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Will Weight Loss Help With Your Diabetes?
Medically Reviewed by Michael Dansinger, MD on May 18, 2021
There’s no question about it. If you’re overweight and have type 2 diabetes, you will lower your blood sugar, improve your health, and feel better if you lose some of your extra pounds.
You’ll want to work closely with your doctor or diabetes educator, because your blood sugar, insulin, and medications will need special attention while you’re losing weight.
You don’t need to lose that much to make a difference for your health. One study found that people with type 2 diabetes improved their blood sugar control when they lost as little as 2% of their body weight. And research shows that losing 5% of your extra weight will make you less likely to get heart disease by improving blood pressure, blood sugar, and HDL cholesterol (the good kind).
So start by focusing on losing that 5% and keeping it off. Later, you can build from that success. Many studies have shown that lifestyle changes such as exercise and weight loss are the most effective and safest ways to manage type 2 diabetes.
If you drop even 10 or 15 pounds, that has health perks, such as:
- Lower blood sugar
- Lower blood pressure
- Better cholesterol levels
- Less stress on your hips, knees, ankles, and feet
- More energy
- Brighter mood
After you’ve lost that first 5% of your weight, press on. To see even more improvements, like a lower risk of heart disease and improved blood sugar over the long term, aim to drop 10% to 15% of your body weight.
Losing this amount of body weight could also be more noticeable. You may lose some inches from your waist, drop a pants size, or just feel better. These changes can motivate you to continue shedding pounds if you need to.
Diet: The Right Balance for Diabetes and Weight Loss
Keep tight control over your blood sugar levels while you lose weight. You don’t want to get high or low levels while you change your eating habits.
It’s generally safe for someone with diabetes to cut 500 calories a day. Trim from protein, carbohydrates, and fat. The USDA says that calories for adults should come from:
- 45% to 55% carbs
- 25% to 35% fat
- 10% to 35% protein
Carbs have the biggest effect on blood sugar. Those that have fiber (whole-grain bread and vegetables, for example) are much better than eating sugary or starchy carbs, because they’re less likely to spike your blood sugar and quickly make it crash.
S.M.A.R.T. weight loss goals: Make losing weight with diabetes easier by setting S.M.A.R.T. goals.
S.M.A.R.T. stands for Specific, Measurable, Attainable, Relevant, and Time-bound. When your goals are S.M.A.R.T., it will be simpler to stay on track with your diet.
Setting S.M.A.R.T. goals help keep big projects, like losing weight or managing blood sugar, from being overwhelming.
Your steps for success are clearly spelled out so that you know when you’ve met the goal.
The biggest payoff comes from turning short-term goals into long-lasting, healthy habits.
To help manage your diabetes, you need to spread carbs out more evenly throughout the day. So, for example, a S.M.A.R.T. goal could be, “I will eat a breakfast containing 45 grams of carbohydrates every day for the next 2 weeks.”
Here’s the S.M.A.R.T. breakdown:
Specific: Targeted to breakfast
Measurable: 45 grams, every day
Attainable: Breakfasts with about 45 grams of carbs are very doable. A few options:
- 1 cup cooked oatmeal (32 grams), ½ medium banana (13 grams), a hard-boiled egg, black coffee
- 2 scrambled eggs, 1 small whole-wheat pita (15 grams), 1 orange (18 grams), 1 cup 1% milk (14 grams)
- 3 rye crispbreads (24 grams), ½ cup nonfat cottage cheese (5 grams), 1 cup of blackberries (15 grams)
Relevant: Spreading carbs out is relevant because it helps you curb hunger, so you don’t overeat. To hit 45 grams, you have to plan to eat protein and fat in addition to carbs at a meal. A piece of toast with an egg, for instance, will keep you feeling full longer than two slices of toast with jam. When you’re more satisfied, you’re likely to eat less overall.
Time-bound: This goal will be your focus for 2 weeks. At the end of that time, you can decide if you want to do it again or set a different goal.
