Dr. Ahmed
Diabetes and Weight Loss: Breaking the vicious cycle of Diabetes, Medications, and Weight gain requires you to identify the key problem.
Once you get the diagnosis of diabetes, you are started on medications, most of which make you gain weight.
Among diabetes medications that make you fat include:
Diabetes Medications that are weight-neutral include:
Diabetes Medicines that help you lose weight include:
Losing weight can help you in diabetes remission. You may be off medicines for some years.
One of our patients, diagnosed with Diabetes Type 2 and an A1C of 11.3% is now off-medicine for the last three years. He cured his diabetes by following a healthy diabetic diet regimen and exercise.
He took Jardiance for a few months but that was gradually tapered off when he lost 10% of his body weight.
A study recently published stressed weight loss after a diabetes diagnosis to help patients go into remission.
Diabetes and Weight Loss: Key points:
- The goal of the study was to determine whether achieving and maintaining diabetes remission was associated with weight loss during the first year following a T2DM diagnosis.
- Among the 37000 subjects, 6.1% had reported experiencing a complete diabetes remission.
- Also, those subjects who lost at least 10% of their body weight in the first year were over 3 times more likely to achieve diabetes remission compared to those who gained weight.
- Researchers suggest that starting weight control and diabetes remission programs early could be better for diabetics.
- Therefore, diabetes remission was linked to a 31% lower risk of mortality which meant it had a positive impact on both lifespan and overall health.
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Why Weight Loss is an Important Component of Diabetes Management?
The benefits of weight loss can not be underestimated in every health condition. Particularly, diabetes where persistent high blood glucose levels can harm other organs and become risk factors for co-morbidities.
Research has shown that. weight loss through bariatric surgery in severely obese individuals has resulted in better glucose control [ref].
On the same note, surgery-induced weight loss has resulted in prolonged diabetes remission and a lower chance of relapse [ref].
So, the importance of weight loss is clear in the case of diabetes. The more critical point of view is its value in the early years after diagnosis when the damage is not as significant as it would be in the next 10 years after diagnosis.
Therefore, clear and concise guidelines must be devised to inform diabetics about the possible health exacerbations of excessive weight gain.
The initial year after diagnosis has been valued the highest for lifestyle interventions by research [ref].
Also, patients are more likely to follow the guidance of physicians as they are better motivated to improve their health.
So, to explore the importance of weight loss in the first year after diagnosis a study was published in PLOS medicine.
The study suggests that reversing type 2 diabetes is possible in real-life situations, especially with significant weight loss in the first year after diagnosis.
However, achieving and maintaining remission through conventional methods is challenging.
Simply telling people to lose weight won’t do any good which is why the governments and policymakers must take a better and more encouraging approach.
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Diabetes and Weight Loss: Study methods and analysis
The study made use of information from the Risk Assessment and Management Programme for Diabetes Mellitus (RAMP-DM) and the Electronic Medical Record system of the Hong Kong Hospital Authority.
They studied 37,326 people diagnosed with type 2 diabetes from 2000 to 2017. To see if diabetes improved, we looked at their HbA1c levels, a measure of blood sugar, and checked their weight changes one year after diagnosis.
Researchers analyzed the weight changes related to diabetes. They paid attention to factors like mortality, relapsing blood sugar levels, and diabetes remission.
Their overall conclusion was that losing weight in the first year after diagnosis was associated with a higher chance of getting rid of diabetes.
For better outcomes with diabetes, the study suggests early weight management interventions.
To ensure the findings were reliable they also conducted additional analyses which focused on particular groups among all subjects and performed sensitivity tests to assess the validity of the results.
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Diabetes Remission with Weight Loss:
Remission is generally defined as an A1C of less than 6.5% (the cut-off used to label a person as diabetic) without using medications to lower blood glucose.
Diabetes remission is not uncommon. Up to 80% of the patients who have had a weight loss surgical procedure such as a gastric sleeve or gastric bypass go into diabetes remission.
Weight loss not only helps in diabetes remission, but it also lowers the risk of complications associated with diabetes.
However, not everyone should undergo weight loss surgery. Following a healthy low-calorie diet to maintain a negative calorie balance is equally important and effective.
Exercise is another great way to become active, feel more energetic, and burn calories easily in a healthy way.
Next, obese patients with diabetes should ask their healthcare providers to manage their weight along with diabetes.
Changing medications like Glipizide or Glimepiride to Jardiance, Farxiga, Ozempic, or Mounjaro is too easy if insurance plans allow as these novel diabesity medications are too costly.
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The bottom line:
While losing weight make sure you don’t rush and be consistent with whatever method you choose. Optimize your portion sizes to reduce the chance of fat deposition and match it with your physical activity.
Immediately consult with your healthcare physician if you experience any side effects. Avoid hidden allergens in foods by carefully reading labels if you use ready-to-use foods.
