When we debut with diabetes and start treatment with insulin, the usual thing is that we regain weight. This does not mean that insulin makes us fat, but rather that this is a normal process since our body is finally acting correctly on insulin. Before the debut, a drastic weight loss is usually produced, precisely because our pancreas is not producing the necessary insulin to transfer blood glucose to the cells. If the latter is not nourished, there is a logical loss of weight. Once we begin to administer insulin, this function is carried out correctly, being able to redirect blood glucose to the cells so that we will recover the lost weight, but BEWARE! this does not mean that insulin makes you fat.
On the other hand, if we do not have well-controlled diabetes. And we are prone to hyperglycemia regularly, that excessive concentration of glucose in the blood will be eliminated through the kidneys. Through the urine (because it is not being redirected to the cells to feed due to lack of insulin). When this happens, it means that this urine, through which it eliminates the glucose that our body does not consume, is full of calories that are discarded without us having used them so that with blood glucose figures above 300mg/dl, the loss of glucose in the urine can be higher than 1000 Kcal; hence, in cases of poorly controlled diabetes with high blood glucose levels, weight loss may occur, not because less insulin is used).
What usually happens in cases of poorly controlled diabetes is similar to the symptoms that appear when When we start with diabetes, blood glucose is not properly transported to the cells, so to counteract this loss of energy, our body makes us eat more to compensate.
What happens is that when we adjust the doses of insulin that we need, or after the start of treatment with insulin, it is that glucose levels are regulated (it is no longer high) so that it is no longer eliminated through the urine and is redirected correctly to the cells, so if we continue to eat the extra calories that we previously needed to counteract the caloric loss through the urine, we will gain weight, but not as a result of insulin, but because we are consuming the same number of calories as when we suffered a significant loss of these calories through urine so that the excess will accumulate, and lead to weight gain.
So, if we adjust the insulin doses to what we eat, avoid spikes in glucose (both constant hyperglycemia and hypoglycemia), and also include sports in our daily treatment (something essential in people with diabetes mellitus), we will not know we will have more problems, when it comes to gaining or losing weight, than anyone else.
Therefore, if the doses of insulin that we inject throughout the day are insufficient, what will happen, as we mentioned before, is that all the blood glucose will not be able to be redirected to the cells, which will cause hyperglycemia, and there will be a tendency to lose weight if this situation is maintained over time continuously; on the contrary, if the doses that we inject daily are higher than what we need, we will have to consume more carbohydrates to overcome the hypoglycemia that we are going to suffer due to that excess insulin, redirecting all that glucose to the cells, and gaining weight (which, as we have already said, is a weight gain that has nothing to do with insulin itself, but rather that due to the excess of insulin we suffer hypoglycemia that we must compensate with the consumption of more carbohydrates), which will also happen if we offset the extra consumption of carbohydrates or, let’s say, cravings with boluses of excess insulin.
In short, what causes us to gain weight or lose weight is not insulin, but a matter of overwhelming logic, applicable to any human being, with diabetes or without diabetes: if we eat more calories than our body needs and we do not consume them, Obviously we will gain weight, but if there is a deficit in its consumption or we compensate that excess with sports activity; then we will lose weight, therefore, if we exceed the intake of recommended carbohydrates based on the metabolism of each one, even if we inject the insulin necessary for those rations, and our blood glucose levels are perfect, we will gain weight like any neighbor’s son, and I repeat NO, it is the insulin that makes you fat, but the fact that you have robbed half the fridge and part of the pantry with a knife in your hand.
To conclude, I have to add to alert those who may have the brilliant idea of “oh, that’s it, I don’t take insulin, or I take less than I need per serving of carbohydrates and thus lose weight and eat what you want,” once again, as Jack Slater would say, a big mistake, because the continuous loss of glucose through the urine seriously deteriorates the kidneys, in addition to the damage that is caused to our blood vessels… and All of this can lead to the appearance of other pathologies as a direct consequence of poorly controlled diabetes and high blood glucose levels, such as retinopathy, nephropathy, diabetic neuropathy, etc.