Weight Management In Patients With Type 1 Diabetes And Obesity
Go to: Introduction In the past 20 years, the prevalence of obesity has tripled worldwide, to the extent that it is now being considered an epidemic . Obesity, defined as a body mass index (BMI) of ≥30 kg/m2, affects approximately 35% of men and 40% of women in the USA [2••]. It has recently been reported that obesity in particular is rising at a greater rate than overweight . Though patients with type 1 diabetes (T1D) have traditionally been thought to have lower BMI, current research has shown otherwise . The trend of increasing obesity prevalence has increased at a faster rate in patients with T1D compared to the general population . Currently, around 50% of patients with T1D are either overweight or obese. They also have higher waist and hip circumferences when compared to healthy controls . In the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study, which followed adult patients with T1D for an average of 18 years, prevalence of overweight increased from 29 to 42% and prevalence of obesity increased sevenfold from 3 to 23% . Weight gain appeared to be unrelated to aging and instead related to clinical factors such as insulin therapy . Comorbidities, often associated with excess body weight, reduce the benefits of good metabolic control . Thus, controlling body weight in patients with T1D is necessary due to the well-known relationship between obesity and cardiovascular disease (CVD) [7••]. Metabolic abnormalities related to obesity, such as the pro-inflammatory state, are likely to modify CVD risk in this population [7••]. So far, complications related to CVD have been the leading cause of mortality in patients with T1D . In this review, we aim to describe the different mechanisms by which patients with T1D gain ex Continue reading >>
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Weight And Diabetes
A balanced diet and an active lifestyle can help all kids maintain a healthy weight. For kids with diabetes, diet and exercise are even more important because weight can affect diabetes and diabetes can affect weight. This is true for kids and teens with type 1 diabetes or type 2 diabetes. In diabetes, the body doesn't use glucose properly. Glucose, a sugar, is the main source of energy for the body. Glucose levels are controlled by a hormone called insulin , which is made in the pancreas. In type 1 diabetes , the pancreas does not make enough insulin. Undiagnosed or untreated type 1 diabetes can cause weight loss. Glucose builds up in the bloodstream if insulin isn't available to move it into the body's cells. When glucose levels become high, the kidneys work to get rid of unused sugar through urine (pee). This causes weight loss due to dehydration and loss of calories from the sugar that wasn't used as energy. Kids who develop type 1 diabetes often lose weight even though they have a normal or increased appetite. Once kids are diagnosed and treated for type 1 diabetes, weight usually returns to normal. Developing type 1 diabetes isn't related to being overweight, but keeping a healthy weight is important. Too much fat tissue can make it hard for insulin to work properly, leading to both higher insulin needs and trouble controlling blood sugar. In type 2 diabetes , the pancreas still makes insulin, but the insulin doesn't work in the body like it should and blood sugar levels get too high. Most kids and teens are overweight when they're diagnosed with type 2 diabetes. Being overweight or obese increases a person's risk for developing type 2 diabetes. Also, weight gain in people with type 2 diabetes makes blood sugar levels even harder to control. People with type 2 di Continue reading >>
Diet Strategies For Women With Diabetes: Why Some Work And Why Some Don't
If you're a woman with diabetes, have you ever cut back on your insulin — perhaps just a little — because you've discovered that you can lose a few pounds in a few days by doing so? And then, when you go back to using your normal amount of insulin, are you dismayed to discover that you gain the weight back — and perhaps more — in equally rapid fashion? Over time, have you come to blame the insulin for your weight gain problems, so you take less insulin than you should — even though you're blood glucose runs higher as a result? Over 40 women with diabetes, many of whom admitted to having let this familiar thought process influence their diabetes program, came together at Joslin's second Women and Diabetes symposium recently. The day-long symposium attracted nearly 100 women with diabetes who heard talks on topics ranging from the interrelationship of diabetes, menopause, and heart disease, to a session on having a healthy pregnancy if you have diabetes. One of the most popular sessions, however, was entitled "Living on the Edge." Presented by Joslin dietitian Karen Chalmers, M.S., R.D., C.D.E., who is the Director of Nutrition Services at Joslin, the session examined the balancing act women with diabetes encounter as they try to keep blood glucose in a safe range — and their weight down too. "Most of the women at the session on insulin and weight gain were between 20 and 55 years old or so," notes Chalmers in an interview after the symposium. "Some were on intensive insulin therapy, but others were doing insulin manipulation to lose weight. This is a fairly common kind of problem in women with diabetes. Weight loss is a big challenge — nearly an obsession — with many women in this day and age. Our society is so hung up on being thin, and these women begin Continue reading >>
