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A healthy weight is key to better blood sugar control

ARTICLESourced from Apollo 24/7 (1 December 2020)
A healthy weight is an important indicator of overall health. For people affected by diabetes, maintaining a healthy weight is even more crucial as obesity leads to disease progression and increases the risk of heart diseases and other complications. Hence, diabetic people should aim to maintain a healthy weight.
If overweight, even a small amount of weight loss can improve insulin sensitivity and help diabetics achieve better blood glucose control. Weight loss can lower cholesterol, blood pressure, and decrease the risk of developing diabetes-related complications. It can also reduce the dose of medication in such individuals.

What is a healthy weight?

Two tools can be used to estimate a healthy weight – body mass index (BMI) and measurement of the waist. When the BMI method is used, a healthy weight is one which falls between 18.5 and 24.9. A person with a BMI of 30 and above falls under the ‘obese’ category. BMI is simply a measure of body fat based on weight and height.
The second way of determining healthy weight is by measuring waist size or waist circumference. Waist sizes less than 35 inches in women (except for pregnant women) and 40 inches in men indicate a healthy range. Unlike BMI, waist size can determine tummy fat which elevates high blood pressure, heart disease, and type 2 diabetes,

Benefits of maintaining a healthy weight in people with diabetes

  1. Improves insulin resistance – Diabetes and obesity go hand in hand. Fat tissues in obese people release higher levels of non-esterified fatty acids, hormones, glycerol, and pro-inflammatory cytokines. This may result in insulin resistance and increased blood sugar. Weight loss can improve insulin resistance and keep blood sugar in check.
  2. Increases insulin production – In people with excess abdominal fat, the fat cells release molecules that can be harmful to the pancreas thereby lowering insulin production. Hence, such individuals should aim to reduce weight, especially abdominal weight, to minimise the harmful effects on the pancreas.
  3. Improves pancreatic function – The bodies of overweight people require 2-3 times more insulin than those with a healthy weight. This makes the pancreas work harder to make up for the increased demand. As a result, the pancreatic tissue gets damaged, reducing the number of insulin-producing cells. This causes a decrease in insulin secretion leading to increased blood sugar levels. Taking measures towards maintaining a healthy weight can help restore the function of the pancreas and control blood sugar.
  4. Reduces sleep apnea that improves diabetes – Obesity is also a risk factor for obstructive sleep apnea, a sleep disorder characterized by abnormal breathing during sleep. With sleep apnea, managing diabetes becomes difficult as it causes more carbon dioxide in the blood leading to insulin resistance. Loss of sleep also has other effects that raise blood sugar levels. These include hormonal disturbances that increase hunger, poor diet, and lethargy leading to decreased physical activity.
  5. Lowers HbA1c levels – Weight loss improves insulin sensitivity, and this is directly correlated to the decrease in HbA1c levels (average blood glucose levels over the last 3 months). Maintaining a healthy weight through diet and exercise is found to lower HbA1c levels.
  6. Lowers the dose of diabetes medication – A healthy weight can improve insulin resistance and help maintain stable sugar levels. This can help to lower the dose of medication to control high blood sugar.
  7. Decreases the risk of high blood pressure and cholesterol – Excess weight is associated with high blood pressure and high cholesterol, which are common in people with diabetes. These factors are linked to coronary artery disease that causes damage to the blood vessels supplying nutrition to the heart. Studies show that a weight loss of 5-10% significantly lowers the total cholesterol, LDL (low-density lipoprotein) or bad cholesterol, and triglycerides.
  8. Lowers the risk of cardiovascular diseases – In people with type 2 diabetes, the fat cells in the body are enlarged and stressed. These fat cells release molecules that cause inflammation and fatty deposits called plaques in the arteries. The plaques can cause hardening and thickening of the arteries leading to cardiovascular diseases. Physical activity and weight loss lower insulin resistance and the levels of inflammatory molecules in the blood. This helps to prevent or delay cardiovascular complications.
  9. Improves mobility in diabetic people – People with diabetes often suffer from bone and joint issues that limit their activity. An increase in weight and a decrease in physical activity are the major causes of mobility-related problems. A reduction in 1% body weight is known to cause a 7% decrease in mobility issues.

How can people with diabetes maintain a healthy weight

  • Plan meals with the right amount of carbohydrates like brown rice or whole grains, fruits, and vegetables. The diet must also include beans, nuts, milk or other dairy products, healthy fats, and oils.
  • Choose carbohydrates containing vitamins and minerals that raise blood glucose slowly and only slightly.
  • Control portion sizes, the amount of food on the plate or bowl. Keeping the portion sizes moderate will help lower calorie intake.
  • Skipping meals to cut down calories is not advisable as it may lead to making poor food choices at the next meal. It can also alter blood glucose levels.
  • Stay physically active. Aim to get at least 150 minutes of moderate-intensity physical activity and 2 – 3 sessions of resistance exercise in a week.

Conclusion

Weight loss and lifestyle changes can have a great impact on blood glucose control. Eating healthy, watching the portion size of meals, and being physically active helps maintain a healthy weight. People with diabetes should also test blood glucose levels frequently to monitor the progress of their weight management plan. A healthy weight not only helps manage diabetes better but also prevents complications associated with it.
For any queries related to diabetes, speak to an endocrinologist or a diabetologist.

References:

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