June 27, 2019

My Diabetes Is Controlled — But Why Am I Gaining Weight?

How to offset side effects of insulin

Woman meeting with doctor or nutritionist about diet and diabetes

By: Marwan Hamaty, MD, MBA

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Exercise, eat right and stay at a healthy weight. These goals are at the core of every type 2 diabetes treatment plan. And, for some people, that’s enough. When it’s not, insulin therapy is one of the treatment options that can help patients. But among the possible side effects is weight gain.

This can become a cycle for patients who need to control both diabetes and their weight. You may get frustrated when you feel the treatment is part of the problem ― and you might jeopardize sticking with your therapy.

With diabetes, getting your blood sugar under control is a crucial task. Insulin is used because it works when other treatments aren’t adequately effective or are contraindicated (shouldn’t be used because it could be harmful to that particular person). The cost of insulin varies. Lower-cost insulin types are associated with more weight gain.

How to break the cycle

In a way, weight gain is a sign that the insulin is working — your body is utilizing sugar, fat and protein more effectively and able to store nutrients.

Typically, your appetite is increased when your blood sugars are higher. (This is a main symptom of having diabetes). When your body is utilizing nutrients better and is able to store them, food intake should be adjusted to maintain the same weight. You’ll need to make further adjustments if you’re attempting to lose weight. If food intake (both amount and types) isn’t adjusted, then you can expect to gain weight.

Also, insulin isn’t necessarily the only factor.

When you’re managing your diabetes, your body has a better chance to rehydrate, which can also cause mild weight gain. Of course, dehydration is a greater risk if you have diabetes (frequent urination and thirst are two common signs of the condition).

Advertisement

Drugs you take for other conditions also sometimes cause you to gain weight.

So what are your options if weight gain and insulin are an issue? Try these three tips:

1. Up the ante on diet + exercise

The most basic (and important) answers are adjusting your diet and exercise. Talk to your doctor and to a nutrition specialist about a food plan that takes the insulin effects into account. Work a bit more activity or exercise into each day. Sometimes, your insulin dosage should be adjusted (usually lowered) when exercising.

Don’t self-adjust the dosage or timing of your insulin to accommodate eating more calories. You can end up gaining more weight. However, it’s good to self-adjust insulin for the purpose of fine tuning the dosage. Of course, you want to keep your doctor informed and continually work on good diet and exercise habits.

2. Take a closer look at your medications

If you aren’t able to offset weight gain by reducing calorie intake and adding more activities, try evaluating what type of insulin you’re taking. Insulin analogs (modified human insulin) are may cause less weight gain.

Some medications for type 2 diabetes may cause weight loss, as a side benefit. You may discuss with your medical providers if using these medications is appropriate for you. And if used, how to adjust your insulin dosage.

The reverse is true as well. If you’re taking other diabetes medications with your insulin, find out if weight gain is a side effect of those medications too. Ask your doctor if another medication might be appropriate for you.

Advertisement

3. Work out the details with your doctor

The best thing a patient can do is ask questions. Make sure you understand all the reasons you might be gaining weight, what medications you’re taking that have that side effect and what alternatives are available. A screening test for low thyroid hormone (a blood test called TSH) is appropriate.

You’ll also want to find out the out-of-pocket costs for each specific drug. Some are costly and you’ll need to consider whether you can easily afford these medications long-term.

Managing diabetes is a challenge, and your treatment plan has to work for you. Talk to your doctor and other healthcare providers and make adjustments until your plan is working well.

If you can effectively make the right lifestyle choices, you can minimize your need for medication. This means less cost, less side effects and an overall feeling of well-being.

Related Articles

Person testing their blood sugar with their home kit
February 29, 2024
Type 1 vs. Type 2 Diabetes: What’s the Difference?

Type 1 diabetes happens when your body doesn’t make insulin, while Type 2 happens when your body can’t use insulin properly

Doctor shaking hands with patient, with large heart and EKG line behind them
February 19, 2024
How Weight Affects Your Heart

Having underweight, having overweight and having obesity can be dangerous for your heart

female healthcare provider speaking with patient in medical setting
January 10, 2024
Can Too Much Sugar Cause Diabetes?

There is an indirect link between the sweet substance and the condition

person adding blueberries to bowl of granola cereal
January 8, 2024
Can People With Diabetes Have Sugar?

The short answer: Yes, but you need to eat it in moderation and keep track of how much you consume

close up of green coffee beans
December 14, 2023
Should You Go Green? What To Know About Green Coffee Bean Extract

There’s no evidence to prove this supplement can help with weight loss, and it may come with risks

beer glass sitting beside diabetes testing equipment
October 11, 2023
Diabetes and Alcohol: Do They Mix?

Blood glucose monitoring and drinking in moderation can help you avoid hypoglycemia

Grilled butternush squash on a white plate with kale and nuts sprinkled on top.
September 24, 2023
Foods To Eat for Diabetes-Related Macular Edema

Plant-based foods and healthy fats can help maintain and improve your eye health

male getting an annual check up
September 17, 2023
Most Common Health Issues for Men

It’s important to watch for and guard against conditions like heart disease and cancer

Trending Topics

White bowls full of pumpkin seeds, dark chocolate and various kinds of nuts
25 Magnesium-Rich Foods You Should Be Eating

A healthy diet can easily meet your body’s important demands for magnesium

Woman feeling for heart rate in neck on run outside, smartwatch and earbuds
Heart Rate Zones Explained

A super high heart rate means you’re burning more than fat

Spoonful of farro salad with tomato
What To Eat If You’ve Been Diagnosed With Prediabetes

Type 2 diabetes isn’t inevitable with these dietary changes

Ad