Unexplained Weight Loss
Tweet Unexplained weight loss is the term used to describe a decrease in body weight that occurs unintentionally and can be a warning sign of diabetes. The amount you weigh is determined by a number of factors including age, your calorie intake and overall health. Once you reach middle adulthood, your weight should remain relatively stable from year to year. Losing or gaining a few pounds here and there is normal, but unexplained weight loss that is significant (10 lbs/4.5kg or more or over 5% of your body weight) or persistent may signal an underlying medical condition. Unexplained weight loss means weight loss that occurs without trying through dieting or exercising. What are the possible causes of unexplained weight loss? Unintentional or unexplained weight loss can be caused by a number of things, including depression, certain medication and diabetes. Potential causes of unexplained weight loss include: Addison’s disease Coeliac disease Chronic diarrhoea Dementia Diabetes mellitus Eating disorders (anorexia and bulimia) Exocrine Pancreatic Insufficiency HIV/AIDS Hypercalcemia Hyperthyroidism Malnutrition Medicines, including chemotherapy drugs, laxatives, and thyroid medications Parkinson’s disease Recreational drugs, including amphetamines and cocaine Tuberculosis Diabetes and sudden weight loss In people with diabetes, insufficient insulin prevents the body from getting glucose from the blood into the body's cells to use as energy. When this occurs, the body starts burning fat and muscle for energy, causing a reduction in overall body weight. Unexpected weight loss is often noticed in people prior to a diagnosis of type 1 diabetes but it may also affect people with type 2 diabetes. When to call your doctor If you have unintentionally lost more than 5% of your Continue reading >>
Why Do People With Diabetes Lose Weight?
Diabetes mellitus is a metabolic disorder where the body does not use energy properly. One of the symptoms of diabetes is sudden and unexplained weight loss. Excessive hunger and thirst are two other symptoms, and patients with untreated diabetes may find themselves losing weight even as they are eating and drinking more than usual. There are several reasons why people with diabetes lose weight, but to better understand why weight loss occurs, you need to explore how diabetes affects the body. Video of the Day Under normal circumstances, your body converts food into sugar during the digestive process. The sugar enters your bloodstream and the pancreas, a small organ behind the liver, release a chemical known as insulin. Insulin tells all the cells in the body to take sugar from the blood and convert it to energy, which the cells use as fuel. Types of Diabetes There are two types of diabetes mellitus -- type 1 and type 2. With type 1 diabetes, the body either does not make insulin, or it does not make enough, and the cells never get the chemical signal to absorb sugar from the blood. With type 2 diabetes, the body makes insulin but the cells do not respond to the chemical signals, or they respond incorrectly. In both instances, the sugar stays in the bloodstream, where the body is unable to use it for energy. When the cells are unable to use sugar for energy, they send a signal to the brain that they need more fuel. The brain then triggers the hunger response to encourage you to eat, hence the excessive hunger that often occurs with diabetes. However, the more you eat, the more sugar ends up in your bloodstream instead of in the cells, where it belongs. You kidneys then have to work overtime to clear the sugar from your blood through the urine. Your kidneys have to use a Continue reading >>
Losing Weight With Diabetes: What Prevents It And Causes Weight Gain
I recently was included in a discussion on a Facebook group for athletes with diabetes about how hard it can be to lose weight through exercise. While I would never claim to have all the answers on this topic, here are some ideas about what can make you gain weight or keep you from losing weight with diabetes, based on my decades of professional and personal experience with diabetes and weight management, and what you can do about it. Insulin My former graduate student with type 1 diabetes went on an insulin pump and promptly gained about 10 pounds, even though his blood glucose control improved only marginally. Why did this happen to him (and why does it happen to so many other insulin users)? As a naturally occurring anabolic hormone, insulin promotes the uptake and storage of glucose, amino acids, and fat into insulin-sensitive cells around your body (mainly muscle and fat cells). It doesn’t matter whether it’s released naturally, injected, or pumped—all insulin and insulin analogues have these same effects. Going on intensive insulin therapy is associated with fat weight gain (1), for people with both type 1 and type 2 diabetes. Some of the weight gain comes from that if you’re using insulin to keep your blood glucose in control, you’ll be keeping and storing all of the calories that you’re eating instead of losing some glucose through urine (during hyperglycemia). Unfortunately, this realization has led some people to try skipping or limiting their insulin use to help them lose weight (2), but that is a dangerous practice that can lead to loss of excess muscle mass and life-threatening conditions like DKA. The best way to balance your insulin use and your body weight, in my opinion, is to be physically active to keep your overall insulin levels lower. I Continue reading >>
Why Can’t I Lose Weight?
