About all

How diabetics can lose weight: The Right Way to Lose Weight When You Have Diabetes

Содержание

The Right Way to Lose Weight When You Have Diabetes

One of the best ways to manage diabetes is to lose extra weight. Dial back just a few digits on your bathroom scale, and you’ll get your blood sugar levels more in check and feel better overall.

Weight loss doesn’t have to be dramatic for you to earn big results. “What we found in our research was that when people lose around 7% of their body weight, their insulin sensitivity improves by 57%,” says Osama Hamdy, MD, PhD, medical director of the Obesity Clinical Program at the Joslin Diabetes Center. So if you weigh 200 pounds, losing just 14 pounds will make a difference.

When it comes to diet, the key is to strike the right balance between carbohydrates, fats, and protein.

“Cutting the carbohydrates is the No. 1 way to lose weight,” Hamdy says. “Carbohydrates cause the pancreas to release insulin.” They should make up no more than 45% or so of daily calories for most people with diabetes. But check with your doctor, because your target might differ based on your weight, activity level, and which medicines you take.

When choosing carbs, pick ones that won’t make your blood sugar spike — high-fiber fruits and vegetables, and whole grains. Skip the pastries and white bread.

Another goal is to lower your daily calorie count, but not by skimping on protein. You need protein to maintain muscle, which helps you maximize your calorie-burning potential. At least 20% to 30% of your plate should be made up of lean protein sources like fish, tofu, and skinless grilled chicken breast.

You also need some fat in your diet — it should contribute about 30% to 40% to your daily calories. But the type of fat you eat matters. Unsaturated fats from foods like nuts, avocado, fish, flaxseeds, and canola oil are much better bets than saturated and trans fats from meat and fried foods.

Pair diet with its partner in weight loss — exercise. “If people would like to lose weight, they should get 300 minutes of exercise per week,” Hamdy says. Split those 5 hours between aerobics and strength training, both of which help your body trim down and use insulin better.

Get Started

Want to see good changes in your weight and blood sugar numbers?

Listen to your “hunger scale.” Before you eat anything, think about how you feel. Are you truly hungry? Then have a bite to eat. Do you feel satisfied or stuffed? Step away from the table.

Fill up on fiber. High-fiber foods keep your blood sugar steady and fill you up, so you won’t be as tempted by less-healthy options.

Take 10. Stretch for 10 minutes in the morning, take a 10-minute walk during lunch, and do 10 minutes with weights in the evening.

How To Lose Weight if You’re Diabetic

Maintaining a healthy weight is important for everyone. But for people with diabetes, it’s even more important. In this article, we’ll explore weight loss for diabetics—and how losing weight is different for people with this common condition.

Weight loss for diabetics

Losing weight can make a big difference for people with diabetes—it can lower glucose levels in the blood, which may decrease the effects of diabetes and make the condition more manageable. But there are added complications and risks, too. For example, making big changes to your diet can cause serious problems. One of these is hypoglycemia, when your blood sugar goes so low that you risk the danger of going into a diabetic coma. If you have diabetes, you have to be especially careful about your weight loss plan.

Losing weight and insulin resistance

Insulin is the hormone that regulates blood sugar (glucose) levels in the body and helps your cells convert blood sugar into energy. In some people with diabetes, however, blood sugar levels are high for a sustained period of time, causing the pancreas to produce more and more insulin. Eventually, the cells stop responding to that insulin—becoming insulin resistant. Losing weight with insulin resistance is more difficult because your body converts blood sugar into fat instead of energy.

The solution? For a start, reducing the sugar and processed carbohydrates in your diet while increasing healthy fats (such as in nuts, avocados, and fish) along with vegetables and whole grains. Even a small improvement can make a big difference. Studies show that a weight loss of just 5–7 percent is enough to reduce the risk of diabetes by 58 percent in a person who has a high risk of the condition.

Diabetic

weight loss diet

Diet is a key part of any weight loss plan, but for those with diabetes it’s even more important. Here are some options to consider for a diabetic weight loss diet:

Mediterranean diet. This diet is based on the traditional cuisines of Mediterranean coast cultures—Italy, Israel, Morocco, Spain and more. This approach features fruits, vegetables, whole grains, beans, seafood, poultry, low-fat dairy, extra-virgin olive oil, nuts, and seeds. It includes very small amounts of red and processed meats, butter, and sweets.

Dietary Approaches to Stop Hypertension (DASH). The focus of this diet is to lower blood pressure and improve heart health by reducing sodium (salt)—but weight loss is often a result, too. This diet emphasizes vegetables, fruits and low-fat dairy foods. It also includes moderate amounts of whole grains, fish, poultry and nuts, while limiting sweets, fats and alcohol.

Paleolithic (Paleo). This diet is based on foods that might have been available to our hunter-gatherer ancestors during the Paleolithic era (from 2.5 million to 10,000 years ago). A paleo diet includes leafy vegetables, lean meats, fish, fruits, nuts and seeds. This diet avoids dairy, legumes, grains, potatoes, sugar and processed foods.

Meal-replacement plans. For many people with diabetes, a good option is to incorporate specially formulated foods for weight loss. The Allina Health OPTIFAST® program, for example, provides meal-replacement products for safe, sustainable weight loss. It also features regular check-ins and coaching from a care team.

Exercising for diabetes and weight loss

Exercise is a key part of any weight loss plan, and for diabetics it offers multiple health benefits:

  • Improves blood sugar levels and insulin sensitivity (which means insulin works better)
  • Some types of exercise can help burn extra glucose in the body and also decrease resistance to insulin
  • Lowers your risk for heart disease
  • Improves circulation
  • Reduces stress

Before you exercise, make sure your glucose level is not too low (below 100 mg/dl) or you could risk low blood sugar (hypoglycemia). You should also be cautious if your blood sugar is too high, because exercise can sometimes raise blood sugar. Check with your doctor before beginning an exercise program.

Weight loss options for diabetes

For many people with diabetes, exercise and dietary changes aren’t enough to lose significant weight. Here are some other weight-loss approaches that work:

Medically managed weight loss. This approach involves a team of health care providers, including physicians, nutritionists and more, who create a weight-loss program uniquely suited to you. Support includes a reduced calorie diet that may feature meal-replacement products such as OPTIFAST®, an exercise plan, behavioral counseling and medication.

Weight loss medications. There are many types of weight loss medications—some work by making you feel less hungry, others by making it harder for the body to absorb fat. It’s important that you follow your doctor’s advice, as some diabetes and weight loss medications have serious side effects. Weight loss medications are typically prescribed and monitored through a medical weight loss program.

Bariatric surgery. Also known as weight loss surgery, this approach permanently alters the digestive tract to limit the amount of food you can eat at one time. It has proven to be an effective option, particularly for people with diabetes. Like any significant surgery, there are risks that you should weigh. There are also some lifestyle changes that go along with this type of surgery. Consult your doctor to see if bariatric surgery is right for you.

Diabetes types and weight loss

Type 1 diabetes is an autoimmune condition where the body sends antibodies to attack the pancreas, which prevents it from producing enough insulin to regulate your blood sugar. It is not clear what causes Type 1 diabetes, but it is thought to be genetic and is usually first diagnosed in childhood or young adulthood.

Type 1 diabetes is not associated with excess weight. But if you are carrying extra weight, losing it can reduce your risk of complications and reduce your need for insulin.

Type 2 diabetes is where your body does not produce enough insulin and/or your cells may not respond to insulin properly and do not take in sugar from your blood. Type 2 diabetes develops over many years. The cause is not known, but being overweight and inactive are major contributors.

For Type 2 diabetes, weight loss is key. If you have prediabetes—that is, you have consistently high blood sugar but do not yet have diabetes—losing 7-10 percent of your body weight can reduce the risk of developing diabetes. If you already have Type 2 diabetes, losing weight could cause your condition to go into remission, potentially eliminating your need for medication.

If you have diabetes, maintaining a healthy weight is a powerful way to take more control of your wellness. From weight-loss surgery to dietary changes to medical weight management, there are many options to lose weight and improve your health. Explore the nationally recognized weight management programs at Allina Health or call 763-236-0940763-236-0940 to learn more.

The Dilemma of Weight Loss in Diabetes

People with diabetes receive mixed messages about weight loss from
magazines, newspapers, friends, family, and, yes, even health professionals.
Few subjects have accumulated as much misleading and potentially dangerous
folklore as the subject of obesity. A common message is that losing weight is
just a matter of willpower, and if you have been losing weight and reach a
plateau, it’s because you’ve lost your willpower and are no longer following
your diet. Furthermore, for people with type 2 diabetes, the message often is
that weight loss is the answer to improving glucose control: “If you
just lose 20 lb, you won’t need insulin.” What does research tell us
about these issues, and what should our messages as health professionals be to
people with diabetes?

Obesity is a serious worldwide problem and is associated with the risk of
developing diabetes. Today, more than 1.1 billion adults worldwide are
overweight, and 312 million of them are
obese.1 In the past
20 years, the rates of obesity have tripled in developing countries that have
adopted a Western lifestyle, with the Middle East, Pacific Islands, Southeast
Asia, India, and China facing the greatest increase. Consequently, the number
of people with diabetes in these countries is expected to increase from 84
million in 2000 to 228 million by 2030.

Thus, preventing obesity is a high priority for the prevention of diabetes
and other chronic diseases. According to some obesity researchers, it may not
be possible to decrease the current numbers of overweight and obese people in
the United States, but we need to try to slow or prevent the increase that has
been occurring at an alarming
rate.2 The hope is
that slowing the rising prevalence of obesity will also slow the diabetes
epidemic.

Can this be accomplished? Thus far, nothing seems to have slowed the
increase in both obesity and diabetes. But there is general agreement in the
medical field and within the government that we still need to try. As
educators, we can encourage healthful eating and increased physical activity
for everyone. Only in the future will we know if these efforts will positively
affect the trend of increased obesity and diabetes.

For individuals who have progressed to pre-diabetes, both the Finnish
Prevention Study3
and the Diabetes Prevention
Program4 showed
conclusively that intensive lifestyle interventions decreased the overall risk
of diabetes by 58%. Lifestyle interventions included a weight reduction of 5%
or more, reduction of total fat intake to < 30% of total calories, and
increased physical activity (≥ 4 hours/week). Even more encouraging is the
report from the Finnish Prevention Study follow-up period averaging 7 years,
in which the intervention group saw a 43% reduction in risk of
diabetes.5 The
intervention group had sustained lifestyle changes that remained even after
individual lifestyle counseling ended.

But what about people who already have diabetes? Is weight loss the
complete answer for improving blood glucose control? Although ∼50% of men
and 70% of women are obese at the onset of
diabetes,6 diabetes
is diagnosed in nonobese individuals, and many obese people never develop type
2 diabetes. Therefore, it is likely that obesity combined with a genetic
predisposition may be necessary for type 2 diabetes to develop. Furthermore,
as the disease progresses from insulin resistance to insulin deficiency, it
often is too late for weight loss to improve blood glucose control
dramatically.7

The remainder of this editorial addresses what is known today about weight
loss in general and how this information applies to people with diabetes. Is
it harder for people with diabetes to lose weight? And, for people with
diabetes, is weight loss the cure?

Weight Loss Goals

Achieving an ideal BMI has been recommended for people with
diabetes.8,9
But can the majority of people with diabetes achieve this goal? Should health
professionals make recommendations that may be ideal but not achievable by
most individuals? By now, many have heard about Mike Huckabee, the former
governor of Arkansas, who lost 110 lb and “cured” his diabetes. Is
this something that everyone can do?

