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Can we talk about "insulin--the weight gain hormone"?

Discussion in 'Parents of Children with Type 1' started by bisous, Aug 8, 2013.

  1. bisous

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    I don't want this to be controversial. I'm interested in medical knowledge and information. I just attended a forum on exercise and diabetes. There were a bunch of athletes there representing all different kinds of exercise and abilities including an Olympic athlete. One of the members of the panel was a physical trainer and he mentioned the phrase, "insulin is the weight gain hormone". I've heard this before. Mostly from people in his field--fitness experts. I'm just wondering if we could have a discussion about this.

    Let me give you my disclaimers. I have a skinny as a rail almost 10 yo. Weight gain really isn't on our immediate radar. But many of the type 1 adults that I know have an issue with gaining weight. They think it is tied to diabetes. I don't know if it really is--this is what they are reporting to me! I want to understand the mechanics of insulin and weight gain. I have no horse in this race, I'm just trying to gain a greater understanding of what may be a future issue for us--or it might not be.

    I'm really most interested in good medical sources on the web or in books. I don't have access to a lot of medical journals but maybe abstracts posted here or else less academic but still rigorous research sources. Quotes from endos are good too. I plan on asking my endo about it as well but our appointment is not until September.

    Thank you!

    Jen
     
  2. swellman

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    Admitting it's anecdotal but if it is it's failing with my son.
     
  3. Amy C.

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    When a person without diabetes eats carbohydrate, the pancreas produces insulin so the cells can use the energy. Once the cells are fed, the excess sugar is stored as fat.

    People eating more carbohydrate than is needed will gain weight. The pancreas is only doing its job which is to process the carbohydrate. More carbs means more insulin which eventually means more fat.

    The source is eating too much, not the insulin produced. Stop eating the carbs and the body stops producing the insulin.
     
  4. Michelle'sMom

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    "Endogenous insulin is secreted into the portal circulation
    whereas sc insulin circulates systemically, before reaching the
    liver. 14 Hence, the liver is ?underinsulinised? and the periphery
    ?over insulinsed?, which may partly explain the disproportionate
    increase in fat mass typically reported with insulin therapy."

    https://secure.sherbornegibbs.com/bjdvd/pdf/1233.pdf

    "After
    an average 6 years of follow up, people in the inten-
    sively treated group had gained a mean of nearly 5 kg
    more than their conventionally treated counterparts
    (p<0.0001). Some individual patients experienced con-
    siderable weight gain, with BMI increasing by more than
    5 kg/m2, this being most common in women (figure 2). It
    is also significant to note that weight gain in the DCCT
    (and in the UKPDS) occurred in the face of quite strenu-
    ous efforts with dietary and behavioural interventions
    specifically aiming to limit this problem in overweight
    patients. This implies that the study data might under-
    estimate weight gain in the everyday clinical setting [9]"

    http://dmh.mo.gov/docs/medicaldirector/insulin-associatedweightgainarticle.pdf

    "Leptin resistance has also been proposed to be of
    significance in weight gain in diabetes, particularly when
    there is excessive weight gain for height in youth with type 1
    diabetes. Increased leptin levels have been observed in chil-
    dren and adolescents with type 1 diabetes receiving intensive
    insulin therapy, and it has been hypothesized that these high
    levels may lead to resistance to leptin through hypothalamic
    feedback. "

    http://www.sld.cu/galerias/pdf/siti...o_con__terapia_insulinica_en_adolescentes.pdf


    "The examination of data from the T1D Exchange Clinic Registry also found that many adult patients are overweight or obese ..."
    http://health.usnews.com/health-new...type-1-diabetes-missing-treatment-goals-study



    Considering the numbers of adult T1s who follow low carb & active lifestyles yet continue to have issues with weight control, it would seem there's a little more to it than just reducing carbs/calories.
     
    Last edited: Aug 8, 2013
  5. Amy C.

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    I thought I specified a person without diabetes in my post.

    Dealing with excess weight with Type 1 diabetes is a different problem as other factors come into play.
     
  6. Sarah Maddie's Mom

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    I still don't quite understand what you were trying to say...
     
  7. Michelle'sMom

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    I don't either.

    Managing weight gain is a lot more complicated than just calories or carbs in vs. energy expended, with or without diabetes of any type. Wish it was that easy.
     
  8. mmgirls

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    This is y understanding and point of veiw on sort of the subject:

    it is not just insulin that a Type 1 is missing, there are several other important beta cell produced/controlled portions to proper digestive process, the two on the top of my head are aymlin
    and cpeptide.

    Without these 2 being properly produced the glucose gets from the digestive tract and out into the blood stream and out to the "body" way faster than a person with a correctly working pank. so instead of the insulin and glucose matching up in igestive tract or blood stream it is more often matching up farther along on the distribution chain when the glucose has made it to the periphery (sp) where fat cells are, any excess will be stored, that is normal.

    So from my point of view it is more about the missing aymlin and cpeptide and that injected insulin is SLOW.

    this is why I am so very hopefull of the whole concept of "encapsulated islets" it is not just insulin, it will have the other needed parts of the beta cell that our T1 poulation needs to replaced what is missing.
     
  9. obtainedmist

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    From a purely common sense/layman approach I see a few issues with regard to maintaining or losing weight for an adult with T1D. First, it's a bit frustrating to want to work out, but have to increase carbs to get to a safe place for exercising. Even with the pump, if you want to spontaneously work out, you often need to consume before or during to make it happen. Then, after you work out, you might have to eat again to keep from going low! Also, you are trying very had to match insulin with carbs and in a perfect world it would be PERFECT...but there are so many times I see the need to head off a low with a reduced basal AND some carbs! Sheesh...it's no wonder it can be a struggle!
     
