Friday, December 17, 2010

Diabetes and Weight Loss: Finding the Right Path By Jeanie Lerche Davis


But before you start a diabetes weight loss plan, it's important to work closely with your doctor or diabetes educator - 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 City.





Lower blood sugar

Reduce blood pressure

Improve cholesterol levels

Lighten the stress on hips, knees, ankles, and feet






Go for the Right Balance in a Diabetes Weight Loss Plan

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," she tells WebMD. "You want tight glucose control while you lose weight."


50% to 55% carbs

30% fat

10% to 15% protein

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For people with diabetes, a refresher course on carbs may also be in order, Gerbstadt says.
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, 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."

Special Challenges when Following a Diabetes Weight Loss Plan

"For anyone, losing weight is challenging enough," Luigi Meneghini, MD, tells WebMD. Meneghini is director of the Kosnow Diabetes Treatment Center at the University of Miami School of Medicine. "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."


Low Blood Sugar (hypoglycemia) occurs when the amount of insulin in the body is higher than your body needs. In its earliest stages, low blood sugar 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 diet.

The Effects of Exercise on Diabetes

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, and 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."





Getting Started on Your Diabetes Weight Loss Plan

Losing weight is never easy. That's where a diabetes educator or a nutritionist can help, advises Deeb A diabetes educator or nutritionist can develop a program that fits you and your lifestyle -- a program with realistic goals, he says.





American Diabetes Association at

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)


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 at the 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 provided in collaboration with the Cleveland Clinic: "Diabetes." WebMD Medical Reference provided in collaboration with the Cleveland Clinic: "Weight Loss."