To answer the question about expected weight loss from weight loss
interventions, a systematic review was undertaken of randomized clinical
weight-loss trials with a minimum duration of 1
year.10 Eighty
studies with a total of 24,698 subjects were identified, and the data were
pooled to determine the mean weight loss from eight different
interventions—diet alone, diet and exercise, exercise alone, meal
replacements, very-low-calorie diets, orlistat, sibutramine, and advice alone.
A mean weight loss of 11–18.7 lb (5–8.7%) was observed during the
first 6 months from interventions involving reduced-energy diets and/or
weight-loss medications; weight loss reaches a plateau at ∼6 months. In
studies extending to 48 months, a mean 6.6–13.2 lb (3–6%) of
weight loss was maintained. Thus, for the majority of obese dieters, achieving
an ideal body weight is likely not achievable, and dieters usually become
discouraged and frustrated if that is the recommendation they receive.

Do dieters stop losing weight after about 6 months of dieting because they
no longer have the willpower necessary to continue following their diet?
Probably not. In fact, if they stop following their diet, they will likely
regain the weight that was lost. Research in recent years has helped us
understand the adaptive mechanisms that occur with a reduced energy intake
(e.g., hormonal
regulation,11–13
adaptive thermogenesis leading to a decrease in energy
expenditure,14 and
decline in weight-maintenance caloric
requirements,15 to
name just a few). So when dieters claim they are not eating any more calories
than they were when they were losing weight but are only maintaining their
weight loss, this may well be true, and we should probably believe them rather
than think they are just not telling the truth, as is often thought to be the
case.

Weight Loss in People With Diabetes

What about people with diabetes? Table
1 pools the data from the studies in the systematic
review10 in which
the subjects had diabetes, reports weight losses at 6 and 12 months and
12-month changes in hemoglobin A1c (A1C) levels, and compares the
weight change of subjects with diabetes to that of subjects without
diabetes. 16 Again,
we see that weight loss plateaus at about 6 months but can be maintained until
at least 12 months. However, to achieve this result, most of the trials had at
least monthly contact with the subjects. And, yes, it does appear that in
people with diabetes, weight loss may be more difficult than in people without
diabetes, as was first suggested by Wing et
al.17 in 1987.

Table 1.

Weight Change and Effect on A1C From Weight-Loss Interventions in People
With Type 2 Diabetes Compared to Weight Change from Similar Interventions in
People Without Diabetes

The use of exenatide seems to provide an exception to the weight-loss
plateau that generally occurs at about 6 months. In subjects taking exenatide,
weight loss was progressive for up to 82 weeks, at which point the mean weight
loss was 8.8 lb.18
However, it is interesting to note that the amount of weight lost is still
less than what occurs with other weight-loss medications by 6 months.

Weight Loss and Glucose Control

Should the focus of nutrition therapy for type 2 diabetes be on weight loss
or improved blood glucose control? Table
1 shows that achievable weight loss has a modest effect on A1C
levels. However, in several studies, weight loss was not associated with
improvement in
glycemia.19,20
Furthermore, other nutrition therapy interventions that tend to focus more on
metabolic control and less on weight loss have been shown to improve A1C
levels by
1–2%.21

It is likely that early in the course of the disease process, when insulin
resistance is still prominent, either energy restriction or weight loss will
improve blood glucose levels. But as the disease progresses and insulin
deficiency becomes more prominent, it may be too late for weight loss to be
helpful. In fact, at later stages of the disease, when medications, including
insulin, need to be combined with nutrition therapy, prevention of weight gain
often becomes the goal. However, glycemic control should take precedence over
concerns about weight.

A question concerning the improvement of glycemic control is whether the
improvement really results from the weight loss or from a decrease in total
energy
intake.22,23
The beneficial effects on blood glucose control begin to occur before much
weight loss occurs. Even in people with diabetes, the benefits of bariatric
surgery on blood glucose occur quickly. Because improvement in blood glucose
occurs rapidly and before significant weight loss, it has been suggested the
improvement results from the diversion of nutrients away from the
gastrointestinal tract and delivery of incompletely digested nutrients to the
ileum rather than to weight loss per
se.24

Another issue that makes weight loss even more of a dilemma is the effect
of intentional weight loss on mortality in type 2 diabetes. Williamson et
al.25 reported that
people with diabetes who had an intentional weight loss in the Cancer
Prevention Study I experienced a 25% reduction in total mortality and a 28%
reduction in cardiovascular disease-plus-diabetes mortality. Because the
cohort was followed for an average of 12.9 years, this suggests a
“memory” effect of intentional weight loss, which may be sustained
for a long duration even if the weight loss is not fully maintained. In
another analysis of 1,401 overweight adults with diabetes sampled in the
National Health Interview Survey, individuals trying to lose weight had a 23%
lower mortality rate than those who reported not trying to lose
weight.26 This
suggests that even if weight loss is not achieved, eating less may have
long-term beneficial effects.

The Bottom Line in 2007

Until all the dilemmas are solved, what are appropriate messages concerning
weight loss for people with diabetes? Consider the following:

  1. The majority of individuals can expect to lose 5–10% of their
    starting weight. So, if you recommend that an individual with or without type
    2 diabetes lose weight, help him or her accept and set realistic weight loss
    goals. Grave et
    al.27 investigated
    the influence of weight loss expectations (expected 1-year weight loss, dream
    weight, and maximum acceptable weight) in 1,785 obese subjects enrolled in
    weight-loss programs. At 12 months, one of the strongest predictors of
    attrition was a higher expected 1-year weight loss with the risk being
    particularly high in the first 6 months. Thus, they suggested that unrealistic
    weight goals should be addressed at the beginning of treatment.

  2. When weight loss plateaus, continue to encourage the same lifestyle
    strategies that led to weight loss to prevent the weight regain. Prevention of
    weight regain is possible. Successful long-term weight management generally
    requires attention to total energy intake, physical ctivity, and behavioral
    modifications. There are no magical diets or specific foods to eat. Dansinger
    et al.28 randomized
    free-living subjects to the Atkins, Ornish, Weight Watchers, or Zone diets.
    Each diet modestly reduced body weight and several cardiac risk factors at 1
    year. The amount of weight lost was not associated with the diet type but
    rather to adherence level to whatever type of diet participants were
    following.

  3. Although not discussed here in great detail, encourage regular physical
    activity. Low cardiorespiratory fitness and physical inactivity have been
    shown to be independent predictors of all-cause mortality in men with type 2
    diabetes regardless of their
    weight,29 and even
    increased BMI did not increase mortality risk in fit men with type 2
    diabetes.30 A
    stepwise relationship between fitness and mortality is evident within all BMI
    strata and is independent of body fat percentages. These results highlight the
    importance of counseling people with diabetes to increase physical activity
    and improve fitness, not only as a means of controlling weight, but also for
    the benefits of fitness that are independent of weight loss.

In the end, setting realistic weight goals and aiming for moderation is
generally the best approach: eating a healthful diet, being more physically
active, and keeping food records along with blood glucose records so that
blood glucose levels can be kept under optimal control and medications can be
added or adjusted when needed. Eating fewer calories and getting regular
physical activity improves blood glucose control independent of body weight
and weight loss.

Footnotes

  • Marion J. Franz, MS, RD, LD, CDE, is a nutrition/health consultant with
    Nutrition Concepts by Franz, Inc., in Minneapolis, Minn. She is a co-guest
    editor of the From Research to Practice section of this issue of
    Diabetes
    Spectrum.

  • American Diabetes Association

References

  1. Hossain P, Kawar
    B, El Nahas M: Obesity and diabetes in the developing world—a growing
    challenge. N Engl J Med 356:213
    –215, 2007

  2. Dautsch JG: The
    obesity epidemic: what’s being done? J Am Diet Assoc102
    : 638–639,2002

  3. Tuomilehto J,
    Lindstrom J, Eriksson JG, for the Finnish Diabetes Prevention Study Group:
    Prevention of type 2 diabetes by changes in lifestyle among subjects with
    impaired glucose tolerance. N Engl J Med344
    : 1343–1350,2001

  4. Diabetes Prevention Program Research
    Group: Reduction in the incidence of type 2 diabetes with
    lifestyle intervention or metformin. N Engl J Med346
    : 393–403,2003

  5. Lindström J,
    Ilanne-Parolla P, Peltonen M, Aunola S, Eriksson JG, Hemiö K,
    Hämäläinen H, Härkönen P, Keinänen-Kiukaanniemi
    S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT,
    Uusitupa M, Tuomilehto J, on behalf of the Finnish Diabetes Prevention Study
    Group: Sustained reduction in the incidence of type 2 diabetes by lifestyle
    interventions: follow-up of the Finnish Diabetes Prevention Study.
    Lancet 368:1673
    –1679, 2006

  6. American Diabetes Association:
    Diabetes 2001 Vital Statistics. American Diabetes
    Association, Alexandria, Va., 2001

  7. Watts NB,
    Spanheimer RG, DiGirolamo M, Gebhart SS, Musey VC, Siddiq K, Phillips LS:
    Prediction of glucose response to weight loss in patients with
    non-insulin-dependent diabetes mellitus. Arch Intern
    Med 150:803
    –806, 1990

  8. Anderson JW,
    Randles KM, Kendall CWC, Jenkins DJA: Carbohydrate and fiber recommendations
    for individuals with diabetes: a quantitative assessment and meta-analysis of
    the evidence. J Am Coll of Nutr23
    : 5–17,2004

  9. Mann JI: Nutrition
    recommendations for the treatment and prevention of type 2 diabetes and the
    metabolic syndrome: an evidenced-based review. Nutr
    Rev 64:422
    –427, 2006

  10. Franz MJ,
    VanWormer JJ, Crain LA, Boucher JL, Histon T, Caplan W, Bowman JD, Pronk NP:
    Weight loss outcomes: a systematic review and meta-analysis of weight loss
    clinical trials with a minimum 1-year follow-up. J Am Diet
    Assoc In press

  11. Schwartz MW, Woods
    SC, Porte D, Seeley RJ, Baskin DG: Central nervous system control of food
    intake. Nature 404:661
    –671, 2000

  12. Korner J, Leibel
    RL: To eat or not to eat—how the gut talks to the brain. N
    Engl J Med 349:926
    –928, 2003

  13. Schwartz MW:
    Progress in the search for neuronal mechanisms coupling type 2 diabetes to
    obesity. J Clin Invest 108:963
    –964, 2001

  14. Major GC, Doucet
    E, Trayhurn P, Astrup A, Tremblay: Clinical significance of adaptive
    thermogenesis. Int J Obes 31:204
    –212, 2007

  15. Astrup A, Gotzche
    PC, van de Werken K: Meta-analysis of resting metabolic rate in formerly obese
    subjects. Am J Clin Nutr 69:1117
    –11122, 1999

  16. Franz MJ:
    Rimonabant: a new weight-loss medication. On the Cutting Edge.
    Diabetes Care and Education 6:19
    –21, 2006

  17. Wing RR, Marcus
    MD, Epstein LH, Salata R: Type II diabetic subjects lose less weight than
    their overweight non-diabetic spouses. Diabetes Care10
    : 563–566,1987

