Psychological And Behavioral Therapy
Patients with overweight or obesity are vulnerable to stigma and discrimination in the workplace, at school, in healthcare settings and in society in general leading to negative psychological consequences. Health care providers should avoid stigmatization and weight bias and employ a motivational interview with the patient.82
Derived from the above knowledge, psychological assessment and behavioral therapy should be incorporated into the routine clinical management of obesity in T1D and involve clear and reasonable goal setting, self-monitoring of food intake and exercise, an approach to problem solving, development of skills for managing difficulties, stimulus control, stress reduction, education and social support. These behavioral interventions have proven to be beneficial in the context of a structured weight intervention program.53
Adjust Your Insulin Doses Sooner Than Later
Even though you wont see the scale budge significantly for 3 or 4 weeks, you will see your insulin needs decrease quickly the moment you start trying to lose weight.
Cutting or reducing junk food, alcohol, and processed carbs can lower your insulin needs after merely a couple of days .
Getting daily exercise when you were not exercising before can lower your insulin needs almost immediately!
And then, when you drop those first couples pounds , youll see another reason to reduce your background insulin doses.
How will you know? Low blood sugars.
If you dont react quickly to your bodys demand for less insulin, youll exhaust yourself trying to prevent and treat the lows.
Then youll be frustrated with how often you have to eat unplanned snacks to treat the lows.
And youll want to give up.
But, dont give up!
Be proactive and make slight reductions in your background insulin dose during that first month. And by slight, I mean never reducing your doses by more than 1 to 2 units per day and remember to give a few days to see the full effects of that reduction.
Your Feelings About Food
The emotional part of trying to lose weight is important and can often be overlooked.
Do you feel guilty when you eat a treat? Do you eat more when youre upset? Do you feel dejected if you cant see progress straight away?These are really common feelings and tackling them can help you on the road to a healthier lifestyle and a healthy weight.
Connect with others and share tips in our online forum weve made a board especially for people who are looking to lose weight.
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How To Lose Weight With Diabetes Type 1
On the other hand, if you are looking for the way to lose weight with diabetes type 1. It is going to provide you a lot of benefits, in this manner. For example, it permits you to analysis exactly so how much insulin you are taking in all the day long. Through range, people outwardly type 1 diabetes to dont have exact knowledge of understanding that exactly how abundant insulin others have in their body. A great habit of thumb is that the further parts of insulin you use by day, the extra suitable you are to place on power.
Limited Insulin Consumption to Lose Weight with Diabetes Type 1
Say Jill and Michelle are harshly similar to lengths and both have type 1 diabetes. Jill concerns 50 units every day on the other hand, Michelle is getting 100 units on a daily basis. Generally talking, it is further likely that Jill will be obtaining it accessible to lose weight with diabetes type 1 in excess of Michelle.
Accordingly, if you seem to lose weight with diabetes type 1, one method to accomplish this is to adjust your diet or snacking ways, so that you take less insulin while maintaining excellent blood control.
We need to make an excellent fortification note that decreasing your insulin while authorizing glucose levels to go raised for long terms of time is not a great idea about all. Achieving this will lead to a much higher hazard of severe health difficulties for instance, neuropathy, retinopathy, as well as kidney disease.
Lower your Carbohydrate Consumption
Will Weight Loss Help With Your Diabetes
Insulin production can only be improved in those with type 2 diabetes. However, weight loss for diabetics, whether diagnosed as type 1 or type 2, will reduce the risk of diabetes-related complications. Furthermore, diabetes weight loss diets can reduce the dose or number of anti-diabetes medications, including metformin, that you need to take.
Many people with type 2 diabetes ask if diabetes can be cured with weight loss. Encouragingly, just a small amount of weight loss can significantly impact your health, while severe calorie restriction can even reverse the progression of the disease.
In trials, moderate weight loss demonstrated the improved function of the cells within the pancreas and increased the bodys responsiveness to insulin. In turn, these biological adjustments help to lower blood sugar levels.
A recent study found that weight loss via lifestyle changes, including a calorie-controlled diet or weight loss medications, improved glycemic control . In diabetic patients, losing weight also positively impacted other associated health problems, including high blood pressure and high cholesterol levels. Patients with diabetes-related kidney disease also demonstrated improvements in kidney function.
Type 1 diabetes is not caused by being overweight or obese, and losing weight will not reverse the diagnosis. However, as your weight decreases, you may require a lower insulin dosage each day. Losing weight can also improve your mood, sleep, and energy levels.