  10. LJM

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    I attended a seminar (excuse my non scientific brain) where they scientist said that in Type 1 diabetes--in addition to lacking insulin producing beta cells--individuals also lack a substance that regulates their satiety (ability to tell when they have had enough food). I think she called this amylin? and there is a company here in San Diego trying to develop this missing component. They have isolated this into an injectable form but I have not yet heard it is on the market. I am going by memory here so don't quote me.

    If this is true, might not this be cause of weight gain as well as other factors?
     
  11. Megnyc

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    Symlin is currently available and it is an analogue of amylin. It is an injection before meals. I use it and absolutely love it. Essentially what it does is to slow gastric emptying, make you feel full, and inhibit glucagon secretion after meals.
     
  12. Sarah Maddie's Mom

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    I'm just reading the "Leptin" article now. Thank you for the links. Very interesting.
     
  13. wilf

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    It is pretty simple - weight gain occurs when you consume more energy (calories) than you burn. If energy intake and consumption are balanced, then no weight gain.

    Here are some day to day situations that for a Type 1 person might tip this balance:
    - going for a run, so down some carby (calorie-y) drink to make sure you don't go low;
    - blood sugar too high, so can't participate in gym class;
    - blood sugar too low, so need to consume some carbs (and calories);
    - overestimated carbs in a meal and overbolused, so need to have more carbs (and calories);
    - going for a longer drive, so want to get blood sugar up on "on the safe side" for the trip;
    - playing in a game that goes into overtime, and want to make sure you're "up" during that key stretch;
    - on a long-distance bike ride, and realizing that you should have reduced basal for that day as you are low and need a sports drink;
    - feel like crap from high blood sugar, so you don't go for that swim with your friends.

    One could extend this list indefinately. In trying our best to replicate the functions of the pancreas and liver, we repeatedly come into situations where the best or most expedient way to compensate for our miscalculations will tip the balance toward weight gain.

    This is not anyone's fault, it can just be part of having Type 1. Lucky are those who don't have this as an issue.
     
  14. Michelle'sMom

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    So leptin, cortisol & other hormones, including thyroid have no effect on weight gain or loss at all? I'm sorry, but the science doesn't support that at all.
     
  15. Michelle'sMom

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  16. joshualevy

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    That is certainly one theory, but it is not fact, and there is lots of evidence that it is not correct. Personally, I think the following is the correct theory:

    Weight gain occurs when your body stores food as fat, rather than burning it as energy. (And Insulin signals your body to store food as fat, rather than burn it as engergy.) When this happens, on the one hand you get fat, on the other hand, you are still hungry, because you still need the energy.
    How much you eat is not a cause, it is an effect. The effect of insulin telling your body to store too much food.

    Gary Taubes has written two excellent books summarizing the research in this area. Well worth reading.

    BTW: Exercise tends to make people hungry, and thus eat more. If they eat more carbs, and thus generate (or inject) more insulin it will make them fat.

    Think about this: if someone wanted to eat a lot at a meal, what would they do? Answer: they might eat a very small meal before hand (maybe skip it entirely), and they might go for a walk or exercise a little bit to "work up an appetite". In short, to eat more they would diet and exercise: exactly what we tell people to do to loose weight! How silly!


    Joshua Levy
     
  17. Lee

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    I think what the fitness trainers are getting at is that insulin helps body builders bulk up. I once dated a body builder, right about the time Coco was diagnosed and he had stated that in the past, he used insulin to add weight, so he was bulkier, it made his muscles look bigger.

    Simply Google "how to use insulin for bodybuilding" and you will see what the guy was talking about.
     
  18. wilf

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    Ok this sort of stuff is great. But you can't gain weight if you eat less in calories than you're burning through exercise and metabolism.

    I get it that there are many things that will affect how fast you metabolize the calories you take in. But each person has their own rate of metabolism, and that's all that matters for that person. If they consume less calories than they're burning, they can't gain weight.
     
  19. Michelle'sMom

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    Every expert I've consulted with in the last year disagrees with you, & I've spent a massive amount of money out of pocket for those consultations.

    My dd gained 16lbs in less than 6 months. She was severely insulin resistant due to PCOS. The addition of OCPs to regulate her cycles (low-dose estrogen) caused the IR to be much worse. Her TDD had reached 130-150u/day, despite regular exercise & following a strict meal plan, & the addition of 1500mg/day of Metformin. Her exercise plan is designed to burn 1800 cal. Her daily intake (lower carb/low fat/low cal) was 900-1000 cal/day. Yet she gained 16lbs?

    Because of the increasing insulin needs & other side effects, we stopped the OCPs. Her TDD has now fallen to 55-60u/day. When TDD reached 75u/day, she began losing weight. She has lost 12 lbs in the last month.

    There is a lot of discussion & disagreement among researchers about which comes first...IR & hyperinsulinemia, or weight gain in T2s. While the condition might be different, the end results can be the same. Insulin is a fat storing hormone, & while proper diet & exercise may help combat or prolong the ill-effects, it doesn't change the action. When high insulin levels are combined with other metabolic issues the ill-effects are much more pronounced.
     
  20. mmgirls

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    But what about glucose not from food?

    keeping it simple; our body makes and releases stored glucose all the time, that is why there is Basal insulin.

    In some people, for reasons I do not fully understand insulin just does not work like it should because the cells of the body are resistant to let insulin in and do its job.
     

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