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

  1. Miriam Ryan, PHD12,
  2. M. Barbara E. Livingstone, PHD2,
  3. Pierre-Henri Ducluzeau, MD, PHD1,
  4. Agnès Sallé, MD, PHD1,
  5. Manon Genaitay, BSC1 and
  6. Patrick Ritz, MD, PHD1
  1. 1Department of Diabetes and Nutrition, CHU Angers F-49033, France
  2. 2University of Ulster, Coleraine, North Ireland
  1. 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}


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.


  • Published ahead of print at on 17 December 2007. DOI: 10.2337/dc07-1171.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted December 11, 2007.
    • Received June 20, 2007.
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  1. Diabetes Care vol. 31 no. 3 448-450
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