Insulin and weight gain?

[phoenix]

The article quoted by 'Geezer' repeats more simply much that is written in this paper: It's a good explanation as to the why people can put on weight though the latter part is a promotion for the efficacy of levimir as a background insulin.

http://dmh.mo.gov/docs/medicaldirector/ ... rticle.pdf

Here's part of the the abstract: with a my comments in blue

. Insulin-associated weight gain may result from a reduction of blood glucose to levels below the renal threshold without a compensatory reduction in calorie intake, (ie once levels are reduced below about 10 glucose is no longer spilled from the urine but people have got unconsciously used to eating more in an attempt to fuel the body so when their levels are normalised they tend to carry on doing so)
a defensive or unconscious increase in calorie intake caused by the fear or experience of hypoglycaemia, ( The fear of hypos causes some people eat when there levels begin to fall, they may also eat far more than necessary to treat hypos )
or the ‘unphysiological’ pharmacokinetic and metabolic profiles that follow subcutaneous administration. (normal insulin is released through the portal vein, not by absorption through the skin. Theres a world of difference between injecting some insulin when we think we need it and the finely balanced feedback loop of insulin/glucagon in a working system, the paper discusses why this aspect can lead to weight gain)

There is, however, scope for limiting insulin-associated weight gain. Strategies include limiting dose by increasing insulin sensitivity through diet ( (bit of a catch 21 here, the author describes how weight loss through calorie reduction increases insulin sensitivity. For my self it's a matter of watching the scales and intervening by reducing calories before any weight gain becomes significant) and
exercise (i exercise in particular improves insulin sensitivy both short term and long term, indeed the body can get glucose into the muscle cells without insulin during exercise) or by using adjunctive anorectic or insulin-sparing pharmacotherapies such as pramlintide or metformin. ( seems to help some people on insulin ; more so Met in the UK)
Insulin replacement regimens that attempt to mimic physiological norms should also enable insulin to be dosed with
maximum efficiency (MDI and even more so pumps try to do this but they are a long way from perfect replication, even a pump together with a continuous monitoring system is not an artificial pancreas : http://en.wikipedia.org/wiki/Artificial_pancreas

[Riesenburg]

Greetings Rebecca,

The key to wieght control is partially due to what we eat for which there has been quite a few good suggestions AND controling the hormonal flow in our bodies. I will give you a few tips with respect to the latter.

Insulin is one of the main hormones we rely upon, it basically keeps us alive. It's function varies depending on whether it is becoming active during the day or the evenings (in healthy individuals). What the ideal position is, is simply to keep the insulin levels higher during the day when it's function is to carry carbs and protein into your muscles and body in order to generate fuel for producing energy. In the evenings, things change and it tends to do what in medicine is termed an increase in lipid synthesis and decreases lipolysis. What this means is that it increases the fat cells uptake of fats from the blood into fat cells for storage and it decreases the conversion of stored fat cells into free fats which flow in the blood. In effect, it will increase the amount of body fat and stop it being used later on. This is what we want to avoid, since this tends to occur mostly at night or in the evenings when we are not as active than during the day it's just a matter of adapting our meals during the evenings to require a little less insulin.

During the day it should not be a problem since you will be active, and I hope exercising, all the insulin should be used in order to promote the intake of the sugars and proteins into the body cells which need it (about 2/3 of your total body).

A final thing to keep an eye out for is check your thyroid hormone levels, if those are too low your metabolic rate will be low and cause an increase in weight amongst other things and unfortunately we diabetics specially type Is are prones to a lot of these problems. Estrogens if elevated can also promote unnecessary fat storage and water retention.

Hypos and Hypers need to be kept in check, each time we either have the one or the other the body will release Cortisol Andrenaline and Growth Hormone. The cortisol if not used gets changed into Cortisone which the body also stores as fat. The only fix for this without resorting to drugs is to simply avoid as many hypos and hypers as humanly possible.

Naturally, don't forget to keep physically active, I have 3 sessions at the gym a week and can't put on fat even when indulging in carbs! It's the key to it all, other than keeping your weight under control exercising will stabilise your HBA1C, will promote circulation, and as mentioned increase glucose uptake, and most importantly will prevent brain decay!

For us chaps, exercise boosts testosterone production which is responsible for increasing sensitivity to insulin too

Let us know how you get along
Frankie

[noblehead]

The article quoted by 'Geezer' repeats more simply much that is written in this paper: It's a good explanation as to the why people can put on weight though the latter part is a promotion for the efficacy of levimir as a background insulin.

http://dmh.mo.gov/docs/medicaldirector/ ... rticle.pdf

Here's part of the the abstract: with a my comments in blue

. Insulin-associated weight gain may result from a reduction of blood glucose to levels below the renal threshold without a compensatory reduction in calorie intake, (ie once levels are reduced below about 10 glucose is no longer spilled from the urine but people have got unconsciously used to eating more in an attempt to fuel the body so when their levels are normalised they tend to carry on doing so)
a defensive or unconscious increase in calorie intake caused by the fear or experience of hypoglycaemia, ( The fear of hypos causes some people eat when there levels begin to fall, they may also eat far more than necessary to treat hypos )
or the ‘unphysiological’ pharmacokinetic and metabolic profiles that follow subcutaneous administration. (normal insulin is released through the portal vein, not by absorption through the skin. Theres a world of difference between injecting some insulin when we think we need it and the finely balanced feedback loop of insulin/glucagon in a working system, the paper discusses why this aspect can lead to weight gain)

There is, however, scope for limiting insulin-associated weight gain. Strategies include limiting dose by increasing insulin sensitivity through diet ( (bit of a catch 21 here, the author describes how weight loss through calorie reduction increases insulin sensitivity. For my self it's a matter of watching the scales and intervening by reducing calories before any weight gain becomes significant) and
exercise (i exercise in particular improves insulin sensitivy both short term and long term, indeed the body can get glucose into the muscle cells without insulin during exercise) or by using adjunctive anorectic or insulin-sparing pharmacotherapies such as pramlintide or metformin. ( seems to help some people on insulin ; more so Met in the UK)
Insulin replacement regimens that attempt to mimic physiological norms should also enable insulin to be dosed with
maximum efficiency (MDI and even more so pumps try to do this but they are a long way from perfect replication, even a pump together with a continuous monitoring system is not an artificial pancreas : http://en.wikipedia.org/wiki/Artificial_pancreas

Good post Phoenix

[DR MICHAIL]

Ask your gp if Victos injection is suitable for you ? It did help me to lose 10kg and also helped others. But after that it will keep you steady