Losing weight is one of the best treatments for type 2 (non-insulin-dependent) diabetes. Being overweight makes it harder for your body to use glucose. Too much weight also makes complications more likely.
Losing weight is hard. One thing is clear: diets don't work. The only way to get rid of extra pounds -- and keep them off -- is to change your behaviour. Eat less, exercise more, and keep up these good habits even after you lose weight.
Diabetes and Obesity: A Dangerous Duo
Around the world, diabetes and obesity go together. Diabetes is common in cultures in which obesity has been common for at least 20 years.
Diabetes is rare in societies in which obesity is rare. For example, American Indians rarely got diabetes before 1900. But as tribes began to adopt a modern lifestyle, with processed foods and inactive jobs, obesity skyrocketed. So did diabetes.
About 80 percent of the nearly 1.2 million people with type 2 diabetes were overweight before getting diabetes. According to one theory, genes that cause people to store fat and become obese can serve a useful purpose. If food is scarce, stored fat may make the difference between life and death. Today, food is abundant in Malaysia. Genes that help pack on the pounds are a burden -- particularly because extra weight increases the risk of diabetes.
What Causes Diabetes?
Does obesity cause diabetes? Not exactly. Although many people are obese, fewer than one-sixth of them have been diagnosed with type 2 diabetes. So obesity does not always lead to diabetes.
Researchers think instead that obesity is a major risk factor for diabetes. Heredity is another risk factor. For example, identical twins have identical sets of genes. When one twin has type 2 diabetes, the other twin has a 50 to 75 percent chance of also developing the disease.
So far, researchers have not found any one gene that causes type 2 diabetes. But they have identified five signs that someone is likely to develop type 2 diabetes.
These are:
A strong family history of diabetes.
A history of gestational (pregnancy) diabetes.
Temporary diabetes during stressful situations, such as surgery or infection.
Abnormal blood glucose levels when taking certain medicines, such as cortisone or birth control pills.
Belonging to an ethnic group with a high rate of type 2 diabetes, such as Mexican Americans or certain American Indian tribes.
All these factors increase the risk of diabetes. But not every person at risk will develop the illness. And not having any of these factors does not mean that a person will never get diabetes.
People with a family history of diabetes can reduce the risk of getting the disease if they stay thin. And people who are obese have a high risk of developing type 2 diabetes, even when they have no other risk factors.
What's So Wrong With Being Overweight?
Obesity seems to lead to type 2 diabetes by decreasing the body's ability to use insulin. This is called insulin resistance.
Although the body produces a normal amount of insulin, cells resist the action of that insulin. Normally, insulin opens the door for the glucose to pass from the blood into the cell. When the body resists insulin, glucose piles up in the blood.
Insulin resistance related to obesity can be caused by many factors. In overweight people, cells are less able to grab the insulin they need from the blood. Resistance also occurs when the insulin that does get grabbed no longer affects cells as strongly.
To make up for insulin resistance, the beta cells (the insulin-producing cells of the pancreas) work extra hard.
For a few years, even decades, obese people can make the extra insulin they need. But 10 to 30 years down the line, the beta cells may slow down and insulin levels start to fall. Glucose starts to build up in the blood. Diabetes results. As obesity continues, diabetes worsens.
Not all types of obesity are the same. type 2 diabetes is more likely when fat collects mainly in the upper body than when most fat collects in the lower body.
Upper-body obesity seems to be caused by large insulin-resistant fat cells. People with lower-body obesity have smaller fat cells that respond normally to insulin. Upper-body obesity is more common in men. Indeed, diabetes and obesity are more often linked in men than in women.
Treatment: Weight Loss
When diabetes develops in someone who is overweight, the first line of treatment is aimed at the obesity itself. If you lose weight, type 2 diabetes is easier to control.
Shedding pounds is not a cure, but it is one of the treatments. In fact, the signs of type 2 diabetes often go away when people return to their ideal weight or even when they lose weight after diagnosis.
When a person has had diabetes for a long time, losing weight helps less. Still, even when diabetes has been around for 10 years or longer, losing weight can improve the disease.
So part of the solution to type 2 diabetes is simply to lose weight. But as any dieter knows, losing weight after years of being overweight is anything but simple.
Many people try to lose weight by dieting. But bad habits led to your putting on the weight in the first place. You need to change your habits permanently if you really want to lose weight. Otherwise, once you stop the diet, you are likely to gain back all the weight you lost.
In fact, many people gain back more than they had lost! People who repeatedly diet and gain back weight have more health problems than people who stay overweight. So keeping weight off is more important than losing it in the first place.
To lose weight, you must change two habits. You must eat less and exercise more.
Successful Plan
To succeed, you must believe that losing weight is important. Obesity is more than a cosmetic problem; it's a danger.