  18. Riddle MC, Henry
    RR, Poon TH, Zhang B, Mac SM, Holcombe JH, Kim DD, Maggs DG: Exenatide elicits
    sustained glycaemic control and progressive reduction of body weight in
    patients with type 2 diabetes inadequately controlled by sulphonylureas with
    or without metformin. Diabetes Metab Res Rev22
    : 483–491,2006

  19. Manning RM, Jung
    RT, Leese GT, Newton RW: The comparison of four weight reduction strategies
    aimed at overweight patients with diabetes mellitus: four-year follow-up.
    Diabet Med 15:497
    –502, 1998

  20. Wolf AM, Conaway
    MR, Crowther JQ, Hazen KY, Nadler JL, Oneida B, Bovbjerg VE: Translating
    lifestyle intervention to practice in obese patients with type 2 diabetes.
    Diabetes Care 27:1570
    –1576, 2004

  21. Pastors JG, Franz
    MJ, Warshaw H, Daly A, Arnold M: How effective is medical nutrition therapy in
    diabetes care? J Am Diet Assoc103
    : 827–831,2003

  22. Kelley DE, Wing R,
    Buonocore C, Sturis J, Polonsky K, Fitzsimmons M: Relative effects of caloric
    restriction and weight loss in non-insulin-dependent diabetes mellitus.
    J Clin Endocrinol Metab 77:1287
    –1293, 1993

  23. Wing RR, Koeske R,
    Epstein LH, Nowalk MP, Gooding W, Becker D: Long-term effects of modest weight
    loss in type 2 diabetic patients. Arch Intern Med147
    : 1749–1753,1987

  24. Guidone C, Manco
    M, Valera-Mora E, Iaconelli A, Gniuli D, Mari A, Nanni G, Castagneto M,
    Calvani M, Mingrone G: Mechanisms of recovery from type 2 diabetes after
    malabsorptive bariatric surgery. Diabetes55
    : 2025–2031,2006

  25. Williamson DF,
    Thompson TJ, Thun M, Flanders D, Pamuk E, Gyers T: Intentional weight loss and
    mortality among overweight individuals with diabetes. Diabetes
    Care 23:1499
    –1504, 2000

  26. Gregg EW, Gerzoff
    RB, Thompson TJ, Williamson DF: Trying to lose weight, losing weight, and
    9-year mortality in overweight U.S. adults with diabetes. Diabetes
    Care 27:657
    –662, 2004

  27. Grave RD, Calugi
    S, Molinari E, Petroni ML, Bondi M, Compare A, Narchesini G, the QUOVADIS
    Study Group: Weight loss expectations in obese patients and treatment
    attrition: an observational multicenter study. Obes
    Res 13:1961
    –1969, 2005

  28. Dansinger ML,
    Gleason JA, Giffith JL, Selker HP, Schaefer EJ: Comparison of the Atkins,
    Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk
    reduction. JAMA 292:43
    –53, 2005

  29. Wei M, Gibbons LW,
    Kampert JB, Nicaman MZ, Blair SN: Low cardiorespiratory fitness and physical
    activity as predictors of mortality in men with type 2 diabetes.
    Ann Intern Med 132:605
    –611, 2000

  30. Church TS, Cheng
    YJ, Earnest CP, Barlow CE, Gibbons LW, Priest EL, Blair SN: Exercise capacity
    and body composition as predictors of mortality among men with diabetes.
    Diabetes Care 27:83
    –88, 2004

Does diabetes cause or prevent weight loss?

In most cases, weight loss is high on the list of ways to prevent and manage diabetes. Losing weight improves cardiovascular health, reduces the risk of high blood pressure, maintains blood glucose levels, cuts insulin resistance, and more. But occasionally, primarily in cases of Type 1 diabetes, weight loss can be unexpected, abnormal, and a cause for concern. Fortunately, knowing how diabetes can cause weight loss, what to look for, and when to see a healthcare provider can go a long way in managing the disease and staying healthy.

Can diabetes cause weight loss? 

Yes, it can. Diabetes mellitus reduces the body’s production and/or its response to insulin—a hormone that regulates blood sugar levels by helping the body convert glucose into energy. If cells can’t create or use enough insulin to perform this conversion, they may think the body is starving and begin consuming muscle and body fat for energy instead, causing sudden weight decreases. Most of the time, this occurs in cases of Type 1 diabetes, although Type 2 diabetes can cause unexplained weight loss, too.

Anyone who isn’t making a concerted effort to lose weight but still sees consistent drops when standing on the scale should take note. This type of unexplained weight loss could be a sign of undiagnosed diabetes. It could also stem from a host of other conditions, including thyroid issues, celiac disease, Crohn’s disease, cancer, and more. The only way to know for sure is to visit a healthcare provider.

Studies have shown that certain diabetes medications, like metformin, can also cause and help maintain weight loss over multiple years. Other diabetes drugs that may decrease appetite and cause weight loss include Byetta and Victoza.

When to see a healthcare provider

Sometimes, body weight can fluctuate naturally, so when should someone be concerned? The general consensus is that an unintentional 5% or more decrease in body weight over a six- to 12-month period is abnormal.

“Sudden weight loss can be a sign of rising or uncontrolled blood glucose levels,” says Lisa Moskovitz, RD, the CEO of NY Nutrition Group. “Whether or not you’re intentionally losing weight, any loss greater than two to three pounds per week should be reported to your healthcare provider.”

On the flip side, obesity is a significant risk factor for Type 2 diabetes. People with a body mass index (BMI) of 30 or higher often have a higher level of insulin resistance, potentially leading to Type 2 diabetes. Not every case of obesity leads to diabetes, but it certainly increases the chances of developing it. On top of that, obesity can exacerbate diabetes symptoms for anyone who already has it. 

For this reason, healthcare providers and dietitians will often develop diets or weight loss programs for patients with diabetes or prediabetes. These programs often include meal plans and physical activity routines that help patients achieve and maintain a healthy weight, reducing the risk or severity of Type 2 diabetes. Typically, this involves analyzing the patient’s current eating and exercise habits, then laying out practical lifestyle changes that will help achieve personal weight loss goals.

RELATED: Overweight and obesity statistics

How to safely lose weight when you have diabetes

Even though people with diabetes can experience sudden, unexplained weight loss, this isn’t the most common outcome. It mainly occurs in Type 1 diabetes cases, which only comprise 5% to 10% of all diabetes cases. More often, it’s the opposite—losing weight is a struggle. Insulin resistance leads to higher insulin levels, which can increase hunger and overeating. And during insulin therapy, the body stores more glucose as fat. Both situations can lead to weight gain or, at least, more difficulty with weight management. 

While there’s no cure for Type 2 diabetes, sustained weight loss through dieting and physical activity can reverse it (the actual amount of weight needed varies). This doesn’t mean that diabetes is gone forever. It simply means that the disease is in remission, and the patient is maintaining healthy blood sugar levels, but symptoms could always return. 

The biggest question is: What’s the best, safest way to lose weight if you have diabetes? There are plenty of fad diets that aren’t healthy. Sure, consuming nothing but carrot juice for a week will probably help lose weight, but it’s probably not the healthiest option in the long run. It’s often better to eat a personalized, well-rounded diet, manage portions, and exercise regularly. Here are some diabetes weight loss options that might be more effective:

  1. Low-calorie diets: This is a time-tested weight loss approach. A calorie deficit day after day will lead to weight loss. Typically, this limits caloric intake to 1,200 to 1,600 a day for men and 1,000 to 1,200 a day for women. But it’s also about eating the right calories—a balanced diet with enough vegetables, fruits, protein, and carbohydrates. A study from the U.K. showed that 45.6% of people with Type 2 diabetes who participated in a low-calorie weight management program achieved remission within one year.
  2. Very low-calorie diets (VLCDs): VLCDs are a more recent trend restricting the patient to less than 800 calories per day. It’s difficult, but in a 2019 study, diabetes patients on a less-than-600-calorie per day VLCD showed “rapid improvement in glycemic control” in just two weeks, and 79% achieved remission in eight to 12 weeks. 
  3. Avoiding certain foods: Specifically, healthcare providers might recommend drastically reducing or cutting out processed grains, full-fat dairy products, foods high in saturated or trans fats, and foods with added sugar or sweeteners. These foods can cause spikes in blood sugar and increase fat intake. 
  4. Portion control: This one is pretty self-explanatory. Overeating can lead to weight gain, which is detrimental to diabetes care. To help keep patients on track, dietitians often create a balanced meal plan to reduce sugar and fat intake while teaching healthy eating habits.
  5. Regular exercise: Exercise can lower blood sugar and increase insulin sensitivity for up to 24 hours after a workout. However, this depends on the workout’s intensity and duration, according to the American Diabetes Association (ADA). Healthcare providers might create an exercise routine to pair with a patient’s meal plan when treating diabetes. 

That said, diabetes “can wreak havoc on one’s relationship with food,” says Moskovitz. “It is not uncommon to develop disordered eating patterns or even eating disorders after diagnosis. For that reason, a personalized, flexible, and inclusive approach that fits the individual’s needs and lifestyle is paramount for long-term success.”

Moskovitz recommends “a low glycemic diet with plenty of plant-based and fiber-rich foods, lean proteins, and anti-inflammatory fats, [which] is the best treatment to regulate hemoglobin A1C, the average blood sugar over the course of three months.” She advises that people with diabetes should consume alcohol and caffeine in moderation (since they can both impact blood sugar levels) and eat balanced meals or snacks consisting of fiber, protein, and fat every three to five hours throughout the day.

What about low-carb diets?

Low-carb and zero-carb diets have been hot for the past several years. Thousands of people have jumped on (and sometimes off) the Atkins Diet and keto diet bandwagons. Some people swear by them, even though certain studies have shown the long-term hazards of cutting out an entire macronutrient.

When it comes to diabetes, “carbohydrate counting can also make weight loss easier and more effective,” says Moskovitz. But while carb counting is often helpful, eliminating carbs isn’t always the best long-term option. It’s more about eating the right type of carbohydrates in the right amounts. Refined, enriched carbs like white bread, baked goods, and sugars can cause quick spikes in blood glucose. Complex carbs and fibers from whole grains, fruits, and vegetables take longer to break down, preventing a spike.

Type 2 Diabetes: Tips to Lose Weight Successfully

Since nearly 9 in 10 people who are diagnosed with type 2 diabetes are overweight or have obesity,  it is likely that your doctor will discuss the benefits—and they are signficant—to achieving weight loss.

There is some urgency to this recommendation since added adipose tissue increases your insulin resistance (which occurs when your body can’t properly use the hormone insulin to metabolize sugar), and leads to further weight gain.

Weight Loss Can Protect Your Health In Many Ways

It’s more important that you focus on reducing the weight around your middle (waist circumference) since the evidence points to central adiposity as the greatest risk for heart disease and other adverse side effects of diabetes.

Loosing weight around your belly is the most important sign that you are reducing the health risks associated with type 2 diabetes.

 

If you have been told you have prediabetes, or you are newly diagnosed with type 2 diabetes, by decreasing your weight by about 10%—which is no more than 10-15 lbs for many people—you may be able to reverse your diabetes, putting it into remission, or putting off developing it at all.

 

By losing weight, people with type 2 diabetes can improve glucose tolerance which is important to be able to use insulin better.  (To learn more about how the hormone insulin works, read our article on how insulin regulates blood glucose levels.)

 

Even more compelling, weight loss will likely protect you from developing common diabetes-related complications like eye diseases (retinopathy), neuropathy (nerve damage especially to your feet, which may lead to amputation), kidney failure, liver damage, high blood pressure, stroke, and heart disease.

