Diabetes and weight loss are the yin and yang of the ideal health state. There is no doubt that if you are overweight and have type 2 diabetes, losing weight can lower your blood sugar, improve your health, and get you in better shape.
But it’s important to work closely with your doctor or your diabetic before starting a weight loss program. This is because controlling your diet requires special attention to changes in blood sugar, insulin, and medication intake.
Loss of weight is good for people with diabetes
Cathy Nonas, a dietitian and spokesperson for the American Dietetic Association and professor at Mount Sinai School of Medicine in New York, said, “No matter how heavy someone is, if they lose some weight, their blood sugar will drop significantly.”
A 2001 study by the National Institutes of Health found that a proper diet with exercise reduced the risk of diabetes by 58% in people who were overweight and had elevated blood sugar levels but did not meet the criteria for a diagnosis of diabetes.
Casey noted, “If people with diabetes lose 5 to 10 percent of their body weight, their blood sugar is significantly lower, and we know that’s possible.”
“We often run into similar situations: patients can lose weight to get off insulin and medications.” She said, “This shows that there is an association between obesity and diabetes.”
The American Diabetes Association (ADA) says weight loss may have the following benefits:
- lowering blood sugar;
- lowering blood pressure;
- Improve cholesterol levels;
- Reducing stress in the hips, knees, ankles and feet.
In addition, it may be possible to feel more energetic, move more freely, and breathe more freely.
Lose weight with professional guidance
A reduction in just one meal can affect the delicate balance between blood sugar, insulin, and medications in the body. Therefore, it is important to control your diet under professional guidance.
Larry C Deeb, a diabetes doctor in Tallahassee, Florida, and former president of the American Diabetes Association (ADA), recommends consulting with your doctor before implementing a weight loss program, and then consulting with a diabetes professional or dietitian to see if it’s feasible.
Larry added, “Don’t lose weight on your own, especially if you’re still on insulin and medications, it’s safe to lose weight under the guidance of your doctor and a professional dietitian.”
Losing weight also requires a balanced diet
Christine Gerbstadt, a spokeswoman for the American Dietetic Association, warned, “Patients don’t want to risk elevated or lowered blood sugar when they lose weight. When you lose weight, you will want to keep your blood sugar under tight control.”
Christine recommends reducing your intake by 500 calories a day, an amount she says is “safe for people with diabetes. The best way to do this is to reduce caloric intake across the board, including in protein, carbohydrates and fats.” She recommends that people with diabetes maintain a healthy ratio of carbohydrate, fat and protein intake. The ideal ratio is:
- Carbohydrates 50% to 55%;
- Fats 30%;
- Protein 10% to 15%.
Large reductions in carbohydrate intake are not safe
Christine said that for people with diabetes, the process of adjusting carbohydrate intake should be reasonable and gradual. Dietary adjustments must be made very carefully as people with diabetes lose weight.
Carbohydrates have the greatest impact on blood sugar because they are converted to sugar earlier in the digestive process. Kristin explained that consuming complex carbohydrates, such as whole-grain bread and vegetables, is beneficial because the blood absorbs them slowly, reducing the risk of blood sugar spikes.
She said, “Sliced white bread is the next best thing. Whole wheat bread is better. A little peanut butter would be better.”
Christine talked about how the common approach to diet control, which is simply to cut back heavily on carbohydrates, is not safe for people with diabetes. When the body lacks the carbohydrates needed to provide energy as fuel, the metabolism turns into a state known as ketosis, which turns to burning fat. Patients will feel less hungry and eat less than usual, but being in ketosis for a long time can cause health problems.
Christine said, “The ketosis state reduces oxygen delivery to the tissues, which puts stress on the eyes, kidneys, heart and liver. That’s why low-carb, high-protein Al’s recipes aren’t very safe for people with diabetes. People with diabetes need to maintain a more balanced diet so that the body can absorb nutrients while also avoiding going into ketosis.”
Appropriate exercise is good for blood sugar control
One of the benefits of exercise is that it helps keep blood sugar balanced so that there is no need to restrict caloric intake too much.
Christine explained, “You can eat more food by walking 20 minutes more each day. You don’t have to reduce your intake by 500 calories; a 200- or 300-calorie reduction is enough to lose weight and still have a good effect. It’s also important to control your blood sugar and lose weight slowly and safely for steady weight loss.”
Keep in mind that each type of exercise has a different effect on blood sugar.
Aerobic exercise, such as running or working out on a treadmill, can lower blood sugar quickly.
Lifting weights or prolonged, high-intensity exercise may affect blood glucose levels after a few hours, and that can be problematic, especially when driving. This is one of the reasons why you need to check your blood sugar before driving. It’s good to keep snacks like fruit, crackers, juice and soda in the car, which is a beneficial diet for people with diabetes.
Luigi Meneghini, director of the Cosno Diabetes Treatment Center at the University of Miami School of Medicine, explained, “Physical activity burns blood sugar and the sugar stored in the muscles and liver.”
“Patients who need to use insulin or stimulate insulin production with medication when increasing exercise should monitor blood glucose levels closely. Over time, performing regular exercise can reduce the dose of medication and insulin.”
Glucose can also create barriers to diet and weight loss
Luigi noted, “Weight loss can be challenging for everyone. For patients who need to use insulin, weight loss is even more difficult. That’s because they have to eat when their blood sugar is low. People with diabetes have to reduce their caloric intake, prevent using too much medication, and prevent hypoglycemia through diet, and losing weight is very difficult in such a situation.”
It is true that elevated and lowered blood sugar are the two main problems that diabetics face with diet and weight loss.
Low blood sugar (hypoglycemia) occurs when insulin levels are higher than what the body needs. Initially hallucinations, dizziness and tremors can occur and then become very dangerous and can lead to fainting or even coma.
Low blood sugar is common when losing weight because lowering caloric intake and weight loss itself can affect blood sugar levels. There is a risk of hypoglycemia if the insulin dose or medication is not lowered to keep up with the new blood glucose levels.
High blood glucose (hyperglycemia) occurs when insulin levels are too low to control blood glucose. Hyperglycemia can occur in patients who are injecting insulin or taking glucose-lowering medications, using the wrong dose or taking the medication after a meal.
Developing a weight loss approach that works for the patient
Larry, president of the American Diabetes Association, suggests that weight loss is not easy and that a diabetes scholar or dietitian can help in this regard. He noted that a diabetes scholar or dietitian can develop a plan that works for the patient and his or her lifestyle.
Larry said, “Patients need a regular daily meal plan and need to understand how to change their insulin and medication use based on diet and increased exercise, which is the safest way to lose weight.”
There are also support groups and classes that help people with diabetes treat and lose weight, often by partnering with hospitals.