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Weight gain from insulin treatment in type 2 diabetes linked to sedentary behaviour

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Non-obese people with type 2 diabetes who gain weight after starting insulin therapy are more likely to do so because of sedentary behavior, research suggests. A research team from the Netherlands randomly selected 40 people with type 2 diabetes and recorded a variety of health measurements. These included their body weight, waist-to-hip circumference, fasting blood sugar levels, and HbA1c levels. The same data was recorded again six to 12 months after. The participants started using insulin as part of their treatment, and had their physical activity monitored through armband monitors. The researchers captured each participants' step count and assessed how much energy they used on a daily basis. They were also asked to write down what they ate every day. Explaining the increase in sedentary behavior, the authors wrote: "Sedentary behavior, especially in non-obese type 2 diabetes patients, may contribute to body weight gain after initiation of insulin therapy. Sedentary behaviour assessment and intervention may be needed in type 2 diabetes management." The findings showed that the increase in sitting time and decrease in light activity only happened in the people who had a Body Mass Index (BMI) of less than 30 kg/m2, when compared with those with a higher BMI, after starting insulin. The researchers added that the results may be because of a "ceiling effect in sedentary behavior in patients with BMI>30 kg/m2". "Indeed, the average sitting time of 12.5 hours [for this group] makes it practically difficult to further increase sedentary behavior," they said. The 12-month review also suggested those with the lower BMI spent less time sitting down and took part in more low-intensity exercise. But, after they started insulin their BMI increased; this did not occur in those with the higher BMI when the study began. The study suggests that a change in activity levels may be at least partly responsible for weight gain upon starting insulin therapy. Benedict Jephcote, Head of Diabetes Education at Diabetes.co.uk, said: "The results are interesting and it will be useful if further research can identify why non-obese people starting insulin therapy are more likely to reduce their activity levels. "Is it because they are worried to exercise when starting insulin because of a fear of hypoglycemia? Do some patients feel a sense of resignation when they start insulin that leads to a decrease in motivation for exercise? These will useful questions to get answers to." The findings have been published in the journal Diabetes Care.

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Or does insulin actually promote the brain to cause sedentary behaviour?
In my experience the lower the insulin in your blood the more energy you have and you are more likely to be more active.
An Imbalance in insulin levels and little control in blood glucose levels will give you symptoms of lethargy plus many more contributors to being sedentary.

I m going to track this article down to see what these people were eating.
 
The print on that article (on the link) is so small I can't read it.

Did they actually measure the sedentariness (if there is such a word) of the participants before they started using insulin?

Just from my own personal experience - when I started using insulin I was just as active as I had been before needing it and my diet was just the same (basically The Eatwell Plate), yet I managed to gain a stone for each of the five years I was using it and couldn't shift an ounce.

Maybe the participants in this research were sedentary before they started being observed.
 
There was no mention wether the dietary advice they were given had a cause and effect on how their symptoms were exacerbated by being sedentary. And I'm assuming, with the insulin on top of such a diet, would if anything promote the symptoms they encountered to further develop the fatigue and lethargy!
How can such a research project be not dietary controlled during the trials for diabetics?
It's not logical!
 

Maybe, they wanted to try and prove that insulin is the only answer for some T2s!
 
@Lamont D - In trials they would be keen that only one thing is changed at a time, so if the subjects were new insulin users, I doubt any lifestyle changes would have been positively recommended, during the research time frame.

There is a research project getting under way shortly, whereby all participants (Pre-ds) will wear Libres for a number of months, just going about their business, then they will have some recommendations for their lifestyle and both sets of data tracked. During the course of the research they will not have access to their data.

My suggestion during the planning phase was that there needed to be a third phase, whereby their data be made available to them, then continue to wear the Libre, with their data visible to them, in real time, and see what happens to their blood scores along the way. I don't know yet if the third phase is approved.
 
I would love to see what you could to by putting a group of people with Type2 and their partners etc in a hotel for a week, have everyone wearing a Libre and all the data visible to everyone. Then provide a wide selection of food, cooking class, excise classes etc along with foot and eye checks etc. Don't tell them anything about what they should etc for the first few days to see what people discover themselves when they see the graphs, then explains how low carb work.

What would the results be on HbA1C tests one and two years after it...... Could a TV program be made from it so as to spread the learning?
 
There's a lot of new focus for prediabetes on high levels of insulin.
Because recent thinking is that hyperinsulinaemia and insulin resistance is a precursor to T2.
But still a standard test is not done on how much first high insulin levels creates insulin resistance, then high blood glucose levels.
This precursor does often occur many years before prediabetes is apparent.
Imagine if tested every five years, they found high insulin levels on a fasting test.
They could advise dietary changes to lessen the high insulin levels.
That's called prevention!
 

Doing some work with the NIHR has helped me realise how long it takes for any idea to become a potential research project, never mind a a planned research project, never mind all the approvals, then funding.

When we look at some of the activity going on now, it was probably proposed a couple of years ago, but there is such a lot going on, even if we don't necessarily hear about it for an age. That's what I have taken a huge a mount of heart from; the amount going on, not the time it takes to get out there.
 
I suggest the weight increase will be due to their diets. I know that the more my insulin resistance increased, the slower I became.
 

More likely to be weight gain caused by insulin treatment leading to more sedentary behaviour perhaps?
 
bulkbiker said:
More likely to be weight gain caused by insulin treatment leading to more sedentary behaviour perhaps?
Click to expand...
Could it be that one feeds off the other and both act as catalyst to the other to produce the outcome? I wouldn't rule it out!
 
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