 

 

If you’ve recently been diagnosed with type 2 diabetes and have been advised to lose weight,  you’re probably saying to yourself: “easier said then done,” or more likely, “don’t you think I’ve tried everything to do that already?!”

Understanding how to achieve lasting weight loss starts with a focused assessment of how you are currently eating so you can pinpoint habits that may be holding you back from succeeding.

For many, the best way to do this may be to work with a registered dietitian or certified diabetes educator to help you design a plan that will work for you—a healthy meal plan, physical activity, and to set realistic goals to help you reach a healthy weight.

Eating to beat diabetes is much more about making wise food adjustments than it is about denial and deprivation. A better way to look at a diet when you have diabetes is one that helps you establish a new normal when it comes to your eating habits and food choices. 

There are many advantages to losing weight (even beyond the benefits related to diabetes):

  • You will feel a boost in energy  
  • Your blood cholesterol levels will drop
  • You’ll gain protect against heart disease
  • Controlling your blood sugar will be much easier, and will reduce the need for medication
  • It will lead to improved hemoglobin A1c levels
  • You will likely sleep better since it will reduce your risk for sleep apnea 

While losing weight can be a challenge, even a struggle, you can’t let that stop you. Rather, realize that you can do it because you want to, then make sure you have the right support to stay motivated.

 

For a little fun, take our carb counting quiz to see how well you know the carb content of certain foods; this can help you make healthier choices.

 

There are 3 food-related factors that lead to weight gain:

  • Eating more calories than your body can burn. You can succeed by making small changes. Start by reviewing your portions. Change to a 9-inch plate since a plate that looks full tends to help you feel more satisfied.
  • Eat most of your food earlier in the day. A big breakfast (and if you are one of those who isn’t hungry first thing in the morning, make your first meal the biggest). 
  •  If you get hungry between meals, drink water, tea, coffee (without sugar), seltzer or have a serving of fresh fruit, or raw vegetables for satisfying crunch. This is a sure way to reduce the total amount of calories you consume each day, and the best method to avoid snacking on foods that offer only empty calories, and the likelihood of weight gain.

There are 3 other important behaviors that have a major influence on weight gain as increasing your physical activity, getting sufficient quality sleep, and finding ways to reduce daily stress.

Tricks that Improve Long-Term Successful Weight Loss

Find cookbooks or search the web for recipes that will inspire you to make-over your favorite dishes. 

Work with a registered dietitian who specializes in diabetes to help you set reasonable goals, and to develop an eating plan that fits your schedule, makes sense for your family, recognizes your likes and dislikes, and feels right. 

And remember, weight loss is a temporary process; the real challenge, as you likely know from past experience, is keeping off the lost weight. To achieve this goal, you must embrace a new way of eating, one that is agreeable but meets the healthy view of the new you. 

Physical activity is probably the best strategy to help keep you from regaining the lost weight, and in the article on exercising when you have type 2 diabetes, you can learn about how to start an exercise plan.

Committing to Weight  Management is for Life

For some people, losing weight may not be enough to control blood glucose levels at target levels, and that’s all right. It may mean that your doctor will prescribe medication to help regulate your blood glucose level to keep it in the normal range.

 

Even so, by eating healthier foods and increasing your physical activity, eventually, you may be able to stop taking the medication so keep up your efforts and focus on reducing the fat around your middle so you are better able to regulate your blood sugar on your own.

 

Of course, whether you have diabetes or not, everyone should strive for a healthy weight (as based on your body type—we have an article that talks about how to calculate your “ideal” weight). 

 

Losing weight can help improve your body’s ability to effectively respond to insulin resistance, but if it doesn’t help you achieve better blood glucose control, that doesn’t mean you should give up.  Losing and then maintaining a healthy weight are important choices for life—whether you have type 2 diabetes, or not. This is a life-long commitment that each and every one of us must strive for.

 

Updated on: 10/29/18

What You Need to Know – Cleveland Clinic

Are you trying to lose weight while managing diabetes? “If you have excess weight, losing even 5% of your total body weight can dramatically boost your health. Weight loss can not only improve your blood sugar levels but can lower high blood pressure, heart disease risk and even the amount of medication you take,” says registered dietitian Andrea Dunn.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

But when you’re considering the weight loss options for Type 1 and Type 2 diabetes, it’s important to avoid a quick fix. For lasting success, Dunn says, focus on good nutrition and changes you can commit to.

Below, she outlines what else you need to know to successfully drop pounds when you have diabetes.

The relationship between diabetes and weight loss

Obesity is a major risk factor for developing insulin resistance. And insulin resistance is a big step toward developing Type 2 diabetes. It’s also a major obstacle to achieving long-term blood sugar control. But weight loss can be an effective antidote — with one study showing that losing 16% of your excess pounds can put diabetes into remission.

Staying at a healthy weight is also a worthy goal if you have Type 1 diabetes. But people with Type 1 diabetes can’t make insulin and need to take an injectable version. In turn, taking insulin can lead to weight gain as can eating extra carbs to stabilize low blood sugars so additional measures are needed.

The four best weight-loss diets if you have diabetes

These diets offer well-rounded nutrition and increased odds for weight loss for patients with both Type 1 and Type 2 diabetes:

1.

DASH diet

DASH stands for Dietary Approaches to Stop Hypertension. It was created to help lower blood pressure, but the DASH diet goes well beyond that. It’s a well-rounded, healthy nutrition plan for everyone, not just those with diabetes.

DASH is rich in fruits, vegetables and grains and low in fat, sugar and sodium. For example, on a 1,600-calorie a day DASH plan, you would eat:

  • Grains: Six servings. Choose at least three that are whole, such as brown rice or oatmeal.
  • Vegetables: Three to four servings.
  • Fruit: Four servings.
  • Dairy: Two or three servings.
  • Meat: No more than six servings. In this case, a serving is 1 ounce.
  • Nuts, seeds, beans or lentils: Three portions weekly.

2. Mediterranean diet

More a lifestyle than a “diet,” the Mediterranean diet is based on how some eat in Greece, southern France and Italy. It involves eating lots of vegetables, nuts and healthy fats.

To follow it properly, you should get the majority of your calories from plant-based foods. Eat:

  • Mostly whole grains.
  • Vegetables and  fruits (at least 2 cups of each per day).
  • Eat beans instead of animal protein a few times/week.
  • Include dairy a few times per day.

You can eat healthy fats every day, such as those from avocados, nuts, seeds and olive oil. Eat fish and seafood weekly. Choose eggs and poultry more often than red meats. Limit sweets to only a few times each week.

3. Plant-based diets

Most plant-based diet plans cut out or dramatically limit meat:

  • Vegan diet: Cuts meat and dairy.
  • Vegetarian diet: Avoids meat but allows foods like eggs and cheese.
  • Flexitarian diet: Mostly plant-based with some animal protein.

4. Heart-healthy, lower fat diet

This diet involves eating lean protein sources, including beans and lentils. The total fat you consume is about 30% calories from fat, with saturated fat at 10% or less. At least half of your daily grains should come from whole grains. You should also eat:

  • Vegetables.
  • Fruits.
  • Low-fat dairy choices.
  • Nuts, seeds and low saturated fat oils.

Dieter beware of low or no-carb diets, fasting and cleanses

“Extreme diets can put you at risk, depending on which diabetes medications you’re taking or if you have other medical issues along with diabetes,” says Dunn.

Here are the diets you may need to avoid:

1. Low or no-carb diets

Using insulin or taking a sulfonylurea (a category of blood sugar-lowering medications) while avoiding carbs can put you at risk for low blood sugar. And if you’re on a fixed insulin dose, you may need to eat carbohydrates more consistently to avoid drops in blood sugar. So if you want to follow this kind of diet for weight loss, check with your physician first.

“Depending on how low carb the diet is, your doctor may order monthly lab work to rule out low potassium or magnesium or elevated lipids or uric acid levels,” says Dunn.

2. Intermittent fasting, extreme calorie reduction or skipping meals

Any diet that promotes fasting for long periods can cause low blood sugar. Even if you aren’t taking diabetes medication, it’s important to maintain consistent eating patterns for weight management and blood sugar control. Be aware of how much you eat at any one time to avoid spiking your blood sugar.

Any weight loss diet that preaches very low caloric intake (800 calories or fewer per day) can also increase the risk of low blood sugar and reduced muscle mass. The bottom line: These kinds of diets should be supervised by your doctor.

3. Cleanses or over-the-counter diet pills not approved by the FDA

“Beware of too-good-to-be-true claims made about non-prescription pills and cleanses,” says Dunn. These dietary supplements aren’t approved by the Food and Drug Administration (FDA), so you don’t know what you’re getting. And, she says, some products may even harm your health or contain ingredients that can interfere with your prescription diabetes medications.

10 weight loss tips for people with Type 1 or Type 2 diabetes

If you still find it hard to lose weight with diet and exercise alone, Dunn shares 10 tried-and-true weight loss tips to help jump-start your progress:

1. Give meal replacement products a try

Dunn says meal replacement shakes specifically for people with diabetes or calorie-moderated frozen meals can make it easier to follow structured, lower-calorie eating plans. “You can feel comfortable eating the whole amount because it’s already portioned. Look for meals in the 220- to 300-calorie range. You can even eat an extra serving of vegetables, fruit or dairy with them and stick to your calorie budget.”

For meal replacement shakes, Dunn recommends you:

  • Make them yourself with whole foods and protein powder.
  • Choose premade shakes that contain 15 to 20 grams of protein and under 250 calories per container.

Another diabetes and weight loss tip you can take to the bank? “Try noshing some raw fruit or vegetables with your meal replacement shakes. They give you chewing satisfaction, which helps quell hunger, and can make you feel fuller and more satisfied than just having the shake alone.”

2. Go crazy on produce

No matter what diet you choose, Dunn says that eating fruits and veggies is a must. “Any style of eating that promotes good health includes produce,” she explains. “Figure out what you like — fresh, cooked, frozen or canned — and get in at least five servings each day at meals and for snacks.”

Just be extra careful around canned options as canned vegetables can have higher sodium and canned fruit can have higher sugar amounts due to syrup. Look for canned vegetables labeled ‘no salt added’ and fruit packed in 100% juice or water.

3.

Stick to whole foods

Choose whole foods over highly processed foods as much as possible:

  • Look for whole grains over refined grains.
  • Avoid or eat less from boxed mixes, breaded and deep-fried foods or those with heavy gravies and sauces.
  • Choose cereals and breads with very little or no added sugars.

4. Ask yourself: Is it hunger or habit?

Analyze your home and work environment. Do you have easy access to high-calorie, sugary foods? (Hello, snack drawer.) Do you snack because you’re hungry or because you saw someone else eating?

“When and how much you eat may make a difference as well. Many newer studies say it’s beneficial to eat more food earlier in the day and then less as the day goes on,” Dunn adds. “If you’re skipping meals all day and then eating dinner and snacking all night, that may be why you’re not achieving your goals.”

5. Sip smart

Make water your beverage of choice. Drinking a lot of alcohol and sugar-sweetened drinks like soda, iced tea and fruit juice won’t do you any favors.

6. Make gradual changes

Overhauling your lifestyle can feel overwhelming. But doing it gradually makes it easier. Try cultivating one new healthy habit at a time, such as:

  • Drink water instead of drinking sugary sodas.
  • Start eating a healthy breakfast.
  • Exercise 10 minutes a day.

