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Is It Low Fitness Motivation or Hyperinsulinemia in Diabetes?

Type 2 Diabetes Challenges

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Updated January 28, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

When you have type 2 diabetes, it can sometimes feel like you have taken a pill that causes carbohydrate and sugar cravings, along with fatigue. It can also feel like no matter how much you diet or exercise, the weight won't come off like you expect it to. Is this all in your mind, or are there real hormonal signals and dysfunction posing a challenge?

The reality is that it really may be more difficult for someone with diabetes to lose weight and maintain it, thanks to a condition called hyperinsulinemia.

How Hyperinsulinemia Can Complicate Weight Loss

Hyperinsulinemia is a condition where the body has high levels of insulin. Insulin helps blood sugar, or glucose, get into your cells to be used for energy. In people with type 2 diabetes, however, the insulin is ineffective because the insulin receptors on cells become desensitized to its action. As a result, the body produces too much insulin in an attempt to get the job done.

When levels of insulin are too high, you may experience increased appetite and cravings for carbohydrates and sugar, as starving cells and excess insulin fool the body into thinking there is famine. It is common to still have strong cravings for carbohydrates after a meal.

Excess insulin can also cause body fat to be retained because the insulin sends your body signals to avoid using the fat as an energy source. This can make losing weight even more difficult.

How to Reduce the Effects of Hyperinsulinemia

If you have diabetes, and hyperinsulinemia is hampering your weight loss efforts, it makes sense to try and reduce the levels of insulin in your body. The best way to do this is with lifestyle changes, such as smart diet and exercise.

  • Diet: Eat small, frequent meals throughout the day that are low-calorie, low-glycemic, and high-fiber. The Mediterranean diet has been found to be effective for people with type 2 diabetes.

  • Exercise: For significant health improvement, do 30 minutes of cardiovascular exercise at least three times a week at moderate intensity. For best results, include strength training and flexibility exercises. To further kickstart your weight loss and weight maintenance efforts, do at least seven hours per week of cardiovascular exercise at moderate-to-vigorous intensity.

  • Educate yourself: Be aware of what is happening in your body. Think about how your body reacts to carbohydrates. Recognize why you may be experiencing cravings and weight loss challenges.

  • Consider your medications: Your medications might lower your blood sugar levels but raise your insulin levels. Some medications lower insulin levels as well, such as the diabetes drug metformin. If you are on a medication that raises insulin levels, lifestyle changes are even more important to help lessen the effects of hyperinsulinemia.

Sources:

Franz MS RD LD CDE, Marion J. The Dilemma of Weight Loss in Diabetes. Diabetes Spectrum July 2007 20(3):133-136

Insulin Resistance Syndrome. American Family Physician. Accessed: January 12, 2010 http://www.aafp.org/afp/2001/0315/p1159.html

Sigal MD MPH, Ronald; Kenny PHD, Glen; Wasserman PHD, David H; Castaneda-Sceppa MD PHD; White MD, Russell. Physical Activity/Exercise and Type 2 Diabetes. Diabetes Care June 2006 29(6):1433-1438

Shai RD, Iris; et. al. Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. N Engl J Med 17 July 2008 359:229-241

Shanik MD, Michael H; Xu MD, Yuping; Skrha MD DSC, Jan; Dankner MD MPH, Rachel; Zick PHD, Yehiel; Roth MD, Jesse. Insulin Resistance and Hyperinsulinemia. Diabetes Care Feb 2008 31(2):5262-5268.

Solomon, Thomas PJ; Haus, Jacob M; Kelly, Karen R; Cook, Marc D; Filion, Julianne; Rocco, Michael; Kashyap, Sangeeta R; Watanabe, Richard M; Barkoukis, Hope; Kirwan, John P. A Low-Glycemic Diet Combined with Exercise Reduces Insulin Resistance, Postprandial Hyperinsulinemia, and Glucose-Dependent Insulintropic Polypeptide Responses in Obese, Prediabetic Humans. Am J Clin Nutr Dec 2010 92(6)/1359-1368.

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