During any physical activity, your muscles can take up blood glucose and use it as fuel without insulin and then following exercise, your insulin action is heightened for a few hours and as long as 72 hours — meaning that you will need smaller doses of insulin to have the same glucose-lowering effect. It is my personal experience that regular exercise is the best way to prevent insulin-induced weight gain, but your insulin doses will also need to be adjusted downward to prevent low blood sugars that cause you to take in extra calories to treat them.
Second, you may be able to avoid weight gain by taking a look at the type of insulin(s) that you are using. For example, in overweight type 2 people with diabetes, use of once-daily Levemir (detemir) caused less weight gain and less frequent hypoglycemia than use of NPH, even combined with use of rapid-acting injections of a separate insulin for meals (and the same is likely true when using Lantus, or insulin glargine). Anyone taking basal insulin alone (once or twice daily) or following a basal-bolus regimen can benefit by making sure that insulin doses are regulated effectively to prevent blood sugar lows and highs — while using as little insulin as absolutely necessary to get the desired glycemic effect.
In other words, the type of insulin you use and the doses you take are both important to consider in the overall management of your diabetes and your body weight, regardless of which type you have. Just as importantly, though, is how you choose to manage your lifestyle — both your exercise and your dietary choices. Changes in your lifestyle, such as cutting back on refined carbohydrates that require larger doses of insulin to cover them and exercising regularly, are likely your best bets to counteract any potential for insulin use to cause you to gain weight. An added side benefit is that if you have type 2 diabetes and start exercising regularly, you may actually lose fat weight and be able to lower your insulin doses more or get off of insulin injections completely.
1-Fajardo, Montanana C., et al. 2008. Less weight gain and hypoglycaemia with once-daily insulin detemir than NPH insulin in intensification of insulin therapy in overweight type 2 diabetes patients: the predictive BMI clinical trial. Diabet Med 25(8);916-23.
2-Jacob, A.N. et al. 2006. Potential causes of weight gain in type 1 diabetes mellitus. Diabetes Obes Metab. 8(4):404-11.
3-Jacob, A.N., et al. 2007. Weight gain in type 2 diabetes mellitus. Diabetes Obes Metab. 9(3):386-93.
4-Jansen, H.J., et al. 2010. Pronounced weight gain in insulin-treated patients with type 2 diabetes mellitus is associated with an unfavourable cardiometabolic risk profile. Neth J Med. 68(11):359-66.
Sign up for the newly-launched DIABETES "Fit Brain, Fit Body!" fitness/lifestyle programs or for 5 free Healthy Living Reports at www.lifelongexercise.com, and access more articles and information at www.shericolberg.com. If you need tips for getting safely started on an exercise program, check out The 7 Step Diabetes Fitness Plan. For people with any type of diabetes who are already more active, consult the the Diabetic Athlete's Handbook.
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NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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