Last year a study revealed that weight gain can be a positive thing for people who have type 1 diabetes. Those who gained an average of 10 to 55 pounds lived longer compared to those who gained less weight. But, in most cases, doctors recommend that you do not gain additional weight, especially if you have type 2 diabetes. Yet some of the diabetes medications they prescribe to lower blood glucose levels can encourage weight gain, including insulin, sulfonylureas, and thiazolidinediones.

Weight gain from these diabetes medications occurs for several reasons, according to Johns Hopkins Medicine:

  • Insulin may cause low blood sugar, or hypoglycemia, which stimulates your appetite.
  • Sulfonylureas such as glimepiride (Amaryl®) and chlorpropamide (Diabinese®) can also induce hypoglycemia and stimulate your appetite.
  • The thiazolidinedione class of drugs makes fat cells store more fatty acids from the blood and increase fluid retention.

It's well-known that weight gain isn't healthy, but when you have diabetes the effects on your body are even worse. Being overweight or obese reduces insulin sensitivity, and causes high fasting and post-meal blood glucose levels. Also, the immune system plays a role in diabetes, creating imbalances in cytokines which create inflammation; weight gain also increases inflammation in the body.

How to Avoid Weight Gain from Diabetes Medications

• Change your medication routine. One of the first steps you can take to reduce weight gain from diabetes medications is to lower the dosage, recommends Johns Hopkins Medicine. You can also add a drug such as metformin (Glucophage® or Fortamet®), which helps minimize weight gain or even promote weight loss.

• Ask about DPP4-inhibitors. This newer class of diabetes medications helps improve A1C levels without causing hypoglycemia and corresponding weight gain, states the American Diabetes Association (ADA). They also have a neutral or positive effect on cholesterol levels. The only DPP-4 inhibitor available at this time is sitagliptin (Januvia®).

• Reduce calorie intake. To avoid weight gain when taking diabetes medications such as insulin, the Mayo Clinic recommends significantly cutting back on calories. Most people take in way more than the daily recommended amount of calories (and remember that about 80  to 90 percent of people with type 2 diabetes are overweight or obese). Work with your diabetes specialist to create a meal plan to control your weight.

• Eat a healthy balanced diet. You're probably used to this piece of advice since being diagnosed with diabetes. Wholesome, nutritious foods provide several benefits for diabetes besides preventing weight gain, such as better blood glucose control, less reliance on insulin or other diabetes medications, and a lower risk of cardiovascular disease (CVD).

The ADA recommends getting at least 50 to 60 percent of your calories from carbohydrates (preferably whole grains), 12 to 20 percent from lean protein, and no more than 30 percent from fat.

• Eat small meals. There's some evidence that eating five or six small meals throughout the day may help to improve daily blood glucose regulation. It also prevents hunger, so you're less likely to overeat, which promotes weight loss.

• Exercise regularly. Physical activity also reduces the side effect of weight gain from diabetes medications. It may increase insulin sensitivity, improves blood circulation, and lower your chances of CVD. Try to exercise at least 2 ½ hours a week.