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Weight Management with Diabetes – A Guide to Weight Loss and Medications

Source: https://renewbariatrics.com/weight-management-with-diabetes/

Weight Management Diabetes

The number of people with diabetes has been rapidly growing. WHO reports that the number rose from 108 million in 1980 to 422 million in 2014.

Diabetes has been linked to other chronic illnesses and medical conditions such as kidney failure, blindness, heart attack, lower limb amputation, and stroke.

Another highly debated outcome and cause of diabetes is weight gain.

Weight management is a great challenge for diabetes patients. Your weight can affect diabetes, but diabetes also affects your weight. Let’s break down this complex subject and see how diabetes patients can manage their weight better.

Can Diabetes Cause Weight Gain?

The most common types of diabetes are diabetes Type 1 and Type 2. Type 2 diabetes results from ineffective use of insulin by the body.

CDC reports that about 90%-95% of diabetes patients have Type 2 diabetes.

The body’s deficient insulin production characterizes type 1 diabetes. Type 1 diabetes patients take daily insulin administrations to supplement the body’s deficiency.

Type 1 diabetes patients often experience weight gain when they start taking insulin. The weight gain depends on your diet, how much insulin you take, and the type of insulin.

Insulin facilitates weight gain because it’s a growth hormone. In most cases, diabetes patients suddenly lose weight before diagnosis. Sudden weight loss is treated as one of the symptoms of diabetes.

Thus, the weight gain resulting from insulin administration hardly raises any concerns and is considered part of recovery, especially if you’d lost a lot of weight.

Different types of insulin also affect weight gain differently. Analogue insulin has the minimal effect on weight gain. However, human and animal insulin can cause significant weight gain.

It is okay to be worried about putting on weight since it can also affect your diabetes treatment and progression. Make sure you’ve consulted with your healthcare practitioner before settling on an insulin type and dose.

Unexpected Weight Loss with Diabetes

Unmanaged type 1 and type 2 diabetes can cause sudden, unintended weight loss.

With type 1 diabetes, sudden weight loss occurs due to the body burning fat and muscle instead of glucose for energy. This happens because the immune system attacks pancreatic cells responsible for making insulin, resulting in a deficiency.

Insulin is responsible for moving glucose from the bloodstream into the body cells for metabolism. Due to the deficiency, the glucose levels build up in the blood, and the kidneys work to remove the excess sugar through urination.

Since the sugars never reach the body cells, the body turns to fat and muscle for energy resulting in rapid weight loss.

Some type 1 diabetes patients who intend to lose weight may be ill-advised to under-treat their diabetes by skipping insulin administrations. Under-treating diabetes is highly dangerous and can lead to high blood sugar levels. This condition is called diabetic ketoacidosis, and it can lead to death.

Reducing calorie intake is the safest way to lose weight for a diabetes patient. Under-treating diabetes for weight loss can also indicate an eating disorder. If you suspect you have an eating disorder, reach out immediately to your doctor or mental health professional for help.

Diabetes Medications

Diabetes Medications that Help with Weight Loss

Certain diabetes medications facilitate weight loss. These include:

GLP-1 Agonists

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) lower blood sugar levels effectively. Research also shows that they help with weight loss1. Examples of this medication include:

  • Exenatide extended-release (Bydureon)
  • Dulaglutide (Trulicity)
  • Semaglutide (Ozempic)
  • Liraglutide (Victoza)

Metformin

Metformin is one of the most commonly prescribed diabetes medications for controlling blood sugar levels. Research also shows that it helps with long-term weight loss in some patients2.

SGLT2 Inhibitors

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective at controlling blood sugar and are commonly prescribed medication. Research also shows that it’s associated with weight loss3. Examples of this medication include:

  • Dapagliflozin (Farxiga)
  • Canagliflozin (Invokana)
  • Empagliflozin (Jardiance)

Diabetes Losing Weight

What are the Benefits of Losing Extra Weight?

Losing extra weight has physical and emotional benefits.

Physically, as you gain weight, you compound fat around vital organs such as the pancreas and liver. This can result in insulin resistance. Losing the extra weight helps your body produce more insulin and use the administered one more effectively.

As you lose more weight and exercise more regularly, your healthcare provider may have to relook your medication, especially if you use insulin or sulphonylurea to treat your diabetes. They may have to reduce your dose or make other adjustments. Ensure you’ve consulted with them first.

Taking less medication is a great incentive for weight loss in most diabetes patients.