Experts, including Dunn, advise adopting a healthy behavior you can live with, and add more changes when you can.

7. Move it!

Move as much as you can. Exercise of any kind speeds up the metabolism and accelerates weight loss.

8. Adjust your meds

Dunn emphasizes the importance of talking to your doctor before making any diet changes. “Some diabetes medications cause weight gain. And if you have Type 1 or Type 2 diabetes and take insulin or another drug that lowers blood sugar, you could be at risk for low blood sugar issues if you change your diet without adjusting your diabetes medicine.”

Some newer Type 2 diabetes medications make it easier for patients to lose weight. These drugs — liraglutide and empagliflozin — are also beneficial to the heart. If you are taking a different medication and having trouble losing weight, ask your doctor if one of these might be right for you. Also, be sure to check if your insurance plan covers its cost.

9. Consider bariatric surgery

If the weight is stubborn, consider consulting a bariatric surgeon. A weight-loss surgical procedure might be your ticket to success. “There’s evidence that the weight lost after these procedures can put diabetes into remission and reduce the risk from its complications,” says Dunn.

10. Seek support

If your doctor is associated with a medical center, find out if there’s a diabetes management or weight loss program you can tap into. If not, check the website of the pharmaceutical company that makes your diabetes drug, since many companies have patient support programs.

“Weight loss is not just about diet and exercise. Hormones, genetics, sleep, medications and stress all play a role,” says Dunn. “So if you’re having problems losing weight, work with your doctor, registered dietitian or a certified diabetes educator to set up a healthy weight-management plan. They can make sure your diet is realistic and right for you — and that it will mesh well with your diabetes treatment plan.”

Unexplained Weight Loss? Why You Need to See a Doctor – Cleveland Clinic

By: Sue Cotey, RN, CDCES and Andrea Harris, RN, CDCES

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

All of us can gain or lose a pound or two; we indulge a little too much, and then we put in a few extra workouts.

But if you haven’t tightened the belt on your diet or ramped up your exercise routine and your weight is still dropping, talk to your health care provider.

While weight loss of just a pound or two isn’t a reason for concern, unexplained weight loss of 10 pounds or more may mean something is wrong. It could be an early sign of diabetes.

This weight loss can occur relatively quickly — over a few weeks to a couple of months.

Why can diabetes cause weight loss?

Insulin is a hormone that allows your body to use glucose (sugar) for energy.

If you have Type 2 diabetes, your body doesn’t use insulin effectively, and can’t transport the glucose to your cells. Instead, it builds up in your blood.

When the glucose doesn’t arrive in your cells, your body thinks it’s starving and finds a way to compensate. It creates energy by burning fat and muscle at a rapid pace. This causes unexplained weight loss.

Your kidneys also begin working overtime to eliminate the excess sugars in the blood. This uses additional energy and can cause damage to the kidneys.

Type 1 diabetes has a similar pattern, but instead of being unable to use insulin, your body stops producing it altogether.

Unexplained weight loss can occur in people who have Type 2 diabetes, but it’s more commonly found in people with Type 1. Parents are often the first to notice the unusual weight loss in a child with Type 1 diabetes.

What other symptoms should you watch for?

Weight loss from diabetes is not usually a standalone symptom. It’s typically accompanied by other signs and symptoms including:

  • Excessive thirst or hunger.
  • Excessive urination.
  • Itchy skin.
  • Dark skin around the neck and armpits.
  • Slow healing of cuts and bruises.
  • Yeast infections.
  • Unusual fatigue.
  • Mood changes, including irritability.
  • Vision changes.

It’s important to remember that unexplained weight loss isn’t normal.

It is a sign not only of diabetes but also may point to other issues such as cancer or problems with your gastrointestinal tract, metabolism or thyroid. If you are dropping weight and you don’t know why, see your healthcare provider as soon as possible.

How to lose weight with diabetes

Maintaining body weight within the physiological norm is important for a diabetic, not only for reasons of beauty. If glucose metabolism is impaired, a set of extra pounds can negatively affect health and provoke the progression of the disease. The question of how to lose weight with diabetes is relevant for many people, regardless of gender and age.

Dietary recommendations for type 1 and type 2 diabetes mellitus may differ, since with type 1 of the disease the insulin-producing function of the pancreas is completely lost, and with type 2 of the disease it is partially preserved.The diet for weight loss in the second type is distinguished by a gentle regimen and a limitation in the duration of adherence.

What are the reasons for gaining body weight?

The main reason for gaining extra pounds is a violation of the glucose utilization process, as a result of which it is converted into glycogen and fats. Before losing weight with type 2 diabetes, it is necessary to create favorable conditions in the body for the utilization of glucose from food. The accumulation of fatty tissue in the anterior abdominal wall negatively affects the process of insulin production, which contributes to the progression of the disease.

In addition, obesity in combination with diabetes is fraught with the development of complications such as hypertension, coronary heart disease and thrombophlebitis. The main feature of losing weight in type 2 diabetes mellitus is a gradual change in diet and a gradual rejection of certain foods. It is important to remember that weight loss through fasting is categorically unacceptable for weight loss in diabetes.

How to lose weight with type 1 diabetes?

The main source of energy in the human body is glucose.With type 1 of this disease, the cells of the pancreas do not produce the hormone even in a minimal amount, as a result of which the process of glucose utilization is disrupted. Against the background of this process, the body begins to look for alternative sources of energy, in the role of which is muscle and adipose tissue. This process is the main reason for dramatic weight loss in type 1 diabetes. Despite the decrease in body weight, diabetics need to follow dietary recommendations that exclude the use of sugar-containing foods, fried, smoked, spicy, too fatty foods, as well as alcohol.

How to lose weight with type 2 diabetes?

A diet for weight loss in type 2 diabetes mellitus has the following characteristics:

  1. The calorie content of the daily menu is reduced.
  2. Food intake is carried out at the same time, while the frequency of meals is 4-5 times a day, fractionally, in medium portions (about 250-350 g).
  3. The last meal should be taken no later than 2 hours before bedtime.
  4. The diet should contain fresh vegetables and fruits rich in fiber.
  5. Reducing to a minimum or completely eliminating foods rich in simple carbohydrates from the diet.

The recommended ratio of proteins, fats and carbohydrates for type 2 diabetes is as follows:

  1. Carbohydrates – 40 to 60%.
  2. Proteins – from 15 to 20%.
  3. Fats – from 25 to 30%.

Food products such as sugar, fatty fish and meat, carbonated drinks, puff pastries and pastries fall under the absolute prohibition.

It is also recommended to exclude from the daily menu canned meat and fish, beets, raisins, dairy and sour milk products with a high percentage of fat, pasta, butter, rich broths, dates, pickles, sausages and cheese with a fat content of more than 15%.

List of approved products for type 2 diabetes:

  1. Green and white beans, green peas, lentils.
  2. Raw carrots.
  3. Cucumbers.
  4. Grapefruit.
  5. Zucchini and asparagus.
  6. Eggplant.
  7. Mulberry.
  8. Broccoli.
  9. Apples.
  10. Oranges.
  11. Diet (veal, rabbit, turkey, chicken fillet).
  12. Bread made from rye flour or with the addition of bran.

It is recommended to heat food by boiling, baking or steaming. The frying process should be excluded, since fried food has not only a high glycemic index, but also contains carcinogens that provoke cancer.The answer to the question of whether it is possible to lose weight with diabetes mellitus is in the affirmative, since a balanced diet can maintain weight even with serious metabolic disorders.

Is it possible to play sports with diabetes?

When talking about whether it is possible to lose weight with diabetes by increasing physical activity, it is important to familiarize yourself with the rules of exercise. With diabetes, it is important to observe dosed physical activity, which has a beneficial effect on the general metabolism and glucose metabolism in particular.In order for physical activity to be beneficial, it is recommended to follow these rules:

  1. The level of physical activity should be increased gradually, starting with simple exercises.
  2. Gymnastics is not recommended on an empty stomach or with a full stomach. After eating, 40-50 minutes should pass.
  3. It is recommended to perform gymnastics every other day.
  4. The duration of a gymnastic session is 25-30 minutes.
  5. If the blood glucose level exceeds 14 mmol, physical activity must be temporarily abandoned until the blood sugar levels return to normal.

Additional recommendations

With diabetes mellitus, the recommended duration of sleep for men and women is at least 8 hours. Depending on age and body weight, the daily volume of water consumed should be from 1.5 to 3 liters. The optimum drinking water temperature is 33-35 degrees. In addition, diabetics should regularly compensate for the deficiency of certain vitamins and microelements by taking pharmacy multivitamin complexes.Vitamins A, E, H, C, B1, B6, B12, magnesium, alpha-lipoic acid, manganese, succinic acid are of particular value.

90,000 how to reduce and control weight in diabetes mellitus?

Scientists and doctors argue that there is a close relationship between such a dangerous disease as diabetes and obesity. For example, the results of a large-scale long-term study Nurses’ Health Study showed that with the appearance of each extra kilogram, the risk of developing diabetes increases by 4.5% in women, and with an increase in body weight by 8-11 kg, this risk doubles [1 ].

Obesity and Diabetes: The Difference in Approaches from East and West

In Western medicine , such a disease as diabetes has been known for a long time. This name means a group of diseases in which a patient develops a chronic insulin deficiency, accompanied by disorders of fat, protein and carbohydrate metabolism. These metabolic disorders appear both due to insufficient synthesis of insulin, and due to the immunity of body tissues to it.With a lack and resistance to insulin, the flow of glucose into the cells decreases, and as a result, its content in the patient’s blood increases. The body includes alternative ways of processing glucose and its assimilation, which leads to the accumulation of harmful substances in the tissues, causing the processes of protein breakdown and the accumulation of ketone bodies. This, in turn, leads to the development of cataracts and neuropathy, joint damage. Increased urination to remove excess sugar from the body, and along with glucose through the kidneys, the necessary fluid is also excreted, which leads to dehydration.

Diabetes mellitus caused by insufficient synthesis of insulin or its complete cessation is called type I diabetes and is more often detected in young people under 30 years of age. Often it is a consequence of the immune response to viral infections or toxic effects. This happens when more than 80% of the cells in the pancreas, which are responsible for the synthesis of insulin, die. Type I diabetes is called insulin-dependent. The only way to treat it at the moment is insulin replacement therapy, while the patient needs injections of insulin daily throughout his life.Their absence threatens a diabetic hyperglycemic coma.

Type II diabetes is characterized by tissue insensitivity to insulin, while its content in the body may be normal or even elevated. Most patients are diagnosed with this type of diabetes, and it is more susceptible to older people, in whom glucose tolerance decreases with age. Depending on the severity of the course, type II diabetes is divided into three degrees.

  • At mild no drugs are prescribed, a low-carb diet is sufficient to maintain normal sugar levels.Unfortunately, due to late diagnosis, this degree is rare.
  • The most common – Medium diabetes, in which the patient needs additional funds to lower blood sugar. Complications at this stage are mild and do not affect the quality of life. Sometimes there is a lack of insulin at this stage, so it is given by injection.
  • Severe degree is characterized by the presence of serious complications such as nephropathy, retinopathy, diabetic foot syndrome, heart failure, diabetic neuropathy.

In addition to these two types, there is also gestational diabetes , which is characteristic of pregnant women. Increased sugar during this period must be monitored so that childbirth goes without complications. After childbirth, blood sugar levels return to normal, but the woman remains at risk of type II diabetes.

In our article we will talk specifically about type II diabetes, why obesity is its comorbidity, and what can be done to reduce weight.