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Creating A Type 1 Diabetes Meal Plan
People can use different methods to plan their type 1 diabetes diet. They can also seek help from a dietitian. Some common ways to prepare meals are:
Carbohydrate counting: This method involves keeping track of how many grams of carbohydrate someone eats and drinks each day.
Glycemic index:Glycemic index and glycemic load measure the amount of sugar in foods and how much they will raise blood sugar.
Plate method: People can use this technique to control portion sizes and food groups. It ensures that half of the plate consists of nonstarchy vegetables while a quarter contains a healthful protein, and a grain or starch fills the last quarter.
Snacks should aim to balance carbohydrates with protein or fats. So-called diabetic sweets are also available, but people should keep these to a minimum. Healthful snack ideas include:
- hummus and oatcakes
- chocolate protein balls made with oats, nut butter, cocoa powder, and a diabetes-friendly sweetener, such as stevia
- celery sticks and nut butter
- a boiled egg
People who are tracking their carbohydrate intake should take care to count fruit if they eat it as a snack. A small piece of whole fruit contains about 15 g of carbohydrate. Berries are a lower GI fruit, and melons, pineapples, and some dried fruits have a medium GI.
Eating a lower sugar fruit together with a protein source may help balance blood glucose more than eating the fruit on its own. For example, someone could have berries with natural yogurt.
Use Tricks To Prevent Overeating
These sneaky strategies can help keep you from overdoing it on diet-damaging foods.
- Fill up on low-calorie foods first. Start every meal with the foods on your plate that are lowest in calories, suggests McLaughlin. Non-starchy vegetables make the perfect low-calorie starter. By the time you get to the other foods, you wont be so hungry.
- Change your salad dressing system. Instead of sprinkling or pouring dressing on your salad, dip your fork into a side dish of dressing and then your salad with each bite. Youll be amazed how much less you use and how many calories you save.
- Take up a busy-hands hobby. If youre idle, youll be more prone to eating when youre not really hungry. Keep busy with activities like walking, knitting, scrapbooking, doing crossword puzzles, or gardening.
- Carry a toothbrush and toothpaste. Keep them in your purse or briefcase. When cravings hit, brushing your teeth with peppermint-flavored toothpaste can dampen your desire to eat.
- Arrive fashionably late to parties. Without as much time near the buffet table and calorie-rich appetizers, youll likely eat less.
Its important to continue to eat healthy and exercise regularly even after reaching your weight loss goal. Thats why its so important to set realistic goals from the get-go: The healthy habits you initiate to lose weight should last a lifetime so you can keep it off.
Additional reporting by Colleen de Bellefonds
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Losing Weight With Diabetes: What Prevents It And Causes Weight Gain
I recently was included in a discussion on a Facebook group for athletes with diabetes about how hard it can be to lose weight through exercise. While I would never claim to have all the answers on this topic, here are some ideas about what can make you gain weight or keep you from losing weight with diabetes, based on my decades of professional and personal experience with diabetes and weight management, and what you can do about it.
My former graduate student with type 1 diabetes went on an insulin pump and promptly gained about 10 pounds, even though his blood glucose control improved only marginally. Why did this happen to him ?
The best way to balance your insulin use and your body weight, in my opinion, is to be physically active to keep your overall insulin levels lower. Its easier to lose weight, too, when youre taking less insulinor releasing less of your own if your pancreas still does that.
Having said that, I have to say that what you choose to eat has a huge impact on your insulin needs as well as your body weight. My graduate student found that by doing frequent dosing with his insulin pump, he was eating more overall, just because he could without having to take another injection with a needle. Just because insulin use can make it easier for you to eat cake and other formerly forbidden foods doesnt mean that you need to eat them!
Lack of Physical Movement
Keep Track Of Your Goals And Progress
Writing down the details of your weight loss journey helps you set healthy targets and notice patterns. Youll be able to appreciate your progress over time, as well as notice when your diet might have gotten a bit off track.
Try jotting down all of the foods you eat, including the serving sizes, in a journal every day. Not a fan of pen and paper? Try one of the many free apps. Its a good idea to weigh yourself at least once a week, per your doctors or diabetes educators recommendation, to keep track of your progress. You might also want to write down when you exercised, what you did, and how you felt after.
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How Much Should You Exercise And What Type Of Exercise
If you are just starting out, you dont want to go from 0 to 100 real quick, because you may burn out or get discouraged. I recommend a combination of resistance training and cardiovascular training for optimal results.
People overlook resistance training in the context of weight loss. This is what is going to help you KEEP your hard-earned muscle mass during the calorie reduction.
That muscle mass will keep your metabolism firing. Your metabolism firing means youll burn more calories ALL the time, working out or not!