Finding Your Trouble Spots You’re trying hard to lose weight. You’ve changed your eating habits, and you’ve been doing more physical activity than you used to. But a few weeks — or even a few months — have gone by, and the scale isn’t budging. “Why?!” you ask in frustration. “What am I doing wrong?!” Body weight is regulated mainly by the number of calories consumed and the number of calories burned off. But there are a number of other things that influence weight, and some of them can make it difficult to lose weight. This article explores what some of these are and how to overcome them. As you make the effort to lose weight, be sure you are aiming for a realistic body weight for you. A starting point for determining this is body-mass index (BMI), a measure of body fat based on height and weight. You can calculate your BMI easily with an online tool such as the one at www.cdc.gov/healthyweight/assessing/bmi. (Note that there’s a separate BMI calculator for children and teens.) Generally, a BMI between 18.5 and 24.9 is considered normal, between 25 and 29.9 is considered overweight, and 30 and higher is considered obese. However, BMI tends to overestimate body fat in athletes and other muscular people and to underestimate it in older people who have lost muscle mass. There is also some evidence that the negative health effects of overweight start at a lower BMI for Asian people. Keep in mind, too, that people come in different shapes and sizes. You don’t necessarily have to be “thin” to be healthy, but losing some excess fat can improve your health in a number of ways. Talk to your health-care team about your weight-loss goals and about what a healthy weight is for you. Frequent hypoglycemia Frequent episodes of hypoglycemia, or low blood glu Continue reading >>
Type 1 Diabetes: Why Is It So Difficult To Lose Weight Being A Type 1 Diabetic? Something To Do With Insulin?
I've been a type 2 for about 20 years. I'm constantly trying to lose. Insulin works against us, portion control is all but impossible in a world that's normal portions are at least triple what you need, you have to balance what you need to eat to keep your glucose levels reasonable, while fighting all the food cravings, it's a constant balancing act. Keep the faith, work on portions, juice if possible, keep the peanut butter handy for a boost of protein that won't spike your glucose and drink lots of fluids, water's best, soda's are not so good, even the SF kinds. We'll get through in the long run, so hang in there. Submit Submit Submit Continue reading >>
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How To Lose Weight When You Live With Diabetes
Losing weight can be difficult for anyone, and living with diabetes definitely doesn’t make it easier. However, there ARE people who set out to lose weight and end up so extraordinarily successful that you wonder if they have some inside information you don’t. That information EXISTS. I’m here to give you the rundown on how to successfully lose weight when you live with diabetes. In this post, I will go through: How to set realistic goals How many calories to eat How much protein, carbs, and fat to eat How much to exercise How blood glucose control affects your weight Without further ado…lets GET TO IT! Temper expectations at the start People these days have this intensive need for instant gratification. They want that 15 lbs gone by yesterday! While I’m all for efficiency, I’m going to be short and sweet and show reality with a pop quiz: True or false: it took more than a week to gain the weight you are trying to lose. The answer is undeniably “True”. So if it took you X number of months to gain weight, why would it take you a week or two to lose it? It doesn’t. It takes time and some concerted effort. Don’t expect to lose all of the weight immediately, but know that with proper habit formation and consistency, you WILL see the results you are after. The general rule for healthy weight loss is to aim for A MAX of 1-2 lbs. per week. It’s also quite common for people living with diabetes to take as long as 2-3 weeks before seeing any weight loss at all on a new diet. “Why?” you ask. Changing caloric intake and workout routines may require a reduction of insulin (or other diabetes medication) as well as diet manipulation, which takes a little trial and error to adjust. BE PATIENT. Once the ball is rolling, a slow and controlled weight loss makes Continue reading >>
Diabulimia: Skipping Insulin To Lose Weight
