Even a small amount on the scale makes a big difference.
Counting/limiting carbs and taking medication to control blood sugar and insulin are go-to treatments for managing diabetes. However, studies consistently show that weight loss—even in small amounts—might be the one of the best tools of all.
“Weight loss is crucial in diabetes management because excess weight is really the thing that fuels [type 2] diabetes,” says Paul Knoepflmacher, MD, a clinical instructor in medicine at The Mount Sinai Hospital.
In a 16-year study from the New England Journal of Medicine, researchers from the Harvard School of Public Health followed nearly 85,000 female nurses, none of whom had heart disease, diabetes, or cancer at the start. By the end of the study, 3,300 of the participants had been diagnosed with type 2 diabetes. The researchers concluded that excess body fat was the “single most important determinant of type 2 diabetes” and attributed 61 percent of the diabetes cases to having a body-mass index (BMI) of 25 or higher.
“When you are overweight, there is more insulin resistance,” explains certified diabetes educator and nutritionist Sandra Arévalo, RDN, a spokesperson for the American Association of Diabetes Educators. “That means you don’t manage your sugars as well as your body should.” (Get more details on what insulin resistance is here.)
“Losing about five to seven percent of your body weight actually translates into having a tighter glycemic control,” says Nesochi Okeke-Igbokwe, MD, an internist in New York City. That’s right: You don’t have to lose every niggling extra pound to see a difference in your health. Dropping even as little as 10 to 15 pounds can improve blood sugar control, according to the American Diabetes Association.
Eating a healthier diet and exercising regularly are two major pillars for long-term weight loss, according to Dr. Okeke-Igbokwe. Even if you’re taking insulin injections or oral diabetes medications, a healthy lifestyle is probably the most powerful way to manage diabetes in the long run.
Dr. Knoepflmacher is a clinical instructor of medicine at The Mount Sinai Hospital in New York City, where he also maintains a private practice.Sandra Arevalo
Sandra Arevalo is a spokesperson for the American Association of Diabetes Educators and Academy of Nutrition and Dietetics and director of nutrition services and community outreach at South Bronx Health Center.Nesochi Okeke-Igbokwe
Dr. Okeke-Igbokwe is an internist and health media expert in New York City.
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Weight loss is crucial in diabetes
management because excess weight is really
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the thing that fuels diabetes.
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When you are overweight,
there is more insulin resistance.
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That means that you don't manage your
sugars as as well as your body should.
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So when you start losing weight, the
insulin resistance, it starts going away.
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Losing about 5 to 7% of
your body weight actually
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translates into having
a tighter glycemic control.
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And also controlling your hemoglobin
A1C levels much more strongly.
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Sometimes you tell people you have to
lose weight and they're like, my God,
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I have to lose 75 pounds.
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No, you start to exhibit the benefits,
in terms of your blood metabolism,
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with just five, seven,
ten pounds of weight loss, which, I think,
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most people can find manageable.
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That's why there's an emphasis on
healthy diet and exercise because
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doing those things consistently
will help you not only lose weight.
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But more importantly,
sustain that weight loss over time so
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that you have a better, tighter control
of your blood sugar regulation.
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So whether or not you're taking insulin,
whether or not you're taking oral
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diabetes medications, a healthy
lifestyle is one of the most important
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modifications that you can make in
order to really control your disease.
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So I can think of one case of
a gentleman who came to see me just for
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a regular check up, was feeling fine.
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And he and I were surprised to
find out that he was diabetic.
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He had no symptoms at all.
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But with medicine, I put him on medicine
right away, cuz his sugars were very high.
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And diet and exercise and
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weight loss, he was able to
completely reverse the illness.
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And actually got him off of medicine.
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Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, Willett WC. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001 Sep;345(11):790-797.Your weight and diabetes. Silver Spring, MD: Obesity Society. (Accessed on February 1, 2018 at http://www.obesity.org/content/weight-diabetes.) Your weight and your risk. Arlington, VA: American Diabetes Association. (Accessed on February 1, 2018 at http://www.obesity.org/content/weight-diabetes.)