Think back to Tammy’s story about her experience with type 1 diabetes. Based on what you have read about the role of insulin in blood glucose regulation and energy storage, why did insulin injections cause Tammy to gain weight?
Secreted by the pancreas, insulin is a hormone that decreases blood glucose levels in the body. Insulin decreases blood glucose levels by: 1) regulating how much glucose can leave the liver; 2) allowing glucose to enter cells; and 3) increasing storage of liver and muscle glucose as glycogen and any excess glucose as fat.
An individual with diabetes does not have enough insulin, so, when they overeat, not all the glucose can enter the cells. Some of the glucose will remain circulating in the blood, be filtered out by the kidneys, and be lost from the body in urine. This glucose is never metabolized by the cells to release calories, and hence the individual can lose weight if no additional insulin is provided.
Since Tammy’s diabetes was unregulated for some time, she lost weight without trying; then, when she started maintaining her blood glucose with insulin injections, she stopped urinating out her glucose and retained more dietary glucose for energy. The same food intake now provided extra calories compared to before, leading to temporary weight gain. If Tammy chose to overeat and not exercise enough the weight gain might continue due to regulated blood glucose and her insulin dosage.
Another common reason for weight gain is often related to type and timing of insulin injections. For instance, if you take pre-mixed, intermediate, or long-acting insulin twice daily, you are forced to eat on time, to avoid skipping meals, and to anticipate exercise by taking an extra snack or decreasing your insulin. This makes it harder to control weight.
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