Why do we (insulin dependent diabetics) say we get fat on insulin?

• Are we displacing our own (insulin dependent diabetics) responsibility to look after our blood glucose level? To care for ourselves?
• Is there some truth to it, that we will just be fatter than a normal person (non diabetic) and its actually a problem?

I've been pondering this today as I'm also on a mission to drastically improve my hideous blood glucose control, and like most of the population would like to be a little leaner too.
Here are some of my thoughts on how insulin affects our body fat. I've written it like a conversation of someone who is thinks insulin does make you fat (F) and someone who has some understanding of human physiology. Both insulin dependent diabetics.

F - Correcting for a high blood glucose level makes us (insulin dependent diabetics) store fat.
HP - Well isn't this what happens at every meal, we make our blood glucose level increase and give insulin to clear it.
F - But this insulin I'm using to correct my blood glucose level with is more insulin than a normal person would be getting, and therefore I'm storing more glucose as fat than them.
HP - If you are having to correct for high blood glucose levels all the time it means that you don't have enough insulin in your basal and or carbohydrate ratio and or correction factor to maintain your blood glucose target. If you add that insulin to those you won't have to correct as often and with as much insulin and you'll have improve blood glucose control.
F - What about the timing of insulin delivery compared to a normal persons. When we give insulin to correct an elevated blood glucose level it promotes storage of the excess blood glucose. A normal person just never has this happen to them, except for those normal people who consume a lot of high glycemic index foods.
HP - This is most likely true.
F - With exercise we can't turn down our insulin with the same responsiveness as a normal person can and therefore have to eat our way through exercise and this excess insulin limits the release of fatty acids to be used as fuel.
HP - This is also true. But I think the difference is fairly small and would probably only matter if you were someone trying to get your body fat percentage really low like a body builder or a figure competitor cutting down for a competition.
F - Our profile of the insulin we give doesn't match the profile of the release of carbohydrate from the food we eat like a normal person's body can.
A - As long as the amount of insulin matches the amount of carbohydrates in a meal I can't see how it would negatively affects our body fat.

If insulin is responsible for a larger amount of body fat in us than a non-diabetic then here are some proposed methods you could implement. I haven't tried any of these, but they are ways that you can reduce your total daily insulin dosage and combat some of the above.

• Eat less carbohydrates - Given that we use a carbohydrate to insulin ratio that is directly proportional if half your carbohydrate intake for a meal then you'll have to half the insulin you use for a bolus.
• Exercise to lower your blood glucose level when it is high. This is also faster acting than insulin, as well as meaning you won't have to give extra insulin.
• Exercise more - This will increase your sensitivity to insulin, which will mean you can potentially lower your basal rate, carbohydrate ratio and correction factor resulting in less insulin being used across your whole day. Also the more time you spend exercising you also are spending more time with a lowered basal rate during the exercise.
• Exercise soon after meals - Doing this will mean you can effectively reduce your insulin by replacing some of it with exercise.
• Exercise first thing in the morning - At this time of day you have no residual bolus insulin on board and thus means the insulin will not inhibit the release of fatty acids for energy during the exercise. You can also use it to combat a morning elevated blood glucose level (from the dawn effect). To manage the exercise at this time of day you could also lower your basal rate 2 hours before (your basal profile) to further reduce the insulin you are using.

One question I'm not sure about the answer to is whether exercise directly after a meal is better than directly before meal for fat-loss in diabetics. What do you think?

If you have any thoughts about the above please post a comment/reply. I'm not expert. I'm just looking for a better understanding and smarter ways to look after myself like you.
Kind regards,
Hamish