Insulin and weight loss
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Insulin Therapy and Weight Gain in Diabetes
Insulin therapy is commonly associated with weight gain in people with type 2 diabetes. This happens because insulin has an anabolic effect, promoting fat storage, and can lead to defensive eating habits due to fear of low blood sugar (hypoglycemia). Patients on high doses of insulin may develop patterns of overeating and reduced physical activity, making weight loss difficult while on insulin therapy .
Weight Loss, Insulin Sensitivity, and Diabetes Risk
Weight loss, whether achieved through lifestyle changes or medications like metformin, improves insulin sensitivity and reduces the demand for insulin secretion. This improvement is directly related to the amount of weight lost, and greater weight loss leads to a lower risk of developing diabetes. Intensive lifestyle interventions have a stronger effect than metformin alone in improving insulin function and reducing diabetes risk .
Effects of Weight Loss on Insulin Sensitivity and Fat Distribution
Losing weight decreases both total and regional fat stores, including visceral fat, and leads to better insulin sensitivity. The improvement in insulin sensitivity is most closely linked to reductions in visceral fat, although after a certain amount of weight loss, further improvements in insulin sensitivity may not be directly proportional to the amount of weight lost . Even in overweight but non-obese individuals with insulin resistance, dietary weight loss improves insulin sensitivity and other metabolic risk factors, especially when it reduces adipose cell size and central fat distribution .
Inflammation, Weight Loss, and Insulin Sensitivity
Weight loss also reduces inflammation in the body, as shown by lower levels of inflammatory markers like C-reactive protein and certain cytokines. These reductions in inflammation are independently associated with improvements in insulin sensitivity, especially in overweight and obese postmenopausal women .
Long-Term Weight Loss Maintenance and Insulin Sensitivity
People who successfully maintain long-term weight loss have better insulin sensitivity compared to those who have never lost weight or who regain lost weight. Weight loss itself is the strongest predictor of improved insulin sensitivity, while regaining weight reverses these benefits. Maintaining weight loss is essential for keeping the metabolic improvements gained through weight reduction .
Weight Loss and Vascular Insulin Sensitivity in Type 2 Diabetes
Diet-induced weight loss improves how blood vessels respond to insulin, especially in women with type 2 diabetes. This means that weight loss not only helps with blood sugar control but also enhances the delivery of insulin and glucose to muscles, further supporting metabolic health .
The Role of Insulin in Obesity and Weight Management
High insulin levels (hyperinsulinemia) are linked to weight gain and obesity. Reducing insulin levels, either through lifestyle changes or medications, can help with weight loss. Studies in animals and humans show that even modest reductions in insulin can prevent weight gain without harming blood sugar control. Therefore, strategies that avoid high insulin levels—such as reducing calorie intake and increasing physical activity—can help limit fat storage and support weight loss 910.
Conclusion
Weight loss improves insulin sensitivity, reduces inflammation, and lowers the risk of diabetes, regardless of whether a person is obese or just overweight. Insulin therapy can make weight loss challenging due to its fat-storing effects, but reducing insulin doses safely, adopting insulin-sparing medications, and making lifestyle changes can help. Maintaining weight loss is crucial for preserving these metabolic benefits, and strategies that keep insulin levels in check are important for effective weight management.
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