Diabetes; Avoid this Insulin Mistake

Have you ever heard someone with diabetes say, ‘I can eat whatever I want. I'm taking insulin!' I have. Unfortunately, some people think that taking insulin allows them to eat whatever and however much they want. They reason that as long as they have the insulin to bring their blood sugar back in check after a meal, that what they eat doesn't really matter. So is this true? Does taking insulin allow you to eat whatever and however much you want? In short, the answer is no.

For the short term, it is true that the carbohydrates (carbs) eaten in a meal will be ‘taken care of' with the proper dose of insulin. However, in the long run, eating excessively and then taking more insulin to neutralize extra carbs can lead to weight gain and encourage complications such as cardiovascular disease and organ damage.

Insulin Resistance; A Viscious Cycle

The problem with consuming extra carbs and neutralizing it with extra insulin is it encourages insulin resistance. When there is too much insulin in the blood stream, the body decides it doesn't need as many insulin receptors. The body then gets rid of some of the insulin receptors. Because there are less insulin receptors, it takes more and more insulin to use the same amount of carbs.

Thus, when we continuously eat large amounts of food and take large amounts of insulin, we encourage insulin resistance. Taking more insulin means more insulin is floating around in the blood stream at any given time. The presence of excess insulin in the body promotes fat storage. Thus people who get caught in this viscous cycle may find that they begin to gain weight. High blood sugar and high insulin levels are also linked to the development of cardiovascular disease and organ damage.

Avoiding Excess Carbs and Insulin

So how do we avoid getting caught up in this cycle? Proper nutrition and insulin dosing will do the trick. The key is to eat only enough carbs to meet your dietary needs and adjust your insulin dose accordingly. This will allow you to use smaller amounts of insulin. Avoiding excess insulin and calories will help deter weight gain and other complications.
Remember that everyone has different dietary needs. So before making any changes to your diet or insulin doses, you will need to talk with your doctor about your personal dietary and insulin needs. Together, you and your doctor should come up with a personal dietary plan. Your doctor should be able to tell you approximately how many servings of carbs to aim for at each meal and how to dose your insulin accordingly.

For example, some people will find that 3 to 5 servings of carbs per meal is adequate. They may also find that taking 1 unit of rapid acting insulin per serving of carbohydrate works for them. Your personal dietary plan should also include proper amounts of protein and good fats (i.e. polyunsaturated and monounsaturated fats).
The number of servings of carbs you need at each meal will depend on your calorie needs. Your calorie needs are based on a variety of factors including weight and activity level. Your doctor will be able to help determine your calorie needs.

Although the goal is to minimize the amount of insulin you need, please keep in mind that one should never eliminate all carbs from their diet. For diabetics, eliminating carbs from their diet can prove to be dangerous or even deadly. Not consuming enough carbs can result in dangerously low blood sugar and/or a serious condition called ketoacidosis. Both extremely low blood sugar and ketoacidosis can cause coma and even death in people with diabetes.

The Bottom Line

Although learning to count carbs and adjust insulin may seem tricky at first, with practice you will find it becomes second nature. Finding a doctor who will work closely with you to come up with a personal dietary plan is key. If you have diabetes and you are not currently seeing a endocrinologist, you may want to consider getting a referral to see one. Endocrinologists specialize in diabetes and other conditions that involve the secretion of chemicals in the body. If you are not sure how to track down an endocrinologist in your area, try asking your primary care physician or friends. It is important that you find a doctor you feel comfortable working with. A good relationship with your doctor is key to getting the most out of your diabetes treatment plan.

Christi Larson, Pharm. D. is a Clinical Infusion Pharmacist, author of Empowered Medicine; A Guide for Consumers and creator of www.empoweredmedicine.com. You can read more about her by visiting www.EmpoweredMedicine.com and clicking on the 'About Us' tab. EmpoweredMedicine.com is committed to providing evidence-based medical information.