Weight gain | I can never lose weight | I need to inject a dose of insulin not completely | Exercise is dangerous | I must adhere to a strict diet | General recommendations
One way or another, in the modern world the concept of attractiveness is often associated with keeping the human body following certain criteria, the main of which is body weight. And if for a healthy person being overweight for a certain time is just a cosmetic defect, then for a patient with diabetes, maintaining a normal body weight affects the course of the disease and the likelihood of serious complications. Many patients starting treatment with insulin note an increase in body weight, mistakenly believing that the hormone itself is the cause of the accumulation of fat. This leads to fear of its use in a number of patients. It is difficult to condemn them: it is unlikely that any of us is willing to consciously get fat and become less attractive to others. The problem is that for a patient with type 1 diabetes, insulin is vital for providing glucose to the tissues, and discontinuing it or introducing it in insufficient quantities can lead to a worsening of the course of the disease and even death. Why, in fact, is weight gain in patients and how can one deal with it? Let’s try to deal with the existing myths about insulin therapy and decide how to achieve a good result.
Myth One: Insulin administration leads to weight gain. This opinion is based on the personal observations of many patients: as soon as they begin intensive insulin therapy, body weight begins to increase. The insulin in adipose tissue really inhibits the breakdown of fats and stimulates the production of complex fats and their accumulation. It must be remembered that this process is physiological and necessary for the normal functioning of the body. In the absence of insulin, there is an increase in the concentration of glucose in the blood (that is, hyperglycemia), and it is lost in large quantities in the urine, since it cannot penetrate into the cells. If there is not enough glucose for the energetic “nutrition” of the cells, this leads to the fact that the body weight not only does not increase, but even decreases (which is one of the symptoms of type 1 diabetes mellitus). The presence of insulin prevents the above loss of glucose and promotes the use of glucose for its intended purpose. The reason for the increase in body weight in the case of hormone administration from the outside is not in the action of insulin as such, but in a change in the ability of tissues to capture glucose from the blood and in the ways in which it is used by cells. With an improvement in glycemic control (that is, with a sufficient decrease in blood glucose under the influence of injected insulin), tissues acquire the ability to not only use more glucose to fulfill their functions, but also store more carbohydrates and fat. Accordingly, if for some reason too much insulin is injected, it will stimulate the accumulation of energy sources “in reserve” and, it is possible that in excess. It is important to emphasize that with a sufficient and correctly calculated amount of insulin this will not happen.
Myth two: using insulin, I can never lose weight. As we already explained above, the optimal amount of insulin administered does not lead to an increase in body weight. Accordingly, first of all, in order to maintain normal body weight, a qualitative and accurate calculation of the dose of the drug is necessary. Among other things, there are a number of ways to reduce the tissue needs for insulin, as a result of which the administered dose can be reduced without losing the therapeutic effect. However, this fact, with an erroneous interpretation, can lead to another misconception.
Myth three: in order to lose weight, I need to inject a dose of insulin not completely. This statement is extremely unfair: administering an insufficient amount of insulin simply will not normalize the blood glucose level, which means that such a treatment is absolutely useless. As a result, instead of normalizing weight, you can get all the possible complications of diabetes, including life-threatening. It is possible to reduce the amount of insulin administered only when actions are taken to improve the uptake of glucose by tissues, as a result of which a smaller amount is required to absorb the same amount of glucose. The best way to achieve this effect is to exercise. Are they allowed for patients with diabetes?
Myth four: exercise is dangerous for patients with type 1 diabetes. Thoughts about the dangers of physical exertion in patients with type 1 diabetes mellitus may be due to the fact that during the course of many exercises, hypoglycemia may occur. Fear of hypoglycemia makes the patient avoid excessive physical activity and lead a sedentary lifestyle. Meanwhile, during the active work of muscles, a unique glucose uptake mechanism is realized, which does not require the presence of insulin. In addition, the contracting muscle secretes hormone-like substances that can increase the sensitivity of tissues to insulin, as well as increase the intensity of the breakdown of fat and reduce its production. All this, one way or another, leads to a decrease in the need for insulin. This means that smaller doses of insulin can be used without losing its beneficial effect. However, one should not forget that it is impossible to simply reduce the dose of the drug without changing the lifestyle to a more active one. This not only does not improve the situation with body weight, but also leads to a worsening of the course of the disease.
Myth five: in order to lose weight during insulin therapy, I must adhere to a strict diet. Type 1 diabetes and insulin treatment do not require adherence to any particular diet. In fact, the patient can afford to eat anything in any quantity, the main thing is that the dose of insulin administered before meals is sufficient to maintain glucose at an acceptable level.
General recommendations for maintaining weight in patients with type 1 diabetes are as follows:
- First of all, it is necessary to ensure adequate glycemic control: the dose of insulin should be sufficient. An “overdose” of insulin leads to increased glycogen synthesis and can subsequently provoke large fluctuations in blood glucose levels. In addition, the excess of the required amount of insulin leads to an increase in the “reserves” of energy sources in the form of fat. Insulin deficiency does not allow glucose concentration to drop to the required level, which threatens the development of complications of diabetes. It is fundamentally important that with a correctly calculated dose of insulin, no adverse events will be observed.
- Physical activity is not only not contraindicated for patients with type 1 diabetes but is also vital. Regular physical activity allows you to increase the ability of tissues to capture glucose and, therefore, reduce the amount of insulin needed for administration.
- If the dose of insulin is selected correctly, and each meal is accompanied by the adequate amount of the hormone, the patient does not need a special diet. Of course, following the so-called “Mediterranean” diet is much more beneficial than eating fast food, but for patients with type 1 diabetes mellitus, the food choice range is much wider than for people with metabolic syndrome or obesity.