Reason #: Typically Recommended Eating Patterns Often Backfire By Keeping You Hungry And Keeping Your Blood Sugar High
If youâre like most people with type 2 diabetes, youâve been told to eat carbohydrates but eat fewer overall calories, and to eat small meals throughout the day to keep your blood sugar steady youâve probably been advised to count your carbs and eat enough of them to keep your blood sugar up after taking medication to lower itâconfusing, right?
What many find as a result is that theyâre always hungry, always thinking about food and facing cravings. Whatâs at work is a survival instinct that even the strongest-willed person canât withstand for long. This is a situation where your physiology is fighting against you. Even worse, those frequent small meals with carbohydrates create spikes in your blood sugar followed by drops in your blood sugarâa blood sugar roller-coaster that stimulates frequent hunger.
Losing Weight With Diabetes: Fat Chance
And it is true that the cellular energy factories, mitochondria, in people with diabetes are more sluggish and that hunger hormone levels in these folks can be unbalanced, but people with blood-sugar and insulin challenges can most definitely lose weight.
In fact, for every bit of weight lost, people with diabetes find that losing weight after each pound lost is easier and makes their metabolic health better.
A healthier diet and sensible physical activity have been proven to be the pathway to success for people focused on glucose health and weight loss, and this is especially true for those who choose a special low-glycemic high-protein nutritional supplement, but more on this below
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:
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.
Diabetes Spectrum.
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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.
Weight Loss In People With Diabetes
What about people with diabetes? pools the data from the studies in the systematic review in which the subjects had diabetes, reports weight losses at 6 and 12 months and 12-month changes in hemoglobin A1c levels, and compares the weight change of subjects with diabetes to that of subjects without diabetes. 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. 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. 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.
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I Love Insulinand You Should Too
When people first are diagnosed with type 1 diabetes, they typically start taking insulin. When they start insulin, they typically gain weight. Therefore, insulin is often associated with weight gain.
Insulin is necessary for people with type 1 diabetes to live. You already know this.
What you probably dont realize, however, is that insulin is not what is causing weight gain. What causes weight gain is a hamster wheel of blood sugar control issues:
Low blood sugar correct with carbs overcorrecting leading to a high blood sugar and a correction bolus too much insulin low blood sugar
The cycle is like a roller coaster that you just cant get off, seemingly forever. Youre eating more calories than expected for your goals, and suddenly, BAM! There are a few pounds you did not plan to gain, or your weight loss goals derailed.
Yes, insulin is a part of the equation, but not THE WHOLE equation.
I get it: low blood sugars can be tough, and some of them you make you want to eat the whole fridge. But, for lows and weight loss, consider the following idea:
All in all, dont worry about how much insulin youre using worry about keeping your blood sugars in great control and preventing lows, and the insulin amount will take care of itself.
To learn more about the best ways to treat lows, read How to Treat a Low Blood Sugar .
How To Lose Weight With Diabetes Type 2
You may have tried a multitude of eating plans only to yo-yo back to your original weight, and maybe then some!
Counting calories makes us obsessed about what we supposedly cant, or shouldnt, eat, so how long can any diet last when youre always hungry?
But, as mentioned above, we know that we can support blood sugar levels by making preventive lifestyle tweaks, mainly by losing weight and increasing physical activity.
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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.
Insulin Resistance Is At The Core Of Type 2 Diabetes
With type 2 diabetes, the pancreas does create insulin, but either not enough or more than enough but, due to insulin resistance, glucose cant enter through the doors of the bodys cells they are literally locked out, unable to enter cells to be used for energy.
In fact, you may even over-produce insulin to meet the energy demands of the body. However, with type 2 diabetes, sugar cannot enter through the doors of the bodys cells they are literally locked out.
With nowhere to go, the glucose stays in your bloodstream, circulating much longer throughout the vascular system, and this is a problem.
Excess blood sugar makes our blood vessels less stretchy and causes them to narrow, blocking blood flow.
Damage to large blood vessels is called macrovascular disease, while damage to small blood vessels is called microvascular disease.
Complications from macrovascular disease include heart attack stroke and peripheral arterial disease .
Microvascular disease can lead to problems with our eyes, nervous system and kidneys.
Even if you dont feel symptoms of diabetes , damage can build up over time, little by little.
The best first option for treatment is diet.
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How To Lose Weight With Type 1 Diabetes
Losing weight can be difficult for anyone, and living with type 1 diabetes definitely doesnt make it easier. However, there ARE people who set out to lose weight and end up so extraordinarily successful that you wonder if they have some inside information you dont.
That information EXISTS. Im here to give you the rundown on how to lose weight with type 1 diabetes .