The mechanism of obesity in diabetes resembles a vicious circle. Those calories that a person did not spend in the process of life are stored as fat. An excess of adipose tissue provokes an increase in the level of lipids in the blood, to combat which insulin begins to be synthesized. An excess of carbohydrates, in turn, causes an increase in glucose levels and for this, insulin production is also increased. The main consumers of glucose in the body are muscles, but with an inactive lifestyle, they do not need enhanced nutrition, so the cells of the body stop absorbing glucose and ignore insulin.It is this condition that is called insulin resistance . The more insulin a person has in the blood, the higher the degree of obesity, and the more obesity, the higher insulin resistance becomes.

In oriental medicine diabetes is perceived and typed in a completely different way. Chinese doctors today distinguish not two or three types of diabetes, but about 10, and practice a slightly different approach to treatment than in the West. When diagnosing, the doctor first of all tries to determine the type of the disease, and already on its basis develops treatment tactics.

This is interesting
The first mentions of diabetes are contained in the “Historical Notes” of Sima Qian, dating back to 145–86. BC. A detailed description of the etiology of diabetes and the principles of its treatment is set out in the books “Su wen”, “Zhen jiu jia and jing” (282) and “Wai tai mi yao fang” (752) [2].

According to Chinese doctors, the main symptoms of diabetes are “three excesses” – excessive appetite, excessive thirst and excessive urination. Diabetes is believed to be caused by Yin Energy Deficiency Syndrome, so diagnosis needs to identify where this energy is lacking. For example, with a deficiency of “Yin” in the lungs, the main symptom is intense thirst, and with a lack of “Yin” in the stomach, severe hunger. To treat one type or another, it is necessary to replenish the “Yin” and stabilize the energy “Chi”, which balance the internal heat in the body and increase the production of fluids, which will help the pancreas to produce its own insulin.

For the treatment of obesity in diabetes, the doctor of traditional Chinese medicine will definitely offer an integrated approach, starting with identifying and eliminating the root causes of excess weight.

Causes of obesity and diabetes mellitus

In Western medicine the main factor in the onset of obesity and diabetes mellitus is hereditary predisposition . If one of the parents had diabetes, then the person has a 30% chance of developing the disease. And if both the father and the mother were sick, the risk increases to 60%. Another likely cause is some disease or injury to the pancreas that damages the cells that make insulin.

The next most important reason is unbalanced diet , including the abuse of sugar and sugary foods. Of course, one should not think that those with a sweet tooth necessarily suffer from diabetes, but excessive consumption of sweets can cause excess weight and obesity, which are often the impetus for the development of the disease.People leading a sedentary lifestyle are also at risk, because their body does not have time to process all the glucose consumed, and because of this, as already mentioned, insulin resistance may occur.

Nervous stress, chronic fatigue, taking certain psychotropic drugs can also cause obesity and diabetes. It is especially important to avoid these factors for people with a hereditary predisposition to the disease.

Refers to risk factors and age . The older a person is, the more reason they have to fear diabetes. Moreover, with age, the hereditary factor ceases to play a decisive role, and obesity comes first, which, in combination with past diseases, weakens the immune system and can lead to the development of type II diabetes.

Chinese Traditional Medicine sees the causes of diabetes and obesity elsewhere.For example, according to one of the classifications, the causes of the disease are rooted in violation of the movement of energy “Chi” along the main meridians of the body, as well as in violation of one of the regulatory systems: the system of the lungs and heart (“Shang-jiao”), stomach and spleen (“Zhong-jiao”), kidneys and bladder (“Xia-jiao”).

In Chinese medicine, it is also believed that diabetes is more likely to occur in people who consume alcohol, fatty and sugary foods, are often prone to anger or anxiety, and are also characterized by excessive sexual activity.

How to lose weight in type 2 diabetes: an integrative approach

Losing weight even for a healthy person can be quite difficult, and if you choose the wrong method, it can also be harmful to the body. Uncontrolled weight loss in diabetes is more dangerous, as it can provoke many additional health problems. The process of losing weight should take place only under the constant supervision of a doctor – losing weight with the help of Chinese medicine is no exception.And in this case, the most justified is the integrative approach, which combines modern and traditional methods. As part of this approach, a person should be guided by several rules so as not to harm their body in the process of weight loss in diabetes.

Rule 1. Let your doctor know that you want to resort to traditional Chinese medicine. Based on your diagnosis, the severity of the disease, the characteristics of the body, the doctor will give you professional advice on what is shown to you and what is not, which techniques can be used, and which are better to refuse. After obtaining permission from your doctor, you can go to the chosen clinic. It should be noted that before prescribing treatment, Chinese doctors will carry out a full diagnosis of your body and only on its basis will prescribe a set of procedures. As a rule, this complex includes the following methods.

  • Acupuncture. With the help of needles acting on the bioactive points of the body, the metabolism in the body is improved, the pancreas is activated, the nutrition of organs and tissues is stabilized, and the body’s own recovery mechanism is launched.An alternative to acupuncture can be moxibustion – impact on active points with the help of special wormwood cigars.
  • Massage. In Chinese medicine, different types of massage are used: with the help of bamboo sticks, a Gua-sha scraper, acupressure. Regardless of the technique, they are all aimed at improving blood circulation and lymph flow. During the massage, tissue nutrition is improved, the work of the endocrine glands is regulated, which contributes to a decrease in body weight. Cupping massage, for example, stimulates active points, removes waste products from subcutaneous fat, removes excess fluid from the body, renews cells and enhances their nutrition.
  • Herbal Medicine is the basic healing method in Chinese medicine. The use of Chinese herbal preparations is very important for those who want to reduce body weight and regulate sugar levels in the body. All funds are prescribed by a doctor individually for each specific case, natural medicines help to stabilize metabolism and reduce weight without side effects.
  • Qigong . Diabetes mellitus – like any disease, according to Chinese philosophy – affects the circulation of the “Qi” energy.To increase its current along the meridians, Chinese doctors prescribe the patient to perform gymnastic qigong exercises. With the help of this gymnastics, you can get rid of excess weight, stabilize sugar levels, and reduce blood pressure. In addition, in the qigong technique, a lot of attention is paid to the respiratory process, the correct mood of consciousness, which helps to strengthen the body and restore vitality to it.

Rule 2. After starting the course of losing weight, in no case should you refuse the prescriptions prescribed by your doctor, such as taking certain medications, performing procedures, etc.e. The doctor prescribes them taking into account the upcoming weight loss, so that any cancellation not authorized by him may adversely affect the health condition.

Rule 3 . It is imperative to increase physical activity. We have already said that a sedentary lifestyle provokes the onset of diabetes, and that it causes an increase in body weight is not even worth talking about. Exercise improves carbohydrate metabolism and glucose uptake, which means it can lower blood sugar levels.

However, improperly selected exercises and loads can cause serious harm. Before starting training, it is imperative to clarify which exercises are shown, what loads are permissible for diabetes and how they are combined with treatment. You cannot reduce weight abruptly, the maximum allowable limit is 3-4 kg per month. The most preferred types of exercise are walking, swimming, cycling or stationary cycling, skiing, and jogging. The ideal option would be a methodical alternation of traditional Chinese gymnastics and a set of Western exercises.The basis of any exercise should be the systematic nature of the exercises, their regularity and moderation. The choice of any type of load is carried out individually, taking into account the age, physical condition and degree of the disease. It is very important not to overload the body, as overload can cause a sharp drop in blood sugar levels.

At the initial stage, only 10 minutes can be spent on exercise, especially if the person has not been involved in sports before. Over time, the duration of the sessions is increased to 40-60 minutes a day.To achieve the effect, you need to go in for sports at least 3 days a week, with intervals between them no more than 2 days. The best option is classes in special groups for patients with diabetes under the supervision of an experienced instructor.

Rule 4 . A low-carb diet and diet should be followed. Traditional low-calorie diets are contraindicated for weight loss in diabetes. The type of nutritional therapy for diabetics, aimed at reducing weight and sugar levels, was developed back in the 30-40 years of the twentieth century.It is still known in dietetics as “table number 9” and is suitable for almost all diabetics. The basic principles of nutrition in diabetes are as follows:

  • frequency of receptions: 5–6 meals a day is recommended, while breakfast, lunch and dinner should account for up to 75% of the total daily ration, and the remaining 25% for snacks; 90 026 90 025 small portions;
  • thorough chewing of food;
  • Keeping a detailed food diary;
  • Mandatory control of sugar levels after meals using a glucometer.

All products in terms of their benefits and harms for diabetics can be divided into 3 groups.

The first group is what can be consumed without restrictions: vegetables, mineral water, tea and coffee without sugar and cream.

The second group – products that can be consumed with some restrictions: lean meat and fish, some fruits, eggs, potatoes, pasta, cereals, low-fat milk, kefir and cottage cheese, peas, beans, bread.

Third group – products that should be excluded from the diet: fatty meat, lard, fish, smoked meats, sausages, margarine, mayonnaise, seeds, honey, sugar, confectionery, bananas, grapes, persimmons, dates, sweet juices and alcohol.

Notes
Special products “for diabetics”, in which sugar is replaced by artificial sweeteners, sometimes contain a large amount of fat, which means that it is no less harmful for patients. The diet of a person with diabetes should not be oversaturated with sugar, salt and fats, but vegetables, fruits, proteins, complex carbohydrates and vitamins should be present in sufficient quantities. .

A sample menu for one day might look like this:

  • Breakfast : 200 grams of low-fat cottage cheese with the addition of berries.
  • Snack: a glass of 1% kefir.
  • Lunch: 150 grams of baked lean beef, 100–150 grams of stewed vegetables, a bowl of vegetable soup.
  • Snack : 100-150 grams of fresh cabbage and cucumber salad with a teaspoon of olive oil.
  • Dinner: 80 grams of grilled vegetables and 200 grams of baked lean fish.

Rule 5. Do not interrupt the proposed treatment at your own discretion!

Prevention of diabetes mellitus and obesity

Prevention of diabetes mellitus is a rather difficult task, since it is primarily a hereditary disease.But if a person is at risk, then he should be especially careful about his health – it is advisable to change his lifestyle and diet even before he has to fight to reduce blood sugar and excess weight. Food with carbohydrates and animal fats should be excluded from the diet, and physical activity should be increased.

As for Chinese medicine, you can use various massage techniques to prevent diabetes and obesity, include qigong or taijiquan gymnastics in your schedule, ask to choose a herbal medicine program.The sooner a person begins to take care of their health, the lower the risk of obesity and diabetes.

Obesity is not just unaesthetic, it is also unhealthy: the close relationship between excess weight and diabetes is proof of this. Fighting excess weight is necessary, and professional doctors of traditional Chinese medicine can help with this.

How to lose weight with diabetes: professional advice

Do not self-medicate.Be sure to consult your doctor.

Article reviewed by an expert endocrinologist.

I have heard that many girls and women are wondering how to lose weight with diabetes. And most of them are convinced that this is almost impossible. There is an opinion that insulin only makes you fat, but in fact, the wrong diet is to blame. For example, some people believe that you can not limit yourself in food, compensating for this by taking insulin.People with diabetes can control their weight and shape as accurately as anyone else. Therefore, it is important to adhere to the principles of a healthy diet, exercise regularly, you also need to regularly measure your sugar level and correctly calculate the dose of insulin.