How Exercise Helps
One of the many benefits of working out is that it helps keep your blood sugar in balance. You’re also more likely to keep the pounds off if you’re active.
If you’re not active now, check in with your doctor first. They can let you know if there are any limits on what you can do.
Aim to get at least 2½ hours a week of moderate aerobic exercise, like brisk walking, to improve your health. You can split up the time any way you choose.
To help yourself lose weight, you’ll need to do more physical activity. You should also do strength training at least twice a week. You can use weight machines at a gym, hand weights, or even your own body weight (think pushups, lunges, and squats).
Physical activity burns both blood sugar and sugar stored in muscle and the liver. If you use insulin or other diabetes medicines, you should closely watch your blood sugar levels when you start exercising. Over time, as you exercise regularly and work with your doctor, you may be able to lower doses of medications and insulin.
Each type of exercise affects blood sugar differently.
Aerobic exercise — running or a treadmill workout — can lower your blood sugar right away.
Weightlifting or working out hard for a long time may affect your blood sugar level many hours later. This can be a problem, especially if you’re driving a car after your workout. It’s one of the many reasons you should check your blood sugar before you get behind the wheel. It’s also a good idea to carry snacks like fruit, crackers, juice, and soda.
SOURCES:
Cathy Nonas, registered dietitian and senior adviser, New York City Department of Health and Mental Hygiene.
Christine Gerbstadt, MD, registered dietitian and author, Doctor’s Detox Diet: The Ultimate Weight Loss Prescription; medical director, Mobile Medical Corp.
Luigi Meneghini, MD, endocrinologist, Miami.
National Institute of Diabetes and Digestive and Kidney Diseases: “Taking Care of Your Diabetes at Special Times.”
Larry C. Deeb, MD, pediatric endocrinologist, Tallahassee, FL.
American Diabetes Association: “Healthy Weight Loss.”
American Journal of Health Promotion: “Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature.”
Organizational Dynamics: “Goal Setting: A Five-Step Approach to Behavior Change.”
Patient Education and Counseling: “Goal-setting for behavior change in primary care: an exploration and status report.”
Self Nutrition Data.
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Diabetes and Weight Loss: The Right Path
If you’ve got diabetes, weight loss can get you off insulin and other medications. But diet safely, with the help of experts.
By Jeanie Lerche Davis
Medically Reviewed by Brunilda Nazario, MD on October 23, 2009
Diabetes and weight loss: They’re the yin and yang of optimal health. There’s no question about it: If you’re overweight and have type 2 diabetes, dropping pounds lowers your blood sugar, improves your health, and helps you feel better.
But before you start a weight loss plan, it’s important to work closely with your doctor or diabetes educator. That’s because while you’re dieting, your blood sugar, insulin, and medications need special attention.
Make no mistake: You’re on the right path.
“No matter how heavy you are, you will significantly lower your blood sugar if you lose some weight,” says Cathy Nonas, MS, RD, a spokeswoman for the American Dietetic Association and a professor at Mount Sinai School of Medicine in New York.
A 2001 National Institutes of Health study found that a combination of diet and exercise cuts the risk of developing diabetes by 58%. The study involved people who were overweight (with an average body mass index of 34) and who had high — but not yet diabetic — blood sugar levels.
“We know it’s true — that if someone with diabetes loses 5% to 10% of their weight, they will significantly reduce their blood sugar,” Nonas tells WebMD.
“We see it all the time: people can get off their insulin and their medication,” she says. “It’s wonderful. It shows you how interwoven obesity and diabetes are.”
Even losing 10 or 15 pounds has health benefits, says the American Diabetes Association. It can:
- Lower blood sugar.
- Reduce blood pressure.
- Improve cholesterol levels.
- Lighten the stress on hips, knees, ankles and feet.
Plus, you’ll probably have more energy, get around easier, and breathe easier.
Diabetes, Weight Loss, and Changes in Blood Sugar
Cutting back on just one meal can affect the delicate balance of blood sugar, insulin, and medication in your body. So it’s important to work with an expert when you diet.
