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Published online December 17, 2007
Diabetes Care 31:448-450, 2008
DOI: 10.2337/dc07-1171
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Is a Failure to Recognize an Increase in Food Intake a Key to Understanding Insulin-Induced Weight Gain?

Miriam Ryan, PHD1,2, M. Barbara E. Livingstone, PHD2, Pierre-Henri Ducluzeau, MD, PHD1, Agnès Sallé, MD, PHD1, Manon Genaitay, BSC1 and Patrick Ritz, MD, PHD1

1 Department of Diabetes and Nutrition, CHU Angers F-49033, France
2 University of Ulster, Coleraine, North Ireland

Address correspondence and reprint requests to Patrick Ritz, MD, PhD, Pôle de maladies métaboliques et médecine interne, CHU, 4 Rue Larrey, F-49033 ANGERS Cedex 09, France. E-mail: patrick.ritz{at}wanadoo.fr

The present study aimed to assess the contribution of energy intake to positive energy balance and weight gain with insulin therapy. Changes in energy intake (self-report and weighed food intake), dietary behavior (auto-questionnaires), resting energy expenditure (REE) (indirect calorimetry), physical activity (accelerometry), and glucosuria were monitored over the first 6 months of insulin therapy in 46 diabetic adults. No change in REE, activity, or glucosuria could explain weight gain in the type 1 (4.1 ± 0.6 kg, P < 0.0001) or type 2 (1.8 ± 0.8 kg, P = 0.02) diabetic groups. An increase in energy intake provides the most likely explanation for weight gain with insulin. However, it is not being recognized because of significant underestimation of self-reported food intake, which appears to be associated with increased dietary restraint.

Abbreviations: REE, resting energy expenditure


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Copyright © 2008 by the American Diabetes Association.