We often hear that weight loss is the answer to improving glucose control, but how else does it benefit diabetics? Obesity is on the rise and strongly associated with the risk of diabetes. With 1.1 billion adults being overweight and 312 million of them being obese, the number of diabetics are expected to increase from 84 million in 2000 to 228 million by 2030.
The prevention of obesity is, therefore, an important step towards prevention of diabetes and other chronic diseases. Although it may not be possible to reduce the amount of current overweight and obese individuals, it is vital that we try to slow or prevent the alarming rate of increase.
For pre-diabetics, studies have shown that lifestyle interventions decreased the risk of diabetes by 58%. About 50% of men and 70% of women are obese at the diagnosis of diabetes. A systemic review consisting of 80 studies with 24,698 patients showed that weight loss for diabetics may be harder compared to non-diabetics.
It was also reported that diabetics who had an intentional weight loss experienced a 25% reduction in total mortality and a 28% decrease in cardiovascular disease mortality.
The most important guidelines for weight loss are:
#1. No-Nonsense Targets
Setting a realistic goal as unrealistic goals lead to disappointment, non-maintenance of weight loss, and possibly regaining the weight lost.
#2. Keep Going!
Remember that weight loss plateaus! Be sure to continue the same lifestyle changes you have made to prevent regaining weight and perseverance is key.
#3. Slowly, But Surely.
Successful long-term loss requires attention to calorie intake, exercise, and lifestyle modifications. Know that there is no magic pill or diet!
Another important fact to remember is that evidence shows that low cardiorespiratory illness and physical inactivity as independent predictors of mortality in men with type 2 diabetes regardless of their weight. This highlights the importance of exercise and fitness for benefits that are independent of weight loss.
Lastly, it is recommended that blood glucose records are kept so that medications can be adjusted as needs may change due to lifestyle changes made.
References
1) Franz MJ. The dilemma of weight loss in diabetes. Diabetes spectrum. 2007; 20(3):133-136.
2) Franz MJ, van Wormer JJ, Crain LA, et al. Weight loss outcomes: a systemic review and meta-analysis of weight loss clinical trials with a minimum 1-year follow up. J Am Diet Assoc In-Press.
3) Wing RR, Marcus MD, Epstein LH, Salata R. Type II diabetic subjects lose less weight than their overweight non-diabetic spouses. Diabetes Care. 1987; 10:563-566.
4) Williamson DF, Thompson TJ, Thun M, Flanders D, Pamuk E, Gyers T. Intentional weight loss and mortality among overweight individuals with diabetes. Diabetes Care. 2000; 23:1499-1504.
5) Wei M, Gibbons LW, Kampert JB, Nicaman MZ, Blair SN. Low cardiorespiratory fitness and physical activity as predictors of mortality in men with type 2 diabetes. Ann Intern Med. 2000; 132:605-611.