The rewards of losing weight are great. Many people with type 2 diabetes who are overweight and use insulin could stop taking insulin if they lost weight. About 90 percent of people with type 2 diabetes who are on medication could throw away their pills once they reach normal body weight.
Of course, people with insulin-dependent (type 1) diabetes who are overweight can't stop taking insulin. But losing weight may prevent some complications in both people with type 1 and those with type 2 diabetes.
You should talk to your doctor and diabetes team before changing your habits. Your doctor will want to run some tests first to make sure that it is safe for you to exercise. Also, your doctor and dietician can help you set goals and create a safe plan for reaching them.
A safe, realistic goal is a loss of one pound per week. To keep from becoming discouraged, try weighing yourself only once a week. Remember, you want a healthier body and life, not just a lower number on the scale.
Rewards work better than punishments for getting people to do something. Set up a system of rewards for meeting small steps toward your goals. Forgive yourself for the many small lapses you will certainly make. Forming new habits takes most people about three months.
Eating Less
Meals with lots of carbohydrates, moderate amounts of protein, and little fat are ideal for losing weight and improving health.
Eating fewer calories does not mean starving yourself. Fat has more than twice as many calories per ounce as carbohydrates. So you can cut your calorie intake while eating the same amount of food just by choosing foods high in carbohydrates and low in fat.
You can also cut your fat intake by eating less butter, margarine, oil, sauces, and gravy. Don't fry food; broil, bake, steam, or poach instead. Eat low-fat or non-fat versions of high-fat foods.
Eating foods high in fiber will make you feel fuller faster. These foods include fruits, vegetables, and whole-grain products (for example, brown rice and whole-wheat bread). Also, it takes at least 20 minutes to feel full. If you eat slowly, you will know when you're full before you've eaten a lot of extra food.
Exercising More
Exercise helps pounds come off faster by increasing the amount of energy you use. You not only burn extra calories while you are exercising, but if you exercise regularly, your muscles use more energy all the time. So you use more calories than before just by sitting at your desk or watching TV.
People are better able to keep pounds off if they both exercise and eat more healthfully than if they do just one or the other. Also, once you start exercising, you will feel less hungry.
In addition to reducing the amount of fat on your body, exercise also tones up the muscles. These improved conditions help reduce the load on your overworked pancreas.
Well-conditioned people need very little insulin. But the beta cells of poorly conditioned people have to churn out extra insulin day after day, week after week. No wonder beta cells wear out. Exercise helps reduce the amount of insulin needed in both people with type 1 diabetes and those with type 2 diabetes.
To help you follow your doctor's suggestions for exercise, choose activities that you enjoy. Choose a convenient time and place for your exercise. Set small goals that you can easily meet, then raise them as you progress.
Losing weight is hard. One thing is clear: diets don't work. The only way to get rid of extra pounds -- and keep them off -- is to change your behaviour. Eat less, exercise more, and keep up these good habits even after you lose weight.
Diabetes and Obesity: A Dangerous Duo
Around the world, diabetes and obesity go together. Diabetes is common in cultures in which obesity has been common for at least 20 years.
Diabetes is rare in societies in which obesity is rare. For example, American Indians rarely got diabetes before 1900. But as tribes began to adopt a modern lifestyle, with processed foods and inactive jobs, obesity skyrocketed. So did diabetes.
About 80 percent of the nearly 1.2 million people with type 2 diabetes were overweight before getting diabetes. According to one theory, genes that cause people to store fat and become obese can serve a useful purpose. If food is scarce, stored fat may make the difference between life and death. Today, food is abundant in Malaysia. Genes that help pack on the pounds are a burden -- particularly because extra weight increases the risk of diabetes.
What Causes Diabetes?
Does obesity cause diabetes? Not exactly. Although many people are obese, fewer than one-sixth of them have been diagnosed with type 2 diabetes. So obesity does not always lead to diabetes.
Researchers think instead that obesity is a major risk factor for diabetes. Heredity is another risk factor. For example, identical twins have identical sets of genes. When one twin has type 2 diabetes, the other twin has a 50 to 75 percent chance of also developing the disease.
So far, researchers have not found any one gene that causes type 2 diabetes. But they have identified five signs that someone is likely to develop type 2 diabetes.
These are:
All these factors increase the risk of diabetes. But not every person at risk will develop the illness. And not having any of these factors does not mean that a person will never get diabetes.
People with a family history of diabetes can reduce the risk of getting the disease if they stay thin. And people who are obese have a high risk of developing type 2 diabetes, even when they have no other risk factors.
What's So Wrong With Being Overweight?
Obesity seems to lead to type 2 diabetes by decreasing the body's ability to use insulin. This is called insulin resistance.
Although the body produces a normal amount of insulin, cells resist the action of that insulin. Normally, insulin opens the door for the glucose to pass from the blood into the cell. When the body resists insulin, glucose piles up in the blood.
