I am afraid that my diabetes treatment will cause me to gain weight. How can I prevent this?

Some types of medication for diabetes do tend  to lead to  weight  gain. This  is especially true  of the classes of medications known as thiazolidinediones, sulfonylureas, meglitinides, and insulin itself. Mem- bers  of  each  of  these  classes of  medications  have been described in Table 4 (see Question 41). These types of medications all have proven effectiveness in lowering blood  sugar and  controlling diabetes and have an important place in its management. However, weight gain is definitely an  undesirable side effect associated with  them.  The  ways in  which  weight gain can be minimized or prevented include  using, whenever  possible,  medications  that   do  not  cause weight gain, such as the classes known as DPP-IV  inhibitors or α-glucosidase inhibitors. Another option is to take medications that are actually known to cause weight  reduction  in  many  people who  take  them, such  as  the  classes known  as  biguanides, incretin mimetics,  or  synthetic  amylins  (e.g.,  pramlintide). Some  representatives of  these  classes can  also  be found  in Table  4.  If  medications  known  to  cause weight gain must be used, then your doctor will try to use them  in  the  lowest effective dose, often by combining them with other types of medications. 

Finally, it is important to remember that adhering to a diet and exercise plan is just as important when you are taking pills for  diabetes as it was beforehand. Many patients who are prescribed pills are told that they have failed diet and exercise. This is not entirely true. The diet and exercise may be making an important contri- bution to the control of the diabetes, but is not quite enough to  control  the  blood sugar adequately. This important  contribution will be lost if the program is not continued and  some weight gain in people who start pills or injections for  their diabetes is undoubt- edly due to this.