My 34 year old brother-in-law, who has a severe case of diabetes, is a very vain person and likes to work out. He goes through times without a diabetic reaction and seems to lose muscle mass, and then there are times when he is having reactions all the time (daily) and bulking up at the same time. Is this possible? Is it possible that his vanity is causing him to take more insulin than needed to bulk up?

In addition to its role in glucose metabolism, insulin as a hormone also plays a role in protein synthesis and growth. High levels of insulin, and the increased caloric consumption to treat the resulting hypoglycemia (low blood sugar) could contribute to a “bulked up” appearance, similar to that which you are describing. Of course, not knowing your brother-in-law, I cannot say that he is involved in this practice.

Unfortunately, however, insulin is being misused and abused in this manner in the world of body building, by people both with and without diabetes. As those of us living with diabetes know all too well, this practice is dangerous. Discussion with a diabetes team member about the emotional and psychological issues that accompany living with a chronic disease can be helpful.

DMW