Recommendation: Make resistance training a STAPLE in your exercise program. For help in designing your first routine, check out my post about how to design a resistance training program.
Combine this with some form of cardiovascular training multiple times a week for 20 minutes get creative here and find something you enjoy and youve got a recipe for success on the exercise front.
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Weight Loss Newsletter Series
Want easy tips, tricks, and evidence-based information to maintain or begin your weight loss? Get the new 12-week Weight Loss newsletter series by Diabetes Daily.
Beginning July 22nd, 2021, every Thursday for 12 weeks.
Treating Low Blood Glucose With Precision
When treating low blood glucose, it is imperative to do all you can to treat it precisely, so as not to overtreat and later require additional insulin. Many people find that the somewhat outdated rule of 15 is too rigid and can frequently lead to overtreating your low.
It is best to consider all the relevant variables, such as insulin-on-board, glucose trends, whether exercise is a factor, etc., to treat more precisely and get back to the normal blood glucose range. This may not always be easy, but with more and more experience and confidence, you can optimize your hypo snacking habits.
It is best to treat low blood glucose with a pure form of fast-acting carbohydrate, such as glucose tablets. Treating with something that also has protein and fat may delay absorption, and lead to more persistent hypoglycemia and subsequent overtreating.
Finally, if you find yourself experiencing low blood glucose on a frequent basis, it is very likely that your insulin doses need to be decreased.
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Treatment Of Obesity In T1d: Challenges And Opportunities
The pillars of obesity treatment include a healthy eating plan, scheduled physical activity, and behavioral interventions that should be adapted in case of T1D. Structured lifestyle intervention programs have shown to be more effective in weight loss than a standard course of action in patients with obesity.49 Although evidence is scarcer, these structured programs have proven equally beneficial when T1D coexists.53 These programs should be executed by a multidisciplinary team that includes endocrinologists, dietitians/nutritionists, nurses, educators, physical activity professionals as well as clinical psychologists.54 The participation of a diabetes educator and a close follow-up by an expert team in diabetes is mandatory to adjust carbohydrate intake and to carefully titrate insulin dose to prevent hypoglycemia. Indeed, one of the main barriers to diet interventions in T1D is the occurrence of hypoglycemia and its compensatory overeating.55
The incorporation of the new technology of continuous subcutaneous insulin infusion in T1D treatment has shown no clinical benefit over multiple daily injections, in terms of weight outcomes in newly diagnosed children and in young patients with T1D, either during the first year of insulinization59 or over a 10-year follow-up.60
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Risk Factors For Type 1 Diabetes:
Any combination of the following factors may put people at a higher risk for type 1 diabetes:
- Self-allergy : The immune system usually protects us from disease, but in the case of type 1 diabetes, the immune system turns against the cells in the pancreas that produce insulin . If you have any type of autoimmune disease, your risk of developing diabetes increases. Doctors can test for diabetes antibodies, specifically one called GAD65. Measuring this antibody early in the disease can help your medical team determine if you have type 1 or type 2 diabetes.
- Genes: People with type 1 diabetes are more likely to have inherited genes putting them at risk. Over 50% of those diagnosed with type 1 diabetes also have a close relative with the disease.
Obesity Type 1 Diabetes Mellitus And Diabetes Complications
Figure 1 In patients with type 1 diabetes adipose tissue deposits produce adipokines and inflammatory cytokines that induce insulin-resistance contributing to the development of cardiometabolic complications. The coexistence of these clinical characteristics of type 2 diabetes in patients with type 1 diabetes has been referred to as double diabetes.
Data from 20,985 adults with T1D included in the Swedish National Diabetes Registry showed that obesity was significantly associated with an increased risk for a heart failure hospitalization, with an adjusted Hazard Ratio of 1.55 and 2.90 for BMI 3034.9 kg/m2 and and BMI 35 kg/m2, respectively.10 In a prospective study of 501 Australian adults with T1D, obesity defined as a BMI > 30 kg/m2 was the main risk factor for cardiovascular disease and retinopathy, although with a similar HbA1c and disease duration compared to non-obese patients.42 In the same study, obesity was also associated with albuminuria in women. Similarly, in a cross-sectional study with 176 adults with T1D, BMI appeared to be significantly correlated with retinopathy only in those without previous nephropathy.43
Patients with T1D and obesity therefore receive more drugs than their normal-weight counterparts in order to treat the associated cardiometabolic risk factors. This can lead to polypharmacy which is a problematic issue as it exposes patients to adverse drug reactions, drug-drug or drugdisease interactions and is associated with morbidity.44
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