limiting carbohydrates in the diet is practically the only non-drug way to lower the amount of insulin in the blood. This enhances the process of breakdown of adipose tissue, making weight loss easy. Low-fat and low-calorie diets often have a very weak effect precisely because of the presence of carbohydrate-containing foods in the menu.
