Diabetes Forecast

Should I Worry About Weight Gain With Insulin?

I am almost 20 years old, have had type 1 diabetes for eight years, and use insulin glargine (Lantus). Should I try to lower the need for insulin to prevent weight gain? I haven't been gaining weight, but I am concerned that I'll get into a cycle of increased insulin dosages and weight gain. Emily Petit, North Kingstown, Rhode Island

Belinda Childs, APRN, MN, BC-ADM, CDE, responds: Insulin has often been given a bad rap for causing weight gain. Generally, if you are taking the right amount of insulin, you will not gain weight. But doing this can be a very difficult balancing act, especially with type 1 diabetes.

What to Know: For blood glucose control, taking the appropriate amount of insulin to cover your meals and snacks while accounting for your level of physical activity is important. The calories you consume include those you eat and drink in meals and snacks as well as calories you take in to prevent and treat hypoglycemia (low blood glucose).

It can seem as if the insulin is causing weight gain. The truth is: Too many calories are causing the weight gain, not the insulin. If you are eating more calories than your body is using and you are taking insulin to keep your blood glucose levels in the normal range, you may gain weight. Taking too much insulin and then having to eat more calories to prevent lows also may cause weight gain.

Find Out More: A consultation with a dietitian can help you determine how many calories you need to maintain your body weight or to gain or lose weight, if that is a personal goal. If you are having frequent lows, especially during the night or while fasting, then you may need a lower dose of long-acting insulin. Lows within two to three hours of eating or during or after exercise may require other insulin adjustments. For a week, test your blood glucose levels while fasting, two hours after meals, and during the night. Record your insulin doses, and note how much food and caloric beverages you consume.

Possible Solution: These detailed records will help you and your health care provider see if you are taking the right amount of insulin, as well as allow the dietitian to evaluate your average daily calorie intake. This is the best way to strike the right balance.



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