Which statement would a nurse correctly include when counseling a patient with diabetes and obesity about insulin and weight?

• A. Surplus fat causes excretion of insulin
• B. Obesity leads to insulin resistance
• C. Fat cells absorb insulin and prevent its circulation to other cells
• D. Lipids accumulate in the pancreas and interfere with insulin production

Answer: (B)

The main concept is that obesity leads to insulin resistance, which affects how insulin works in the body. When there is excess adipose tissue, especially around the abdomen, fat cells release free fatty acids and inflammatory molecules that interfere with insulin signaling in muscle and liver. This means glucose isn’t taken up as effectively after meals, so blood glucose stays higher and the pancreas has to release more insulin to try to achieve control. Over time, this can strain the beta cells and worsen glycemic control.

With counseling, emphasize that weight loss improves insulin sensitivity. As insulin works better, the body needs less insulin to achieve the same effect, which can lower the required insulin dose and help control blood sugar more easily. Encouraging gradual, sustainable changes in diet and physical activity can reduce fat mass and improve how the body responds to insulin.

Notes on the other ideas: the notion that surplus fat causes insulin to be excreted isn’t how insulin biology works, and fat cells don’t simply absorb insulin to block its circulation. While some pancreatic fat can be associated with dysfunction, the primary driver in obese individuals is peripheral insulin resistance in tissues like muscle and liver, which improves with weight loss.