By Bonnie Goldberg, MA, RD, CDE
One of the most common concerns among people with type 2 diabetes is that they’ll gain weight when they start on insulin pump therapy. The truth is that insulin pump therapy does not cause weight gain, but many people who start taking insulin do gain weight. In fact, research from a study by the United Kingdom Prospective Diabetes Study Group (1998) found that study participants with type 2 diabetes gained an average of 9 pounds in their first 3 years of taking insulin.1 Why does this happen, and how can an insulin pump help reduce insulin-related weight gain?
How can insulin cause weight gain?
There are three primary reasons why people with type 2 diabetes might gain weight when they start on insulin therapy:
1. High blood glucose levels: The hormone insulin enables the body’s cells to take up sugar in the bloodstream to burn for fuel. When we consume more fuel than we burn, some of the excess fuel is stored as fat. When there isn’t enough insulin available in the body to store this extra energy, the glucose remains in the bloodstream, causing elevated blood glucose levels. High blood glucose can cause a person to feel tired, sluggish, hungry, and thirsty. When blood glucose is very high, some of that extra sugar passes through urine instead of being stored as fat, resulting in unnatural weight loss. When insulin therapy is started, the body can store excess energy in the cells again, and the person can gain weight.
2. Treating hypoglycemia: Hypoglycemia is often treated with glucose (sugar), and a lot of episodes of hypos can lead to eating a lot of extra sugar! Those excess calories can lead to weight gain.
3. Fear of hypoglycemia (“defensive eating”): Some people with diabetes are afraid of going too low and will eat extra calories (especially carbohydrates) to prevent this. Again, these excess calories will lead to weight gain if they’re not burned by the body for fuel.
How can an insulin pump help with insulin-related weight gain?
1. Better glucose control: An insulin pump helps minimize excessive high and low blood sugars by providing the body with a steady source of insulin all day and all night. When blood glucose is in better control, people often feel less hungry and stop consuming the excess calories they craved when their sugars were out of control.
2. Fewer hypos: Since blood sugar is under better control on an insulin pump, people will experience fewer episodes of hypoglycemia that need to be treated with glucose. They could therefore reduce the calories they consume overall and minimize weight gain.
3. Less insulin: In the recently published study on insulin pump therapy and type 2 diabetes, OpT2mise, patients who switched from multiple daily injections to an insulin pump showed a 19% reduction in total daily insulin dose.2 Reducing your insulin dose could also help reduce insulin-related weight gain.
Controlling weight gain while on insulin can require some lifestyle changes. However, your healthcare team and Medtronic are there to support you every step of the way. Work with your dietitian to develop a nutrition and activity plan that is right for you. Leverage your care partners—they can help you stay on track!
For more information on Medtronic MiniMed insulin pump systems for people with type 2 diabetes, please visit http://www.medtronicdiabetes.com/treatments/insulin-pump-therapy-type-2.
Bonnie Goldberg, MA, RD, CDE, is a Registered Dietitian with a Masters Degree in Health Education from Columbia University. She specializes in diabetes care and has spent her career educating and empowering people with diabetes. She is proud to currently work for Medtronic Diabetes.
IMPORTANT SAFETY INFORMATION
– Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems.
– Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.
Medtronic Diabetes Insulin Infusion Pumps
– Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day.
– Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.
Please visit MedtronicDiabetes.com/isi for more details.
1. United Kingdom Prospective Diabetes Study Group: Intensive blood glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet 353:837-853,1998.
2. Aronson, R., Reznik, Y., Conget, I., Castañeda, J. A., Runzis, S., Lee, S. W., Cohen, O. and for the OpT2mise Study Group (2016), Sustained efficacy of insulin pump therapy compared with multiple daily injections in type 2 diabetes: 12-month data from the OpT2mise randomized trial. Diabetes, Obesity and Metabolism, 18: 500–507. doi: 10.1111/dom.12642