A dangerous eating disorder is affecting thousands of teenage girls and women with type 1 diabetes. Sometimes called “diabulimia,” the common practice of skipping or reducing insulin to lose weight is putting lives at risk. “We think more than 10 percent of young women with type 1 diabetes are regularly omitting insulin to control their weight,” says William Polonsky, PhD, a diabetes educator and chief executive officer of the Behavioral Diabetes Institute in San Diego. But since it’s a secretive disorder, the percentage is probably much higher, he says. A recent report in the World Journal of Diabetes estimates that between 30 to 40 percent of teens and young adults with type 1 diabetes skip insulin after meals in order to lose weight. What Is Diabulimia? You won’t find diabulimia in medical books because it’s not a recognized condition. It’s a term now used in the media to describe the eating disorder bulimia among type 1 diabetics. Bulimia is a disorder in which a person eats and then purges, usually by vomiting or abusing laxatives. In diabulimia, the tool used to purge calories is simply to cut back on insulin. “It’s extraordinarily successful and quite addictive,” says Polonsky. “But it can harm you terribly in the near-to-long term. It is so scary and hard to treat.” Diabetes: The Insulin and Weight Loss Connection People with type 1 diabetes need daily insulin doses to live. In this type of diabetes, the pancreas doesn’t produce insulin, the hormone the body needs to absorb glucose (sugar) and use it as energy or store it as fat. If insulin is used appropriately, the glucose is absorbed from the blood into the body’s tissues and used (or stored). Without insulin, the glucose builds up in the blood and is excreted in the urine. This Continue reading >>
Unexplained Weight Loss With Diabetes
You might be aware that as a metabolic disorder, some forms of diabetes come with excessive weight. But diabetes might also cause a sudden drop in weight too. In fact, many patients who are ultimately diagnosed with diabetes first go to their doctor with concerns about unexplained weight loss. Several mechanisms are behind this symptom. Weight loss can occur as a consequence of high blood sugar, dehydration, muscle breakdown and problems with your thyroid. Video of the Day Although both type 1 and type 2 diabetes can involve fairly dramatic weight loss over several days at the onset of the disease, it tends to be more common among people with type 1. In both cases, the cause is that your body fails to adequately deal with insulin. The job of insulin is to transport glucose from the foods you eat into your cells to provide energy for all the work that’s required to keep you alive. However, most type 1 diabetics don’t produce insulin. Type 2 diabetics either don’t produce enough insulin or their bodies don’t respond to it properly. Consequently, even if you eat normally, that blood sugar simply builds up and gets excreted in your urine. This causes weight loss, but it could also damage your organs if you don't receive treatment. If you experience an unexplained weight loss, surpassing 5 percent of your body weight within days, see your health care provider as soon as possible. Another symptom of diabetes associated with weight loss is frequent urination. When you urinate more frequently and don’t drink enough to replace the lost fluid, you become dehydrated. Urination increases in diabetes, because your kidneys have to work harder to filter the excess glucose building up in your system. The increased glucose in the urine draws fluid from your tissues. When you l Continue reading >>
Low Carb And Weight Loss In Type 1 Diabetes
Tweet In type 1 diabetes, the body doesn’t automatically respond to meals by releasing insulin, this has to be done manually through taking injections or through bolus doses via insulin pump. If you’re looking to lose weight, this can give an advantage, in a way, as it allows you to review exactly how much insulin you’re taking each day. By contrast, people without type 1 diabetes have no good way of knowing how much insulin they have in their body. A good rule of thumb is that the more units of insulin you take per day, the more likely you are to put on weight. See also more general advice in our guide to weight loss on a low-carb diet Less insulin intake, improved weight management Say Jill and Michelle are roughly the same height and both have type 1 diabetes. Jill is taking 50 units per day and Michelle is taking 100 units per day. Generally speaking, it’s more likely that Jill will be finding it easier to manage her weight than Michelle. So, if you’re looking to lose weight, one way to achieve this is to modify your diet, or eating habits, so that you take less insulin whilst maintaining good blood control. Warning note: We need to make an important safety note that reducing your insulin whilst letting glucose levels go high for long periods of time is not a good idea at all. Doing this will lead to a much greater risk of very serious health problems such as retinopathy, neuropathy and kidney disease. Reducing insulin intake safely There are a number of ways insulin intake can be reduced in a safe way: Lower your carbohydrate intake Lower your protein intake -if you eat a lot of protein Increase physical activity Reduce snacking Out of these, reducing carbohydrate intake is likely to have the greatest effect. Lowering insulin doses should only be done if Continue reading >>
Lose Weight With Type 1 Diabetes