Insulin resistance related to obesity can be caused by many factors. In overweight people, cells are less able to grab the insulin they need from the blood. Resistance also occurs when the insulin that does get grabbed no longer affects cells as strongly.
To make up for insulin resistance, the beta cells (the insulin-producing cells of the pancreas) work extra hard.
For a few years, even decades, obese people can make the extra insulin they need. But 10 to 30 years down the line, the beta cells may slow down and insulin levels start to fall. Glucose starts to build up in the blood. Diabetes results. As obesity continues, diabetes worsens.
Not all types of obesity are the same. type 2 diabetes is more likely when fat collects mainly in the upper body than when most fat collects in the lower body.
Upper-body obesity seems to be caused by large insulin-resistant fat cells. People with lower-body obesity have smaller fat cells that respond normally to insulin. Upper-body obesity is more common in men. Indeed, diabetes and obesity are more often linked in men than in women.
Treatment: Weight Loss
When diabetes develops in someone who is overweight, the first line of treatment is aimed at the obesity itself. If you lose weight, type 2 diabetes is easier to control.
Shedding pounds is not a cure, but it is one of the treatments. In fact, the signs of type 2 diabetes often go away when people return to their ideal weight or even when they lose weight after diagnosis.
When a person has had diabetes for a long time, losing weight helps less. Still, even when diabetes has been around for 10 years or longer, losing weight can improve the disease.
So part of the solution to type 2 diabetes is simply to lose weight. But as any dieter knows, losing weight after years of being overweight is anything but simple.
Many people try to lose weight by dieting. But bad habits led to your putting on the weight in the first place. You need to change your habits permanently if you really want to lose weight. Otherwise, once you stop the diet, you are likely to gain back all the weight you lost.
In fact, many people gain back more than they had lost! People who repeatedly diet and gain back weight have more health problems than people who stay overweight. So keeping weight off is more important than losing it in the first place.
To lose weight, you must change two habits. You must eat less and exercise more.
Successful Plan
To succeed, you must believe that losing weight is important. Obesity is more than a cosmetic problem; it's a danger.
The rewards of losing weight are great. Many people with type 2 diabetes who are overweight and use insulin could stop taking insulin if they lost weight. About 90 percent of people with type 2 diabetes who are on medication could throw away their pills once they reach normal body weight.
Of course, people with insulin-dependent (type 1) diabetes who are overweight can't stop taking insulin. But losing weight may prevent some complications in both people with type 1 and those with type 2 diabetes.
You should talk to your doctor and diabetes team before changing your habits. Your doctor will want to run some tests first to make sure that it is safe for you to exercise. Also, your doctor and dietician can help you set goals and create a safe plan for reaching them.
A safe, realistic goal is a loss of one pound per week. To keep from becoming discouraged, try weighing yourself only once a week. Remember, you want a healthier body and life, not just a lower number on the scale.
Rewards work better than punishments for getting people to do something. Set up a system of rewards for meeting small steps toward your goals. Forgive yourself for the many small lapses you will certainly make. Forming new habits takes most people about three months.
Eating Less
Meals with lots of carbohydrates, moderate amounts of protein, and little fat are ideal for losing weight and improving health.
Eating fewer calories does not mean starving yourself. Fat has more than twice as many calories per ounce as carbohydrates. So you can cut your calorie intake while eating the same amount of food just by choosing foods high in carbohydrates and low in fat.
You can also cut your fat intake by eating less butter, margarine, oil, sauces, and gravy. Don't fry food; broil, bake, steam, or poach instead. Eat low-fat or non-fat versions of high-fat foods.
Eating foods high in fiber will make you feel fuller faster. These foods include fruits, vegetables, and whole-grain products (for example, brown rice and whole-wheat bread). Also, it takes at least 20 minutes to feel full. If you eat slowly, you will know when you're full before you've eaten a lot of extra food.
Exercising More
Exercise helps pounds come off faster by increasing the amount of energy you use. You not only burn extra calories while you are exercising, but if you exercise regularly, your muscles use more energy all the time. So you use more calories than before just by sitting at your desk or watching TV.
People are better able to keep pounds off if they both exercise and eat more healthfully than if they do just one or the other. Also, once you start exercising, you will feel less hungry.
In addition to reducing the amount of fat on your body, exercise also tones up the muscles. These improved conditions help reduce the load on your overworked pancreas.
Well-conditioned people need very little insulin. But the beta cells of poorly conditioned people have to churn out extra insulin day after day, week after week. No wonder beta cells wear out. Exercise helps reduce the amount of insulin needed in both people with type 1 diabetes and those with type 2 diabetes.
To help you follow your doctor's suggestions for exercise, choose activities that you enjoy. Choose a convenient time and place for your exercise. Set small goals that you can easily meet, then raise them as you progress.