After reading a lot of literature and consulting with experts, I came to the conclusion that a variety of diets and heavy physical activity can complicate the control of sugar levels, which affects health.Personally, I am not in favor of experimenting with nutrition, because I know how important it is to balance protein, fat and carbohydrates with every meal. For example, trendy protein diets are not a method that will allow you to lose weight with diabetes and not pay with your health. They deprive the body of the required amount of carbohydrates. The most correct thing is to adhere to the principles of a healthy diet and exercise regularly. I will tell you more – nutrition has a much stronger effect on the figure, and no exercise will help with improper nutrition!

What am I eating?

Fresh vegetables and dairy products, lean meat and fish, I drink at least two liters of water a day.Of course, I avoid fried and fatty foods – this is generally not good for anyone. If I want something sweet, I will eat some fruit or dark chocolate.

How do I eat?

I eat often and in small portions. I have three main meals and two or three snacks, depending on the intensity of the day. I never go hungry, because at such moments my sugar can drop. And even if I am at a meeting, for example, there is always a chance to have a snack. To do this, I carry a bag of dried fruits or muesli bars in my purse.

I always have porridge for breakfast. I cook it from absolutely all types of cereals with different fillings: I add berries, nuts, pieces of fruit. I come up with recipes myself or look for information on the Internet. And there are a million of them!

At lunchtime, I do this – mentally divide the plate into 2 halves. I completely fill one half with fresh or boiled vegetables and herbs. If you want to fill the salad with something, I can add two teaspoons of olive oil. I also divide the second half of the plate into 2 parts – “quarters”.I fill one part with a main course rich in protein (river fish, lean poultry), and the other part with a side dish with slowly digestible carbohydrates. It can be durum wheat pasta, potatoes, buckwheat, wild rice.

For dinner I try to eat something protein and vegetables: for example, steamed fish and broccoli.

I have snacks between meals. For lunch, I usually eat something fermented – a casserole or yogurt – since in the morning I almost always have sports or important meetings.3 hours after lunch I have an afternoon snack: usually it is a sandwich with cereal bread, soft cheese and vegetables.

I also make sure that my daily diet does not exceed 12 XE, and the calorie content of products is in the range of 2000-2200 calories per day. So I manage to be in shape and not gain weight.

When to measure blood sugar?

I always measure my blood sugar before and after the main meals, and I put special marks on the food in my meter.I love that it automatically remembers and analyzes all my results so I can see what affected my sugar and when.

For those who are just picking up their diet, I recommend keeping a diary. The fact is that the same foods affect sugar levels in different ways. And in order to understand everything, you need to write down what you eat, drink and do during the day; and then correlate this with the blood sugar readings. I understand that at first it may seem inconvenient, but after a month you will remember all your “reactions” and can easily do without a diary.

My little secret

For those who are worried about their figure or want to lose weight, I can give one simple advice: try to think over your diet in advance. Better a week ahead. Personally, I follow a low-calorie diet and exercise at the same time. Therefore, I compose my weekly menu so that the ratio of proteins, fats and carbohydrates is 1: 1: 4 (carbohydrates in it were no more than 30%, proteins – about 40%, and fats – 30%). When I shop at the supermarket, I definitely go through the grocery list I wrote in advance, and I can resist impulsive purchases of “something tasty.”And the less “tasty” and more physical activity every day, the slimmer the figure. That’s the whole secret.

Medical Center “Institute of Endocrinology”: Lesson No. 1

Lesson number 1

Signs of diabetes mellitus

One of the first signs of high blood sugar levels is constant thirst. Dry mouth and skin are caused by dehydration. When the level of glucose in the blood rises, it becomes concentrated and thickens.The liquid rushes to where the concentration is higher, that is, from the cells and tissues of the body, water passes into the blood, where there is a lot of glucose, which cannot enter the cell due to lack of insulin. Lack of water in the cells overexcites the center of thirst in the brain. There is an unrestrained desire to drink – a feeling of thirst. However, it cannot be said that this symptom is an obligatory evidence of an increased glucose level.

People experience similar dry mouth and a feeling of thirst after eating salty food, pickles, herring, smoked meats, or after drinking a lot of alcoholic substances that can keep water in the bloodstream.Dryness in the mouth and skin is observed both with stagnation of bile in the gallbladder, and with inflammation of the kidneys, when the process of reabsorption of water by the kidney tubules is disrupted. A pronounced feeling of thirst is also noted in diabetes insipidus . As the name implies, with this disease, blood sugar levels will be normal, while the reasons for the feeling of thirst are more often associated with disorders in the brain. And, naturally, a person is thirsty when he loses more fluids than usual. For example, sweats in heat, fever, vomiting, loose stools.Not so often, but the same person sometimes has both diabetes mellitus and diabetes insipidus.

When we talk about such a sign of diabetes as frequent urination, the term “renal threshold” should be familiar. The kidneys, usually by filtering blood when urine forms, do not allow glucose to pass through. But when the blood glucose level exceeds 8.5 – 10.0 millimol / liter, the kidneys are unable to keep it further. This indicator of blood glucose, at which sugar appears in the urine, is called “renal threshold”, and it is individual for each diabetic.Each diabetic can define their own “kidney threshold”. To do this, he needs to determine the level of sugar in the blood and at the same time in the urine 1 hour after eating. Thus, you will find out at what level of sugar it begins to cross your renal threshold, in other words, appears in the urine. If you are unable to determine sugar in urine, then this means that your sugar level does not reach 8.5 millimol / liter. For this test, you must use fresh urine – the urine that has accumulated in your bladder over the last 30 minutes.As soon as glucose crosses the kidney threshold, it appears in the urine and begins to be excreted from the body. Water rushes after concentrated urine. Therefore, urine is excreted in abundance, and if you accidentally step on it, it is sticky.

Now let’s try to understand why a person loses weight in diabetes mellitus . We all know that glucose is the main source of energy for our body. With diabetes mellitus, the working cells of the body cannot withstand a glucose deficiency for a long time and begin to use fats for this purpose.Fats are also a source of energy, but stored in the store. When fats are broken down to replenish cellular energy needs, a person loses weight. If this process lasts a long time or fats in the body become the only source of energy, there is a danger of accumulation of ketone bodies (acetone) formed during the breakdown of fats. Ketone bodies are poisonous substances. Their accumulation in the body has a toxic effect. At the same time, as in cases of other poisoning, headaches, nausea, vomiting, and abdominal pains are troubling.The body tries to get rid of this poison by removing it with exhaled air, while the diabetic breathes often and deeply. The air he exhales smells like acetone. This condition is called ketoacidosis. It develops in a diabetic with an untimely and late diagnosis. For the first time, many diabetics are admitted to hospitals in an unconscious state – in a ketoacitodic coma due to the effect of toxic ketone bodies on the brain and other organs. An increased level of urine acetone can be found not only in the body of diabetics.It appears in the blood and is excreted in the urine during weight loss, when a person who wants to lose weight excludes food intake containing glucose and fats. Acetone can be gradually excreted from the body in the urine if a person has worked in contact with it for many years (painters, gas station workers, etc.). This means that the appearance of acetone in the urine is not a reason for panic, if the level of glucose in the blood is normal.

You can say that not all diabetics lose weight. Yes, indeed, some people even put on weight some time before diabetes is discovered.This means that such diabetics had not a lack of insulin, but a lack of sensitivity of the body’s cells to their own insulin. Some people deny the presence of diabetes, not finding any of the listed signs. A person is individual, and the manifestations of diabetes are different for everyone – everyone has their own “barometer” for the presence of excess glucose. At the same time, some of them begin to be bothered by itching, others – tongue tingles, still others have “seizures”, some deteriorate vision and, as the glucose level decreases, it is restored, etc.e. Often they turn to endocrinologists after a long and ineffectual treatment of various pustular diseases, itching in the genitals, skin rashes, bleeding gums, and teeth shakiness. After examination, cardiologists, ophthalmologists, urologists and other specialists refer their patients to endocrinologists. Accidental detection of diabetes mellitus during preventive examinations during preoperative preparation is not uncommon. Therefore, no matter how diabetes mellitus manifests itself, the only and final confirmation of the diagnosis is an increase in fasting glucose levels above 6.0 millimol / liter when determined at least 2 times or above 11.1 millimol / liter two hours after eating.

The insidiousness of diabetes lies in the fact that it proceeds latently in the second type of this disease and causes such disturbances in the body that, simultaneously with the establishment of the diagnosis, its complications are also discovered.

90,000 Type 2 diabetes: why weight loss is the worst strategy and what to do instead.

I wrote some time ago about a study that found that obese type 2 diabetics who specifically reduce weight for recovery die earlier than those who maintain a large but stable weight (1).The results of the study so shocked its authors, who, of course, expected a completely opposite effect, that they checked the data several times, trying to find an error. There was no mistake – diabetics who lost weight died earlier.

Another study has just come out that confirms a previously discovered phenomenon: weight loss in type 2 diabetes is associated with earlier mortality (2). In it, a sample of 173,246 respondents was studied for 5 years.

🖍In this study, weight loss of only 10% of current weight in people with newly diagnosed type 2 diabetes was significantly positively associated with earlier death.

In other words, weight loss in type 2 diabetes is a shorter road to the graveyard. And if this is not part of your plans, then what to do?

Typically, the diagnosis of type 2 diabetes is shock, shock, fear, and the subsequent acute attack of a healthy lifestyle. People immediately give up all kinds of carbohydrates, count bread units, and purposefully lose weight. Together with weight loss, blood sugar also decreases slightly – the endocrinologist praises the patient for his diligence, the patient is happy and… research shows that such a patient dies earlier.

What if you are diagnosed with type 2 diabetes?

❗️Stabilize the weight – that is, arrange the food in such a way that the weight is kept, “as if nailed”, at the same level, plus or minus 2-3 kg. This is easy to achieve if you eat every 2.5-3 hours, while your main meals include proteins, fats, complex carbohydrates, and foods containing calcium. Foods that cause insulin spikes are best eaten at the end of a full meal – this reduces the risk of overeating them, and the insulin response will be less high.

❌The recommendation to eat 3 times a day with long breaks is not only outdated, but also extremely dangerous for many people with type 2 diabetes. Before following it, make sure that your eating behavior is not disturbed (according to statistics, it is disturbed in 7-8 women and 4 out of 10 men). Trying to eat with long interruptions in conditions of RPP will lead to bouts of overeating, and, as a consequence, even larger surges in sugar. And the endocrinologist who gives you a recommendation to eat like this without screening for RPE is professionally incompetent.

❌Another harmful recommendation is to completely abandon products containing sugar. First, not all sugary foods necessarily cause insulin peaks (see below for why).

Secondly, denying yourself goodies completely is a risky undertaking, overeating is the best friend of restrictions. It is not sugar itself that harms the diabetics, but diets with insulin peaks. Restriction followed by overeating is the best way to trigger a drop and subsequent spike in blood insulin.

If you have completed the block “Down with the Diet Program!” at the IntuEat Center – then you’ve mastered the versatile weight stabilization tool – Marsha Herrin’s Plan of Three. If you are eating this plan, then your insulin “seismic zone” is at rest (for those who decide this paragraph is a native ad. The SDA course is part of the eating disorder recovery program we offer at the IntuEat Center. it is not possible separately, and at present there is a waiting list in the Center – the flow of clients is too large, so it will be possible to get to us only closer to the end of summer).

❗️Check the glycemic sensitivity of all foods important to you. Not only for sweets, bread or other carbohydrates – for everything.