Check with your doctor before starting a weight loss plan, then consult with a diabetes educator or nutritionist, advises Larry C. Deeb, MD, a diabetes specialist in Tallahassee, Fla., and past president of the American Diabetes Association.
“Don’t try to lose weight on your own,” says Deeb. “With a doctor and a good nutritionist, it’s very safe to do. This is very important if you’re taking insulin or medications.
The Right Balance for Diabetes and Weight Loss
Christine Gerbstadt, MD, a spokeswoman for the American Dietetic Association, warns: “You don’t want to run the risk of high or low blood sugar while you’re dieting. You want tight glucose control while you lose weight.”
Gerbstadt suggests cutting 500 calories a day, “which is safe for someone with diabetes,” she says. “Cut calories across the board — from protein, carbohydrates, and fat — that’s the best way.” She recommends that people with diabetes maintain a healthy ratio of carbs, fat, and protein. The ideal:
- 50% to 55% carbs
- 30% fat
- 10% to 15% protein
Watch the Carbs on a Diabetes Weight Loss Diet
For people with diabetes, a refresher course on carbs may also be in order, Gerbstadt says. With diabetes and weight loss, dietary changes must be made carefully.
That’s because carbs have the biggest effect on blood sugar, since they are broken down into sugar early in digestion. Eating complex carbs (whole-grain bread and vegetables, for example) is good because they are absorbed more slowly into the bloodstream, cutting the risk of blood sugar spikes, Gerbstadt explains.
Worst-case scenario is sliced white bread,” she says. “Whole-wheat bread is an improvement. Adding a little peanut butter is even better.”
Simply cutting lots of carbs — a common dieting strategy — can be dangerous for a diabetic diet, Gerbstadt says. When your body doesn’t have carbs to burn for fuel, your metabolism changes into what’s known as ketosis — and fat is burned instead. You’ll feel less hungry, and eat less than you usually do — but long-term ketosis can cause health problems.
“Ketosis decreases oxygen delivery to the tissues, which puts stress on eyes, kidneys, heart, liver,” Gerbstadt says. “That’s why the low-carb, high-protein Atkins diet is not really safe for people with diabetes. Diabetics need to try to stick with a more balanced diet so your body can handle nutrients without going into ketosis.”
Exercise, Diabetes and Weight Loss
One of the benefits of exercise is that it helps keep your blood sugar in balance, so you won’t have to cut as many calories.
“Walk an extra 20 minutes a day, and you can eat a little bit more,” Gerbstadt explains. So instead of cutting 500 calories, “you can cut back just 200 or 300 calories, and still get excellent results in weight loss. You’ll also control your blood sugar. And the weight will be more likely to stay off if you lose it slowly, safely.”
Keep in mind: Each type of exercise affects blood sugar differently.
Aerobic exercise — running or a treadmill workout – can lower your blood sugar immediately.
Weight lifting or prolonged strenuous exercise may affect your blood sugar level many hours later. This can be a problem, especially when you’re driving. It is one of the many reasons that you should check your blood sugar before driving. It’s also a good idea to carry snacks such as fruit, crackers, juice, and soda in the car to help your diabetic diet.
“With physical activity, you burn blood sugar as well as sugar stored in muscle and in the liver,” explains Luigi Meneghini, MD, director of the Kosnow Diabetes Treatment Center at the University of Miami School of Medicine.
“People using insulin or medications to stimulate release of insulin should closely monitor blood sugar levels when they begin exercising more. Over time, as you exercise regularly, you can reduce doses of medications and insulin.”
Special Challenges for Diabetes Weight Loss Diets
“For anyone, losing weight is challenging enough,” Meneghini tells WebMD. “For people who inject insulin, it’s even more difficult because they have to eat when they have low blood sugar. When you have to reduce calorie intake, prevent overmedication, and eat to correct your low blood sugar, it’s very challenging.”
Indeed, low and high blood sugar levels are the two big concerns with diabetes and weight loss.
