不是说所有的会增肥，但挺普遍。insulin detemir相对NPH的副作用小。二型的病人里更普遍。

 

 

这个是解释为什么打胰岛素会增肥：

Insulin therapy endeavours to enable patients to replicate the normal physiological insulin response. However, in healthy individuals, insulin first passes through the liver where up to 50% is removed, and endogenous glucose production is suppressed, before entering the peripheral circulation. Treatment with subcutaneous exogenous insulin produces higher levels of peripheral insulin relative to hepatic levels compared with levels in healthy individuals. When good glycaemic control is achieved with exogenous insulin, blood glucose is utilised effectively and any excess energy intake is more likely to be retained and stored as fat. Thus, it is not unexpected that intensive insulin treatment regimens may produce weight gain when initiated in previously poorly controlled patients. This occurs through decreasing glycosuria, and also by insulin-stimulated lipogenesis.

Eating as a defence against hypoglycaemic episodes is a further cause of weight gain in some people with diabetes...... patients who fear hypoglycaemia or experience its symptoms will be likely to eat more, thus avoiding hypoglycaemia, but gaining weight.

In patients transferring to more intensive diabetes treatment regimens, there may be multiple mechanisms for weight gain if energy intake is not reduced or closely managed. It is not surprising, therefore, that weight gain may be seen as an inevitable consequence of diabetes treatment, as the disease progresses over time, whatever therapy is employed to control blood glucose.

控制的好的，一般都是在饮食上做到了严格自律。我知道一位一型糖尿病人，12岁时诊断的，他胰岛素分泌为0，所以必须打针。很多年10个手指频繁测血糖被扎得都有老茧了。但是控制得很好，饮食上十分严格地低碳水，现在快90岁了，很健康。一点也不胖。