🖍Glucometer is your best friend. The glycemic index is not universal – your personal insulin response to creamy ice cream can be quite calm, but sugar can go off scale when you eat tomatoes. This was established by Israeli researchers in 2015 (3) They postulated that a single dietary model for all type 2 diabetics is impossible: if you have been diagnosed with such a diagnosis, your task is to develop your own dietary model based on the readings of the glucometer.

❗️Do not switch to low-fat dairy products, no matter what the endocrinologist says. And if your endocrinologist says that milk fat is bad for you, change your endocrinologist, he does not read new studies on diabetes.

And they say that high-fat dairy products – cream, butter, cheeses, yoghurts – help reduce the risk of diabetes and help cure it. A Swedish study (4) found that people consuming 8 servings a day of these foods had a 23% lower risk of type 2 diabetes than people consuming 1 serving a day.

1 serving is 200 g of milk, 20 g of cheese (1 slice), 25 g of cream or 7 g of butter (one and a half teaspoon).

Scientists have found that milk fat plays a key role in glucose metabolism and in the control of insulin sensitivity. Here we will remember with an unkind word the new dietary fashion to completely abandon dairy products, which increases the already high risk of developing type 2 diabetes in those who are always losing weight or “on detox” (the reasons are weight jumps back and forth, the use of sugar substitutes and a whole range of others factors.increasing the risk of developing type 2 diabetes).

Later meta-analyzes confirmed what the Swedes found – more milk fat in food means a lower risk of type 2 diabetes. Yoghurt and cheese especially distinguished themselves (5).

🖍Specially for those who have now exclaimed that 8 servings of cheese a day will stop passing through the door – a study (5) showed that in the long term (12 years) those who consumed fatty dairy products were less likely to develop obesity than those who refused them (6).

❗️Pay attention not only to WHAT you eat, but also to HOW you eat. The same food, eaten in different ways, produces a different insulin response – my favorite study from the Singapore Center for Clinical Science established. In it, white rice eaten by the same person elicited a glycemic response of 68 GI when eaten with chopsticks and 81 GI when eaten with a spoon (7).

🖍From here follows the last important point – diabetics, master mindful eating! “I woke up, washing down a chocolate bar with borscht” – this is not only an attack of overeating associated with restrictions, it is also a response surge in the production of insulin in the body, which is not needed either by diabetics or those who are healthy.The same borscht, eaten at a set table, without being distracted by the TV and phone, calmly and thoughtfully realizing the taste of food, and then tea and chocolate for dessert – will cause a completely different, much less threatening glycemic response.

In other words, intuitive and conscious nutrition, attention to what the needs and reactions of my body are to different foods, the lack of food rules “this is possible, this is not” and the division of food into “dangerous” and “safe” is a much more effective strategy preventing and coping with type 2 diabetes rather than mindlessly following significantly outdated and unsafe guidelines.And the point is not at all about “bad doctors” – even a very good doctor has the right to miss some new data. The fact. that you and only you are the manager of your health. You make decisions. Be an informed manager and be healthy.

(1) https://cardiab.biomedcentral.com/articles/10.1186/s12933-019-0838-9?fbclid=IwAR07_Uu4fAHRfH9ECUTdTd4ogFgT23THXx4FdiXuxqJgS39Mf4IKd049NjE (2,0003) = 10.1371% 2Fjournal.pone.0146889 & fbclid = IwAR2nXRwM74o8njb8-EsxQqxYEtlKM_7sThpwmf1rPCmaZ1nU47SnvI07IrI

(3) https: // www.ncbi.nlm.nih.gov/pubmed/265

(4) https://academic.oup.com/ajcn/article/101/5/1065/4577562

(5) https: //www.dairynutrition. ca / scientific-evidence / roles-on-certain-health-conditions / milk-products-and-type-2-diabetes? fbclid = IwAR0kIwH6_a9NVyrUBeSwjAutFQvEMhxi2R-FdbEolSvCSZ-RCyhg4GRT99M

(6) https://www.youtube.com/watch? nih.gov/pubmed/%2023320900

(7) https://www.sciencedirect.com/science/article/abs/pii/S0031938414006179? Weight Loss School

With diabetes, weight loss is perhaps the most urgent problem.After all, overweight and diabetes are directly related. People with this disease should follow certain rules , without which it will be very difficult to lose weight. Let’s talk about this in more detail.

This is the author’s channel of nutritionist-nutritionist Inna Zorina. Only information verified by practice is published here. Subscribe to the channel ( click here ) to receive reliable information about health and weight loss!

Often my clients ask me a question – is it possible to lose weight at all with a disease such as diabetes? The answer is that it is not only possible, but also necessary! Indeed, in adipose tissue, the hormone resistin is produced , which causes insulin resistance , which means an increase in blood sugar.

In short – the lower the weight, the lower the sugar!

Therefore, it is very important to strive for weight loss. In order to lose weight with diabetes mellitus, the following rules must be observed:

The first rule. With diabetes completely , semi-starvation diets are unacceptable, which can lead to a decrease in blood sugar levels to a critical minimum. Low blood sugar levels can trigger various health problems, including coma.

Second rule. It is very important to observe fractional meals , in which a person eats in small portions at least 4-5 times a day. Such nutrition, firstly, significantly reduces the load on the pancreas. And secondly, small amounts of food are absorbed much faster and better. This means that food goes to nourish the cells, and is not deposited in fat (which happens with rare but plentiful meals).

Third rule .Eliminate (or limit as much as possible) the use of simple (fast) carbohydrates, replacing them with complex ones . When losing weight, it is very important for diabetics to control the amount of carbohydrates in the diet. An excess of carbohydrates leads to the accumulation of fat mass, since the body cannot cope with their processing. The paradox is that the same thing happens with a deficiency of carbohydrates – the body is forced to stock up on calories for future use, putting them in reserve. Therefore, nutrition should be balanced – the body should receive all the necessary nutrients in the right amount.

Fourth rule. Eat foods with a low glycemic index . This will provide a smooth, not abrupt, increase in blood sugar levels. Insulin will be produced without sudden surges, this reduces the load on the pancreas.

Fifth rule. Exclude the intake of carbohydrate food in the evening . Any organ in our body has its own periods of activity and periods of decline. In the evening, the pancreas decreases its activity, which is why carbohydrates are very poorly absorbed in the evening, glucose is deposited in fat.

Sixth rule. It is compulsory to observe the water and drinking regime . In diabetes, the cells of the body are dehydrated, which leads to a slowdown in intracellular metabolism and poor lymph flow (the cell is not cleansed, accumulates toxins). This makes it much more difficult to break down and burn fat. In addition, dehydration in diabetes can cause a sharp drop in blood sugar levels, which in itself is dangerous to health.

Seventh rule. Easy exercise, enough physical activity will ensure you maintain your metabolism at the proper level.Your “motor” must work: I mean not only the heart – all the metabolic processes of the body. The correct assimilation and digestion of food, nutrition of cells, the work of all organs and systems depends on this.

If you follow these rules, the body will respond rather quickly, weight will go away and sugar will return to normal .

See what changes happened in one of my clients with diabetes in just 2 weeks. Sugar dropped from 11-20 to 6-8!

Was this article helpful? Then I ask you to support my channel like and share this article with your friends on social networks .Side buttons. Thank you!

Subscribe to my channel ! There is still a lot of interesting things ahead!

With you was Inna Zorina, nutritionist-nutritionist, weight correction trainer, healthy nutrition specialist. Add to friends on my VK page!

“I just saw a white light and walked away from the refrigerator”: a scientific way to lose weight was found

  • Nikolay Voronin
  • Science Correspondent

Photo author, Getty Images

Clinical trials of the drug Semaglutide, developed for the treatment of diabetes mellitus, have confirmed the effectiveness of this drug in the fight against obesity.

According to scientists, the results of a study published this week in the New England Journal of Medicine look so compelling that Semaglutide could revolutionize the fight against obesity.

A year after the start of the weekly intake of the drug, the participants in the experiment got rid of an average of 15 extra pounds, while two-thirds of them lost at least 10% in weight.

Patients in the control group who received placebo lost only three weight.

“[Scientists] have been trying for a long time to find a drug that would help to lose weight,” recalls Professor Emeritus at Oxford University Keith Frain. “Many drugs have been tried, but most of them were either not effective enough or gave side effects, so they had to refuse”.

“In the same study, clinically significant weight loss was achieved with a drug from a group of drugs that have long been shown to be safe for type 2 diabetes,” he says.“It remains to be sure that the result will be long-term and the weight lost will not return.” behaviors that threaten the development of diabetes

Best performance

Clinical trials, which lasted more than a year, were attended by almost 2000 people from 16 countries.There were no diabetics among them, but all participants were overweight.

Body mass index, which normally should not exceed 25 (it is calculated individually, based on the height and weight of the patient), was at least 30 in them – which corresponds to the clinical definition of obesity.

Photo by Getty Images

To begin with, all patients received a training course aimed at leading a healthy lifestyle and quitting bad habits. The participants were then randomly divided into two groups: two-thirds received a weekly dose of Semaglutide (2.4 mg by subcutaneous injection), the rest received a placebo injection.

The results of the experiment were summed up after 68 weeks. Throughout this time, patients kept a diary, recording data on food eaten and exercise.

The difference in results was unexpected even for the organizers themselves: the participants who received the placebo lost, on average, 2.4% (compared to the initial body weight), while the patients who took Semaglutide lost almost 15% in weight.

Baptiste Leurent, professor of medical statistics at the London School of Hygiene and Tropical Medicine, who was not involved in the study, confirms that it was carried out in full compliance with all requirements, so, in his opinion, there is no reason to doubt the results obtained.

“Given the nature of the experiment, it can be argued that the difference [between the groups] was achieved precisely due to the treatment with Semaglutide,” he says. In this case, 90% of the subjects reached the end – and this is perhaps the best of their possible results. ”

While acknowledging that some of the participants have side effects (such as diarrhea or nausea), Professor Leuran nevertheless says that Semaglutide could revolutionize the fight against obesity.

“People sit at home, seize stress”

Diabetes mellitus type 2 is often accompanied by excess weight gain. However, the opposite often happens: diabetes develops against the background of obesity, since the body begins to react worse to insulin, which lowers blood sugar levels.

According to Anna Nevolnikova, candidate of medical sciences, endocrinologist, in both cases, eating disorders are the most common cause of the problem. To put it simply, a person has “downed saturation mechanisms”.

“People do not start eating from scratch,” she explains.

Photo by PA Media

The main role in the development of diabetes, continues Nevolnikova, is the damage to the so-called beta cells. They are located in the pancreas and produce the same insulin that helps our body to uncouple glucose and convert it into energy.

However, if the normal functioning of these cells is impaired, it is the excess weight that “increases the load on an already lame horse.”

And here, according to Anna Nevolnikova, Semaglutide comes to the rescue. It belongs to a group of drugs (the so-called GLP-1 agonists) that reduce appetite, and “who can cope with appetite and excess weight, he can cope with diabetes.”

“Otherwise, we run after the departing train all the time,” the doctor explains.- The patient eats anyway, we tell him to inject more insulin to lower the sugar. He injects – but as a side effect he only wants to eat more. “

In Russia, according to Nevolnikova, several drugs from the group of GLP-1 agonists are available, but only one of them has obesity in the indications.

Now that, due to the coronavirus pandemic, most diabetics, who normally control their blood sugar in normal conditions, go outside less and exercise has significantly decreased, these drugs are especially important for them.