Diabetes and Weight Gain
Diabetes can be both the cause of weight gain and the result of weight gain. People with diabetes have an increased tendency to gain weight and those who are overweight have an increased chance of developing diabetes.
Insulin is a natural, protein-based hormone produced by the pancreas in normal people. Its function is to promote the absorption of glucose into the cells to be used for cellular fuel. It also manages the absorption and storage of amino acids and fat by cells of the body that are sensitive to insulin (which are mainly the fat and muscle cells).
Insulin has the above effects on the body, whether the pancreas releases it naturally or given as exogenous insulin to insulin-dependent diabetes. Diabetics who go on insulin therapy seem to have an increased tendency to gain weight. This is true of both type 1 diabetics and type 2 diabetics. Some of the gain is weight is due to the fact that, when insulin is in the bloodstream, it takes the glucose absorbed by the GI tract and puts in in storage rather than have the glucose be excreted by the kidneys. This causes a natural gain in weight.
Some diabetics recognize the connection between insulin and weight gain. In order to lose weight, they often skip doses of insulin so that the blood sugar they take in is not stored but instead is flushed out by the kidneys. They don’t realize that this could be dangerous and can result in life-threatening side effects, such as diabetic ketoacidosis.
The most effective way to strike a balance between insulin use and body weight is to take the insulin as directed and also to step up the amount of physical activity you engage in. This keeps the levels of insulin lower and you will lose weight. When you take less insulin and burn calories through exercise, your weight will naturally decrease.
Making Good Food Choices
Because insulin intake generally leads to weight gain, what you put in your mouth has a great deal to do with your insulin needs and your ultimate body weight. Things like stepping up the insulin dosing through the use of an insulin pump can allow the diabetic to eat more with an overall decrease in the amount of insulin needed to keep the blood sugars under control.
There are all sorts of different types of diets for diabetics, including vegan diets, very low calorie diets, and low carbohydrate diets. In actuality, the best diet for diabetics is a diet that is balanced in carbohydrates, protein, and fat and is low enough in calories to prevent weight gain. The diet doesn’t have to be extreme to help the diabetic lose weight.
Low carbohydrate diets don’t necessarily lead to weight loss, even though it means that your needs for insulin are lower, because excess fat contains more calories than either protein or carbohydrates. Each gram of fat contains 9 calories, while each gram of protein or carbohydrates contains only 4 calories.
If you eat a low carbohydrate diet, you need to eat something else besides carbs. It’s easy to instead eat too much fat unnecessarily and, even when the muscle cells develop insulin resistance, the insulin will still work to put fat into storage in the fatty areas of the body.
The trick is to avoid skipping carbohydrates altogether and to instead eat the better forms of carbohydrate. This means eating carbs that have a low glycemic index. Foods with a low glycemic index absorb glucose more slowly from the gastrointestinal tract and don’t result in spikes of blood glucose levels that lead to increased insulin levels and increased fat storage. Most of the carbohydrates you eat are absorbed after 1 hour, while even quick-acting insulin can be present in the system for up to 8 hours following a meal.
A person’s requirement for insulin is determined by more than just the amount of insulin you take in. One study performed in 2013 indicated that eating fatty foods with the same number of carbohydrates also increases the individual requirement for insulin. This means that the diet of a diabetic shouldn’t be one that only counts carbohydrates. You need to have a balance of macronutrients, including having adequate amounts of all three macronutrients—including protein, carbohydrates, and fat.
Treating Low Blood Sugar Levels
Diabetics can gain weight if they are often using insulin to treat low glucose levels. This is a common reason why some diabetics gain weight even though they aren’t eating very many calories. Lows in blood glucose levels are often treated by eating foods containing simple carbohydrates and this causes weight gain in diabetics.
One of the biggest reason why diabetics gain weight is because they overdo it on the insulin they take in (or on medications used to treat diabetes) and must make up for it by drinking sugary beverages, eating foods high in simple carbohydrates, and eating more calories than are necessary as part of a balanced diet.
One way a diabetic can decrease the frequency of low blood glucose levels is to decrease the insulin injected into the system. This can include decreasing the amount of insulin necessary for injection during mealtimes and decreasing insulin doses prior to exercising, or after exercising. This decreases the chances of having low blood sugar levels that need to be treated by overeating.
If an episode of hypoglycemia does occur, you need to try taking glucose tablets or by eating candy that contains dextrose, reassessing the blood sugar level to see if you need to take in any more food. If you need to take in food to treat hypoglycemia, you should have a mixture of protein, carbohydrates, and fats in order to keep the blood sugar from dropping down again.
Juice is sometimes used to treat episodes of hypoglycemia. Juice is primarily a fructose-containing beverage that is very slowly absorbed by the GI tract when compared to glucose. If the fructose-containing beverage doesn’t bring up the blood sugar fast enough, you are forced to eat more food, which ultimately leads to weight gain.
Lack of Exercise
Research has definitively shown that people with type 1 diabetes who actively engage in physical exercise have a lower body mass index (BMI) when compared to diabetics who do not exercise. The percentage of total fat and belly fat is lower as well in diabetics who exercise.
The more you exercise, the less insulin you need to lower blood glucose levels. When you need smaller amounts of insulin, you have fewer episodes of hypoglycemia and will not need to eat so many calories to counteract the low blood sugar level.
Diabetics with type 2 diabetes are usually diabetic because of insulin resistance rather than a lack of insulin. Their total insulin requirements will be higher when exercising and this can lead to weight gain instead of the expected weight loss. The goal is to eat a well-balanced diet and exercise to burn calories so that the exercise can lead to a weight loss situation without having excess insulin around, which promotes weight gain.
References:
- Losing Weight with Diabetes: What Prevents It and Causes Weight Gain. http://www.diabetesincontrol.com/losing-weight-with-diabetes/. Accessed 5/28/16.