Low Blood Sugar (hypoglycemia) occurs when the amount of insulin in the body is higher than your body needs. In its earliest stages, it causes confusion, dizziness, and shakiness. In its later stages, it can be very dangerous — possibly causing fainting, even coma.
Low blood sugar is common when people lose weight, because cutting calories and weight loss itself affect blood sugar levels. If you don’t reduce your insulin dosage or pills to match new blood sugar levels, you’ll be risking high blood sugar.
High Blood Sugar (hyperglycemia) can develop when your body’s insulin level is too low to control blood sugar. This happens when people on insulin or sugar-lowering medications don’t take the correct dose or follow their diets.
Diabetes and Weight Loss: Getting Started
Losing weight is never easy. That’s where a diabetes educator or a nutritionist can help, advises Deeb, president-elect of the American Diabetes Association. A diabetes educator or nutritionist can develop a program that fits you and your lifestyle — a program with realistic goals, he says.
“You will need a meal plan, one that you can follow every day. You’ll need to know how to alter your insulin and medication based on what you’re eating and whether you’re exercising more,” Deeb tells WebMD. “That’s the safest way to lose weight.”
A consultation with a diabetes educator or dietitian/nutritionist can cost from $60-$70. Typically, insurance covers the first two visits, but may not additional ones, says Meneghini.
Reasonably priced support groups and classes are available, frequently through hospitals, to help with diabetes and weight loss. Ask your doctor or physician assistant for recommendations.
There are also web sites with in-depth information on diabetes and weight loss, including:
- American Diabetes Association at www.diabetes.org
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) diabetes.niddk.nih.gov
“Information is power, and the better informed you are, the better decisions you can make,” says Meneghini.
SOURCES: Cathy Nonas, MS, RD, spokeswoman, American Dietetic Association. Christine Gerbstadt, MD, MPH, RD, LDN, spokeswoman, American Dietetic Association. Luigi Meneghini, MD, director, Kosnow Diabetes Treatment Center, University of Miami School of Medicine. National Institute of Diabetes and Digestive and Kidney Diseases: “Taking Care of Your Diabetes at Special Times.” Larry C. Deeb, MD, president-elect, American Diabetes Association. WebMD Medical News: “How to Avoid Diabetes – Landmark Results Unveiled.” American Diabetes Association: “Healthy Weight Loss.” WebMD Medical Reference with the Cleveland Clinic: “Diabetes.” WebMD Medical Reference with the Cleveland Clinic: “Weight Los
Weight Loss Helps Diabetes Control
Study: Type 2 Diabetes Patients Who Lost Weight Soon After Diagnosis Had Better Control
Medically Reviewed by Louise Chang, MD on August 11, 2008
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Weight Loss Helps Diabetes Control
Study: Type 2 Diabetes Patients Who Lost Weight Soon After Diagnosis Had Better Control
Medically Reviewed by Louise Chang, MD on August 11, 2008
FROM THE WEBMD ARCHIVES
Aug. 12, 2008 — People diagnosed with type 2 diabetes who lose excess weight soon after their diagnosis are up to twice as likely to maintain control of their disease than those who don’t lose weight or who gain weight, according to a new study.
Even if they regain the weight, as most in this study did, the benefits remain, the researchers found.
“People who lost [excess] weight were more likely to attain their blood sugar and blood pressure goals than people who gained weight or maintained a stable weight,” says Gregory A. Nichols, PhD, an investigator for Kaiser Permanente’s Center for Health Research in Portland, Ore., and a co-author of the study. That was no surprise, he tells WebMD, as other research has found the same.
But the surprise was finding that the benefits remained even if the weight was regained during the four-year follow up.
Weight Loss and Diabetes
Nichols and his team followed more than 2,500 adults, all members of the large Kaiser Permanente HMO, who were diagnosed with type 2 diabetes between the years 1997 and 2002. They looked at medical records to track weight, blood sugar, and blood pressure.