For type 2 diabetes patients, losing about 5% of their body weight can significantly benefit their health. Obese patients are more likely to put their diabetes into remission if they lose a large amount of weight, about 15kgs or two stone 5lbs, quickly and safely after diagnosis.

Putting your diabetes into remission means you can come off the medication completely, which is life-changing. The chances are higher when you lose this weight soon after your diagnosis.

Research shows that losing even 10lbs or 5% of your body weight can improve blood pressure and cholesterol levels4. Apart from significantly impacting your overall health, this can also reduce the risk of diabetes-related complications such as stroke and heart disease5.

Emotionally, losing weight can lead to better moods, more energy, and better sleep.

Healthy Weight You Should Aim For

Knowing the healthy weight you should aim for involves understanding the meaning of numbers such as Body Mass Index (BMI) and waist size.

BMI uses your weight and height to calculate if you’re at a healthy weight. This metric doesn’t measure how much fat you have in the middle.

That’s why waist size is also included as a separate metric.

NHS has a handy online tool for calculating BMI, which also shows your target range.

A healthy waist size depends on gender and ethnicity. Some typical figures include:

  • Less than 31.5 inches (80cm) for all women
  • Less than 37 inches (94cm) for most men
  • Less than 35 inches (90cm) for South Asian men.

A handy YouTube guide from Diabetes UK breaks down this topic further.

How to Lose Weight Healthily with Diabetes

Losing weight healthily for diabetes patients involves combining a balanced diet with physical activity.

Diet Plans to Help Lose Weight

Minor changes to your diet can go a long way in encouraging weight loss. However, you should note that there’s no special diet for diabetes patients. No one size fits all.

Typically, you should aim for a diet rich in lean protein, non-starchy vegetables, and whole grains.

The American Diabetes Association recommends using the Diabetes Plate Method to prepare meals. This method makes it easier to prepare healthy meals that help manage blood sugar levels with a healthy balance of protein, vegetables, and carbohydrates.

Keeping tight control of your blood sugar levels through diet while losing weight is vital. As you diet, you don’t want to fluctuate between high and low blood sugar levels since this will affect your diabetes medication and progression.

Typically, it’s safe for diabetes patients to cut 500 calories a day. This trim should come from fat, protein, and carbohydrates. According to the USDA, adult calories should constitute:

  • 45% – 55% carbs
  • 25% – 35% fat
  • 10% – 35% protein

Carbohydrates have the most significant effect on blood sugar levels. Eating carbs with fiber, such as whole-grain bread, is better than sugary or starchy carbs since they’re less likely to spike your blood sugar levels then crash them.

Work with small, short-term goals, driving towards larger, long-term goals.

Exercise

Diet changes should be accompanied by exercise for effective weight loss. However, you should consult your doctor before starting any physical exercise regime.

Like dieting, start with reasonable goals and ramp-up to harder, long-term targets. For instance, you can start walking for 10 or 20 minutes outside or on a treadmill daily.

According to research, getting at least 150 minutes weekly of moderate-intensity aerobic exercise can significantly improve blood sugar control and weight loss.

Some aerobic exercises you can try include:

  • Hiking
  • Walking
  • Running
  • Dancing
  • Swimming
  • Playing tennis

You can join a gym, group fitness class, or exercise with a friend for motivation.

Look at Bariatric Surgery Options

People with type 2 diabetes and obesity often get exemplary results through bariatric surgery for weight loss. It is a therapeutic option that provides metabolic, mechanical, and psychological benefits.

Bariatric surgery encompasses several weight loss procedures that result in sustained weight loss for most patients. It also leads to significant improvements in comorbidities related to obesity, which includes the control or remission of type 2 diabetes.

Bariatric surgery is often recommended for people with a BMI greater than or equal to 40.0kg/m2 or a BMI between 35 and 39.9 kg/m2 but with obesity-related complications such as type 2 diabetes. The patient must also have shown an inability to achieve weight loss through healthy behavior interventions or pharmacotherapy.

Before taking bariatric surgery, a qualified interdisciplinary team with surgical, nutritional, medical, and psychiatric expertise will evaluate your candidacy.

Then, you will have to make careful risk vs reward assessments with your healthcare provider or doctor, the goal being to ensure that you understand the lifelong lifestyle change commitments you have to make to enjoy the full benefits of the procedure.

Get in touch with a qualified bariatric surgeon today and start the process.