Without further adolets GET TO IT!
Treatment Of Overweight And Obesity
The goals of therapy for people with diabetes and overweight or obesity are to achieve optimal glycemic and metabolic control and, ultimately, improve quality of life, morbidity and mortality. Attaining and maintaining a healthy body weight, and preventing weight regain, are key components of optimizing glycemic control in people with diabetes. Often people with obesity and diabetes have greater difficulty with achieving weight loss compared to people with obesity but without diabetes . Health-care providers should attempt to minimize use of weight-inducing agents without compromising glycemic control, or switch the person with diabetes to agents not associated with weight gain .
The National Institutes of Health -sponsored multicentre Look AHEAD trial, investigated the effects of lifestyle intervention on changes in weight, fitness and cardiovascular risk factors and events in people with type 2 diabetes . The 8-year data revealed a 4.7% decrease in weight in the intensive lifestyle arm . This provided evidence that lifestyle changes can have a positive impact on weight change, fitness level and a decrease in medications, along with a small decrease in glycated hemoglobin and other health benefits .
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Reason #: With Type 2 Diabetes Insulin Is High And Insulin Is A Fat
Everyone has glucose, a type of sugar, in their blood at all times. Glucose is a source of energy that largely comes from eating carbohydrates. Simply put, when you eat carbohydrates, your blood sugar rises.
Insulin is produced by your pancreas, and insulin has many functions in the body. One of insulinâs functions is to help get glucose out of the blood and into cells where it can be used. In order to do this, insulin rises along with glucose. So when you eat carbohydrates and glucose rises, the insulin is rising as well. Once in the cells, glucose is mostly used for energy. If you have type 2 diabetes, this process doesnât work well anymore: your body has become resistant to the signal of insulin, so the insulin isnât as effective at moving the glucose out of your blood. Thatâs how you end up with high blood sugar levels after eating carbohydrates. Having chronically elevated blood sugar levels is dangerous, so your body needs to do something about it.
Your body responds by making more and more insulin to try to get the job done. Recall now that insulin has many functions, not just to facilitate the removal of glucose from the blood. Insulin also works to promote the storage of fat and to block the release of fat from fat storage. So instead of losing weight, you just keep gaining, thanks to all that insulin.
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 prediabetesthat is, you have consistently high blood sugar but do not yet have diabeteslosing 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.
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Benefits Of Losing Extra Weight
There are so many benefits to losing extra weight both physically and emotionally.
Extra weight around your waist means fat can build up around your organs, like your liver and pancreas. This can cause something called insulin resistance. So losing this weight could help the insulin you produce or the insulin you inject work properly.
And as you start to lose weight and get more active, you and your healthcare team may need to look at your medication, especially if you treat your diabetes with insulin or sulphonylurea. This might mean reducing the dose or making other adjustments, but talk to your healthcare team about it. For some people, needing fewer diabetes medications is a great motivation for losing weight.
Although getting type 1 diabetes has nothing to do with weight, losing any extra weight will help you reduce your risk of complications and could mean injecting less insulin.
And if you have type 2 diabetes, losing around 5% of your body weight can have real benefits for your health. If you have obesity, you are more likely to put your diabetes into remission if you lose a larger amount of weight,15kg , as quickly and safely as possible following your diagnosis. This could mean coming off your diabetes medication completely a life-changing possibility. This is even more likely if you lose the weight nearer to your diagnosis and quickly. It’s a myth that losing weight slowly is better for you.
Douglas Twenefour, our Deputy Head of Care and dietitian
Why High Fat Diets Alone Wont Work
The high fat/low carbohydrate diet has its positives and negatives, yet as a stand-alone nutrient source it doesnt hold up. Here are two big time pros to this diet strategy:
So then why not go all in with fat? Here are two even bigger cons to the singular approach of fat consumption only:
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The Dilemma Of Weight Loss In Diabetes
Marion J. Franz The Dilemma of Weight Loss in Diabetes. Diabetes Spectr 1 July 2007 20 : 133136.
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. 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.
What Should You Eat
If you have diabetes, you should focus on eating lean protein, high-fiber, less processed carbs, fruits, and vegetables, low-fat dairy, and healthy vegetable-based fats such as avocado, nuts, canola oil, or olive oil. You should also manage your carbohydrate intake. Have your doctor or dietitian provide you with a target carb number for meals and snacks. Generally, women should aim for about 45 grams of carb per meal while men should aim for 60. Ideally, these would come from complex carbs, fruits, and vegetables.
The American Diabetes Association offers a comprehensive list of the best foods for those with diabetes. Their recommendations include:
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