Long-term, intermittent, insulin-induced hypoglycemia produces marked obesity without hyperphagia or insulin resistance: A model for weight gain with intensive insulin therapy

Author:

McNay Ewan C.1,Teske Jennifer A.2,Kotz Catherine M.34,Dunn-Meynell Ambrose56,Levin Barry E.56,McCrimmon Rory J.7,Sherwin Robert S.8

Affiliation:

1. Behavioral Neuroscience, University at Albany, Albany, New York;

2. Nutritional Sciences, University of Arizona and Southern Arizona Veterans Affairs Health Care Sysytem, Tucson, Arizona;

3. Geriatric Research, Education and Clinical Center, Minneapolis Veterans Affairs Health Care Sysytem, Minneapolis, Minnesota;

4. Food Science and Nutrition and Minnesota Obesity Center, University of Minnesota, Minneapolis, Minnesota;

5. Veterans Affairs Medical Center, East Orange, New Jersey;

6. Department of Neurology and Neurosciences, New Jersey Medical School/University of Medicine and Dentistry of New Jersey, Newark, New Jersey;

7. Cardiovascular & Diabetes Medicine, University of Dundee, Dundee, United Kingdom; and

8. Endocrinology, Yale University School of Medicine, New Haven, Connecticut

Abstract

A major side effect of insulin treatment of diabetes is weight gain, which limits patient compliance and may pose additional health risks. Although the mechanisms responsible for this weight gain are poorly understood, it has been suggested that there may be a link to the incidence of recurrent episodes of hypoglycemia. Here we present a rodent model of marked weight gain associated with weekly insulin-induced hypoglycemic episodes in the absence of diabetes. Insulin treatment caused a significant increase in both body weight and fat mass, accompanied by reduced motor activity, lowered thermogenesis in response to a cold challenge, and reduced brown fat uncoupling protein mRNA. However, there was no effect of insulin treatment on total food intake nor on hypothalamic neuropeptide Y or proopiomelanocortin mRNA expression, and insulin-treated animals did not become insulin-resistant. Our results suggest that repeated iatrogenic hypoglycemia leads to weight gain, and that such weight gain is associated with a multifaceted deficit in metabolic regulation rather than to a chronic increase in caloric intake.

Publisher

American Physiological Society

Subject

Physiology (medical),Physiology,Endocrinology, Diabetes and Metabolism

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