Weight Loss and Diabetes: Study Results
The researchers found that most participants stayed at about the same weight during the study. About 76% were at a stable weight for four years, Nichols says, while about 12% gained weight.
Another 12%, or about 314 people, lost on average 23 pounds at the 18-month mark. But by 36 months, they had gained nearly all of it back, on average.
This loss and regain group was still more likely to meet their goals for blood sugar levels and blood pressure, Nichols found.
Those who got 7% or higher on a blood test called or HbA1c, which indicates average blood sugar control over the past two or three months, were considered above goal. Those whose blood pressure was at or above 130/80 were above goal.
he findings about weight loss might have gone unnoticed, Nichols says, if his team had done what he says most researchers have done — look at the weights at only the start and finish of a study.
“We used all of the weights available to plot these trajectories,” he says. “That’s how we were able to identify this weight loss group.”
To those newly diagnosed who are overweight, Nichols says, “You shouldn’t get discouraged if you regain some or all of what you lose because your blood sugar and blood pressure control may still be better.”
The study is published in online in Diabetes Care, the journal of the American Diabetes Association. About 23 million people in the U.S. have diabetes, according to the American Diabetes Association.
Weight Loss and Diabetes: Pounds Come Back?
How does Nichols explain the finding that the benefits remain even as the pounds come back on?
“One possibility is, had we looked further out, the benefit may be gone,” he says. “The other possibility is, there are long-term benefits to weight loss even if the weight is regained.” Why? One hypothesis is “metabolic memory” — the body remembers the benefits of an intervention such as weight loss.
Another possibility is proposed by Steven Edelman, MD, professor of medicine at the University of California San Diego and director of the Diabetes Care Clinic at the Veterans Affairs Medical Center in San Diego. “Kaiser has a very good education program,” he says, so the patients probably got counseling in how to take care of themselves and their diabetes.
Some of the lifestyle changes may have stuck with them, he says, even though the pounds crept back on. “These people could still be doing regular exercise but still be overweight,” he says.
Weight Loss and Diabetes: Window of Opportunity
Other diabetes experts who reviewed the study for WebMD say the findings may be a wake-up call for doctors and patients alike. “The study is a reminder that we need to diagnose diabetes early, we need to treat it aggressively as soon as it is diagnosed to maintain the remission of the diabetic state,” says Om Ganda, MD, a senior physician at the Joslin Diabetes Center in Boston.
The weight loss soon after the diagnosis, he says, “is like you are creating a honeymoon period” during which the diabetes is under better control than if you hadn’t lost the weight.
Doctors need to stress to newly diagnosed type 2 diabetes patients that they need to “seize that opportunity” and lose weight, says Sue Kirkman, MD, vice president of clinical affairs for the American Diabetes Association. She calls it a “window of opportunity.”
Patients should try to keep off the weight, she says, despite the hopeful finding that the benefits of diabetes control remain even with regain. “We don’t want people to think, ‘I’ll lose weight’ and then ‘Oh, it’s OK to regain.'”
The new finding may spur doctors to encourage newly diagnosed patients even more strongly to lose weight, says David Baron, MD, chief of staff at Santa Monica-UCLA Medical Center & Orthopaedic Hospital in Santa Monica, Calif. “Even if you can’t maintain the weight loss results, this shows it is worth making the extra effort to lose weight as soon as you find out you have type 2 diabetes.
SOURCES:
Gregory A. Nichols, PhD, investigator, Kaiser Permanente Center for Health Research, Portland, Ore.
Feldstein, A. Diabetes Care, published online August 2008.
David Baron, MD, chief of staff, Santa Monica-UCLA Medical Center & Orthopaedic Hospital, Santa Monica, Calif.
Steven Edelman, MD, professor of medicine, University of California San Diego; director, Diabetes Care Clinic, Veterans Affairs Medical Center, San Diego.
Om Ganda, MD, senior physician, Joslin Diabetes Center, Boston.
Sue Kirkman, MD, vice president of clinical affairs, American Diabetes Association, Alexandria, Va.
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