by Judy
(Wisconsin)
Question from Judy:
I am an insulin diabetic and cannot seem to lose weight. I watch what I eat carefully, limit carbohydrates, and exercise on the treadmill, but my weight stays the same. What can I do?
Answer by Dr. Albana Greca, MD, MMedSc, Family Physician
Dear Judy,
I can understand why this is frustrating. When someone is using insulin, eating carefully, and exercising but the scale will not move, I usually look at the whole diabetes plan rather than assuming the answer is simply “eat less.”
Yes, weight loss while taking insulin can be harder, but it is still possible. Insulin helps move glucose into cells, and weight can increase when insulin, food intake, activity, and low-sugar treatment are not well matched.
Do not skip or reduce insulin to lose weight. That can cause dangerous high blood sugar and, in people with significant insulin deficiency, ketoacidosis.
The best next step is to review your insulin doses, any low-sugar episodes, food portions, and exercise plan with your diabetes team.
Insulin is essential for many people with diabetes, but it can make weight management more complicated. I would especially look for these common issues:
Our insulin treatment guide explains how insulin fits into overall diabetes care.
Judy, this is the part I want to emphasize most. Never skip, delay, or reduce insulin simply to lose weight. Too little insulin can send glucose dangerously high. In type 1 diabetes and other states of marked insulin deficiency, ketones and diabetic ketoacidosis can develop.
Instead, ask your doctor whether your basal dose, meal doses, correction doses, or timing need review. Any changes should be based on your actual glucose pattern, not the number on the scale.
Repeated lows can quietly interfere with weight loss. Each episode may mean glucose tablets, juice, sweets, or extra snacks. Those rescue calories can add up.
For a week, record your glucose, meals, insulin, exercise, and any symptoms of a low. A blood sugar log can help your doctor see whether a pattern is developing. You may also find our guide to low blood glucose causes useful.
Limiting carbohydrates can help glucose control, but weight loss still depends on overall energy intake. Foods such as cheese, nuts, peanut butter, oils, cream, dressings, and keto snacks can be low in carbohydrate but high in calories.
A simple starting point is half the plate non-starchy vegetables, one-quarter lean protein, one-quarter a measured carbohydrate portion, plus a modest amount of healthy fat. Our guide to foods and drinks for diabetes can help with meal choices.
The treadmill is good for your heart and glucose, but I would not rely on it alone. If your doctor says it is safe, add strength training two or three times a week. Building and maintaining muscle can improve insulin sensitivity and support weight management.
Also look for more movement during the day: short walks after meals, standing breaks, and fewer long periods of sitting.
If you have type 2 diabetes, your doctor may review whether medicines such as metformin, a GLP-1–based treatment, or an SGLT2 inhibitor are appropriate alongside insulin. Some options can support weight management and may sometimes reduce insulin requirements, but they are not suitable for everyone.
If you have type 1 diabetes, medication choices are different and should be discussed with an endocrinologist. Do not add weight-loss or diabetes medicines on your own.
Judy, if you were sitting in my office, I would first look for hidden lows, extra rescue calories, insulin doses that may need adjustment, and whether your exercise includes strength training. The goal is not to fight your insulin—it is to make the insulin, food, and activity plan work together.
Do not stop, skip, or reduce insulin for weight loss. Seek urgent help for very high glucose with ketones, vomiting, dehydration, deep or difficult breathing, confusion, or severe weakness.
Educational safety note: This answer is for general diabetes education and does not replace personal medical advice. Do not change insulin, diabetes medicines, diet, or exercise plans without speaking with your healthcare professional.
Last medically reviewed: August 2026.
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