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Patients with type 1 diabetes who take
multiple insulin injections each day may lower their risk
of nerve damage and blindness, but such intensive therapy
may also put them at increased risk of obesity.
According to researchers, adults who
treated their disease with multiple daily insulin injections
or continuous infusion were more likely to become overweight
after 6 years.
This group gained
an average of 9.5 pounds more than patients who
took one or two insulin shots a day. The weight gain translated
into an increase in body mass index (BMI) of 1.5 for men and
1.8 for women.
BMI, which takes into account a person's
weight in relation to their height, is considered a more accurate
measure of overweight and obesity than body weight alone.
A person with a BMI of at least 25 is considered overweight
and one with a BMI of 30 and above is considered obese.
Previous research has shown that intensive
insulin therapy can lower the risk of some of the medical
complications associated with type 1 diabetes. However, it
may also lead to severe hypoglycemia -- a significant drop
in blood sugar -- and weight gain.
The results show that weight gain was
most rapid in the first year. Although
the rate of weight gain slowed in subsequent years, patients
did not shed any pounds, even after 9 years. Women
tended to put on weight at a faster rate than men did, and
women treated intensively tended to gain weight in their abdomens.
Abdominal obesity, the authors note,
is believed to be a risk factor for heart disease.
Intensive therapy for type 1 diabetes
produces substantial excess weight gain compared with conventional
therapy. However, the additional weight appears to include
lean tissue as well as fat.
Diabetes
Care October 2001;24:1711-1721
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