Tips + Tricks: Losing Weight While Taking Insulin

Editor’s note: Always consult your healthcare team before making any changes to your insulin regimen.

Insulin is considered the most powerful hormone in the human body—and we all need insulin in order to stay alive. On the other hand, it has acquired a bad reputation when it comes to weight management, weight loss and weight gain.

It’s time to get the facts straight on the role insulin plays in weight loss and weight gain.

Everyone needs a certain amount of insulin—finding that amount isn’t easy

You cannot live without insulin. We all need enough insulin to help us manage blood sugar levels in our personal target range.

Insulin makes use of the glucose in your bloodstream in a few ways:

• Using it immediately for energy
• Storing it as glycogen (backup fuel) in your liver and muscles
• Storing it as body fat

Determining how much insulin your body needs isn’t easy—and it can change frequently throughout your life! Getting just a few units more or less than your body needs can wreak havoc on your blood sugar levels throughout the day.

Too much insulin can lead to:

• Constantly “feeding” excessive insulin to prevent lows
• Binge-eating excessive calories during frequent low blood sugars
• Feeling constantly hungry and on the edge of a low
• Frequent lows increasing the risk of over-treating, then rebound highs, then more insulin, etc.
• Preventing you from being able to exercise without eating more food

Too little insulin can lead to:

• Constantly taking more correction insulin
• Frequent correction doses increase the risk of lows, then eating more calories, etc.
• Feeling lethargic from running high, interfering with motivation to exercise
• High blood sugars can increase cravings for food, sugar, etc. despite eating

Your background/basal insulin needs can change frequently throughout your life based on changes in age, stress, menstruation, menopause, pregnancy, sleep habits, activity levels, etc.

Get support from your healthcare team to fine-tune your background/basal insulin doses to ensure you’re getting the amount your body truly needs!

Tips to help reduce the amount of insulin you need

Regardless of your diabetes type or how much insulin you use, there are always things you can do to help increase your natural sensitivity to insulin—which can help reduce your mealtime and background insulin doses.

This can make it easier to lose weight—especially if you’re struggling with severe insulin resistance and taking large doses of insulin.

Here are a few clear habits from SaRene Brooks, RD, CDCES at Integrated Diabetes Services that can help reduce your background and mealtime insulin doses:

• Go for a walk before/after eating: Even just 15 minutes of walking after eating can help reduce your mealtime dose. If you don’t want to worry about lows, try walking before your meal when you don’t have mealtime insulin on board. You’ll still benefit from increased insulin sensitivity but with a lower risk of hypoglycemia.
• Go for a walk every single day: Walking is like the fountain of youth when it comes to diabetes management. This low-impact form of exercise gets your blood flowing, burns calories and increases your sensitivity to insulin. The more consistently you make it a daily habit, the more you’ll reap the benefits.
• Reduce your carb intake: Especially starchy bread, rice, pasta, sugar, etc.—at a meal by increasing the veggies. Even just a 10 percent reduction can make a big difference! You don’t have to cut all the carbs—just try to make a small reduction.
• Get more sleep: Sleep deprivation leads to increased cortisol and insulin resistance.
• Start strength-training: A strength-training workout can increase your sensitivity both immediately and long-term, because muscle burns more calories at rest than body fat.
• Reduce your dietary fat intake: while dietary fat is part of a healthy diet, high-fat meals can cause you to need more insulin for that meal.
• Reduce your caffeine intake: Excessive caffeine consumption can easily lead to over-production of glucose from your liver and increased insulin needs. How much are you drinking?
• Take a look at your stress level: If you’re living at a constantly high stress level, the impact on your blood sugars and insulin needs can be substantial. Not all stress can be reduced, sure, but if there are any stressful factors within your control, addressing them will help improve insulin resistance!

These may sound small, but they add up! These habits can make a big difference in your body’s overall insulin sensitivity.

Avoid these diabetes management habits that lead to weight gain

Managing insulin therapy isn’t easy. Your body is supposed to do this properly on its own and it ain’t. No one expects you to do it perfectly because it’s quite complicated! But there are a few things you might be doing that are leading to weight gain.

As the go-to weight-loss coach at Integrated Diabetes Services, Brooks says these habits can easily contribute to gradual weight gain with insulin use:

• Over-treating during low blood sugars: If you frequently binge-eat during low blood sugars, you could be consuming hundreds or thousands of extra calories every week that contribute to gradual weight gain. Here are tips to help you stop overeating during low blood sugars.
• Taking too much basal/long-acting insulin: If your background insulin dose is too high, you could be experiencing frequent lows that look related to other things (like exercise or mealtime insulin). Feeding those frequent lows adds up to calories your body doesn’t need!
• Forgetting to reduce your basal rate in your insulin pump during exercise: The goal is to avoid eating calories you don’t want or need because of frequent lows. If you can anticipate your exercise and reduce the basal rate in your insulin pump, you’ll save yourself from consuming more calories.
• Exercising right after eating with a full dose on board: Again, it’s about feeding the insulin calories you wouldn’t otherwise be eating. Learn how to reduce your mealtime insulin dose or exercise before eating so you don’t have a bolus of rapid-acting insulin on board.
• Taking too much insulin up front with high-fat/high-carb meals: If you’re frequently going low after eating, then you feed the low, then you go high because the meal is still digesting, chances are you’re getting too much insulin up front. High-fat/high-carb meals take longer to digest, which means you may need to split your insulin dose so you take some when you eat, and some a few hours later.

Remember: Talk to your doctor before making any changes to your diabetes regimen. Always be prepared for hypoglycemia when exercising by carrying fast-acting carbohydrates or glucagon with you! And never accept frequent hypoglycemia as a regular part of life with diabetes that you simply have to endure—ask for help! Frequent lows mean your insulin doses need to be adjusted ASAP.

Other medications can help reduce insulin needs + help weight loss

If you are overweight or living with obesity, you may be eligible for other medications that can help people with diabetes lose weight.

While there are a variety of diabetes medications that support weight-loss goals and improve insulin sensitivity, there are a couple of GLP-1 agonist medications that are significantly effective in research:

• Ozempic (semaglutide)
• Mounjaro (tirzepatide)

These medications can help your body compensate for the thing it struggles to do: Produce normal amounts of insulin. People with type 1 diabetes also don’t properly produce amylin—a hormone that regulates appetite, blood sugar levels after eating and liver glucose production! It’s okay to need support from medications to help your body reach or manage your weight.

Educational content related to severe hypoglycemia is made possible with support from Lilly Diabetes, an active partner of Beyond Type 1 at the time of publication. Editorial control rests solely on Beyond Type 1.