HOW INSULIN THERAPY INCREASES THE RISK OF WEIGHT GAIN IN DIABETIC PATIENTS

WHAT IS INSULIN?
Insulin is a peptide and essential anabolic hormone which is secreted by the beta cells of pancreas when a person blood sugar level is high especially after having meal. It is very crucial hormone for the regulation of blood sugar or glucose level and in absorption or uptake of glucose into the body cells for consumption as energy or in storing glucose as a fat for long term energy consumption demands.

NOW THE QUESTION IS THAT HOW INSULIN THERAPY INCREASES THE RISK OF WEIGHT GAIN?
There are many reasons for weight gain association with insulin therapy. I will address them one by one. Let’s check it out.

IMPROVED GLUCOSE UPTAKE
Before starting insulin in diabetic patients, the sugar level is high in blood stream due to insulin resistance (cells are unable to absorb glucose into cells) or lack of insulin (as in type 1 diabetes due to autoimmune destruction of beta cells of pancreas). When a person starts to take insulin, the body cells start to uptake the glucose from blood for energy utilization or for storage as fat.

LESS PHYSICAL STRESS OR WORK LOAD
If a person physical activity is less than all the glucose will be stored as a fat and it will not be burn out as energy and become risk factors for cardiovascular diseases, osteoporosis and many other metabolic disorders.

ENHANCE APPETITE
In recent successful experiments, insulin is being utilized to make thin people fat which clearly indicates that insulin and hunger (appetite) has some indirect relation. Exogenous insulin increases the hunger may be by affecting functional activity of stomach or by sending hunger signaling to brain (Hypothalamus which control hunger) which ultimately stimulate hunger hormones that is mainly due to uptake of glucose by the body cells and due to a drop of sugar in the blood (hypoglycemia). This hypoglycemia results in increase intake of food and subsequently gain in weight or obesity.

FEAR OF HYPOGLYCEMIA OR DEFENSIVE SNACKING
Diabetic patients may experience a drop in blood sugar level (hypoglycemia)l by taking more insulin than their need. In order to avoid hypoglycemic consequences (Dizziness, confusion, depression, heart problems, shortness of breath and loss of consciousness) people eat more food and calories with net gain in weight.

REDUCTION IN GLYCOSOURIA
Glycosuria is a condition in diabetic patients in which due high blood glucose level, the kidneys are unable to reabsorb all the glucose from blood and allow the body to make more fluid and excreted out the excess glucose into urine which is also one of the main reasons of urgency of peeing in the diabetic patients. With insulin therapy less glucose is present in blood which upon reaching to kidneys efficiently reabsorb and results in subsequent weight gain.

DROP-IN BASAL METABOLISM RATE
Basal metabolism rate can be defined as the rate at which body burns out calories during rest position. Insulin therapy causes a drop-in normal basal metabolism rate which results in less calories burn out throughout the day and eventually causes weight gain.

STORAGE OF FAT IN ADIPOSE TISSUE
Insulin causes fat storage in adipose or connective tissues (also known as body fat) as subcutaneous fat (under the skin), as visceral fat (the space between internal organs) and as bone marrow fat (in the inner cavities of bones).

HOW THE WEIGHT GAIN ASSOCIATED WITH INSULIN THERAPY CAUSES PROBLEMS IN MANAGING DIABETES?
Weight gain is the main leading cause of insulin resistance in the body which ultimately results in metabolic disorder called diabetes. After starting insulin therapy at certain dose, body showed resistance to this dose due to weight gain after certain period of time. As a result of it, now more dose of insulin is required for effective blood sugar management. In this way a viscous cycle of weight gain is initiated which further worsen diabetes if less calories intake, physical activities and exercise are not taken into consideration.

CONCLUSION
Life style modification has an important role in diabetes management. Less carbohydrates, sugar and calories intake and more physical activities and exercise is critical to prevent someone from obesity associated with insulin therapy.