WRITTEN BY: Cliff Scherb Editor’s Note: Cliff Scherb, Founder of Glucose Advisors and TriStar Athletes LLC, is a nutrition and fitness expert. He consults through virtually teaching his decision support system – Engine1 the app and its methodologies to aspiring T1 individuals and athletes. Cliff also creates custom training programs and insulin plans for endurance athletes, using Training Stress Modeling and real-time coaching. To inquire about coaching openings, FB LIVE sessions, and general questions please email [email protected] Losing weight can be difficult — add Type 1 diabetes to the mix with its daily management demands — and it’s even more of a challenge. I know, because I’ve been a Type 1 diabetic for 29 years and I’m also an endurance athlete. The internet is saturated in advice on how to lose weight with or without Type 1, so it’s hard to know what is worth while and what will just waste your time — or worse, can negatively impact your health. I’m not going to declare all out war on carbohydrates, or tell you can or can’t drink your calories in the form of olive oil, or feast and fast with cayenne peppers and maple syrup. No, the real distilled learning from my years of consulting and data analysis shows that a balanced, low-insulin diet with nutrient timing and activity is the best way to lose weight with Type 1 diabetes. It also helps you maintain brain and body function as well as energy levels. If you are reading this you’ve probably already given this some thought and know why it’s important to lose weight and/or lean out, but I maintain it’s all about performance! Performing means living a longer or healthier life or if you’re an athlete, it can also translate to beating out your competition. Things that Impact w Continue reading >>
Diabulimia: The Dangerous Way Diabetics Drop Pounds
At age 14, Erin Williams was tired of medicine. Williams was diagnosed as a type 1 diabetic at age 11, and after three years of enduring a never-ending regimen of insulin shots and strict diet restrictions, she was frustrated. Embarrassed by her disease, she kept it a secret from everyone but her closest family and friends. At birthday parties, she made up excuses about why she couldn't have soda or cake. When a classmate saw her drinking juice boxes in the nurses office, she endured weeks of being called the "juice box thief" rather than just tell her classmates she had low blood sugar because of diabetes. Eventually, Williams rebelled the only way she could, she decided not take her insulin. She just didn't want to adhere to the strict diet and medical regimen even though it was vital to her health. "It wasn't this dramatic moment," recalled Williams. "It was mostly like I want to be like everybody else." The next morning when Williams woke up, she felt fine. "Well, nothing bad happened to me," Williams remembered thinking. "It creeps up on you. That's how it does it." Emboldened by her experiment, she continued to restrict her insulin. Without a regimented amount of insulin in her body to process glucose, Williams' body started to burn through fat and muscle. She lost weight very quickly even as she ate all the same foods. Classmates started commenting on her weight loss and remarked that she looked great. "You hear all these things and you're like, 'This is the greatest thing in the world,'" said Williams. "It takes a hold of your life like nothing else." After living with type 1 diabetes for three years, Williams was exhibiting the first signs of a disorder often called diabulimia. The term refers to the dual diagnosis of type 1 diabetes and an eating disorder. Man Continue reading >>
Type 1: Impossible To Lose Weight
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community I have been type 1 for 26 years and overweight for all but 3 of these years. The lowest my weight has been is 10st and now I am at my heaviest and it is drivig me crazy. Before anyone starts with the 'rip Maria apart', I want advice, NOT a load of people criticising me. I do not snack and all test results (thyroid etc) always come back as 'normal' I walk loads and go swimming 3 or 4 times a week. I was a VERY badly controlled diabetic for a few years and this is the time my weight was at its lowest. My sugars are all between 4-6 usually now but no matter what I do, the weight creeps on. I am not going to say my weight now but it is enough to make me feel depressed, I have no social life as I dont want people to see me looking like a beached whale. Any advice would be greatly appreciated before I end up driving myself crazy. Unfortunately I cannot offer any advice as I have not lost an ounce since being diagnosed and changing lifestyle myself ... so will be watching for responses and advice you receive. I can offer you a hug though .... good luck Hi @MH2010 How many carbs do you eat on a typical day, and how much insulin are you on? I am by no means an expert, as I have been stuck at 80kgs for a couple of years, but have started to look into low carb in order to lower insulin in a controlled manner. Unfortunately, diet restrictions due to CKD are making it difficult, but from my limited knowledge, insulin is a type of growth hormone, and I believe this is why weight gain is attributed to insulin. This may be something worth looking into, but please don't take this as advice to simply stop taking insulin! novorapidboi26 Type 1 Well-Known Member for me t Continue reading >>