What is the effect of losing weight on Type II Diabetes?

In My Humble Opinion
1

I was going to post this question in Wesley Clark’s thread about a sugar filter for out of control Diabetics. But no matter how hard I tried, it always seems to be end up as thread hijacking to me. So, I decided there was no alternative except to start a new thread. However, if anyone would like to comment on a sugar filter or other medical device or otherwise reference Wesley’s thread, that would certainly be OK with me.

I was first diagnosed with Type II D in 1995. At that time I weighed about 210 pounds and a friend of mine kept telling me about the importance of losing weight for my D. But the doctor I had at that time never said hardly anything about that.

I got a new doctor about ten years ago and he kept telling me about the importance of losing weight. But he was very gentle about it. He was not at all nagging. His style was just “gentle persuasion”. He just kept finding different ways to pressure me. He would say things like this, “There is nothing else you could do that would have any better effect on your D than losing weight. If you just lost a little weight, that would do you more good than any medication or any kind of D pump or other device. Nothing would be better for your health than losing weight. Even if you only lost a little weight, that would extend your life and prevent you from getting all kinds of serious health problems. Losing weight would improve your overall health more than anything else you could ever do”.

The poor guy seemed to be driven almost to the point of tears as he would tell me that he just couldn’t understand why he kept telling so many of his patients with D about the importance of losing weight, but almost none of them did. Well, he finally changed gears and tried to explain to me what the effects would be to my lifestyle. Instead of just talking in generalities, he started talking about specifics - like losing my eyesight or having my legs or other limbs amputated or what it would be like to suffer kidney failure. He asked me, "How would you like to go to the hospital every other day and spend several hours hooked up to a dialysis machine? What impact would that have on your lifestyle? Well, that did the trick. Shortly after he made that change I went from 210 pounds to 160 pounds and thank God, I have kept it off for almost one year now. I know that one year is not much time when compared to the amount of time other people have kept off their weight loss. I’m just trying to live one day at a time and keep it off.

However, I now have a new problem that is almost worse than my original problem and it seems so absurd that I just can’t find any way to tell you about it. I spend most of my time now wishing I had never lost the weight in the first place. I may be willing to tell you about it in a few days or something. It is just so stupid, you just wouldn’t believe it. But if you want to know, I’m sure that I will tell you eventually. This doctor just seemed so happy that one of his patients finally took his advice that he now seems to have gone bonkers (gone overboard). You have no idea how frustrated I feel. Fuck!

But I’d like to ask people with D, what do you think about the effect of losing weight on D and have you tried to lose it? If you have been unable to lose weight, what do you think is the reason?

How important do you think losing weight would be as compared to other factors or physical devices? Has any doctor tried to tell you about the importance of losing weight? If so, I’d just love to hear what they told you.

2

Losing weight brought my blood sugar levels down to where they should have been prior to Type II. Weight control and exercise are the key, IMHO.

3

Very glad to hear that, Muffin. Congratulations. Good for you.

I live alone and many of the Diabetes experts I have consulted say that one of the best things to do is to get some exercise and to do that regularly. They say one of the keys to that is to have an “exercise partner” like a spouse or another Diabetic.

I don’t do much exercise although I do walk up the stairs in my apartment building every night. That has helped enormously with my back pain. One of the nurses I know, has told me several times a nice slogan they use. She says, “Motion is lotion”. meaning that regular exercise goes a long way towards easing physical pain. Seems to work for me. But I do about 90 percent wt loss and only 10 percent exercise. Maybe I need a spouse.

4

Once you have been diagnosed with diabetes, you are considered to have the diagnosis for the rest of your life, even if your blood glucose levels can be kept normal without insulin or medication. Many people who developed type II diabetes after becoming overweight, if they lose weight and keep it off, can keep their blood glucose under control with a healthy lifestyle only. (Insulin is a different matter–once you’re dependent on exogenous insulin, you can generally never go back.) Such people still officially have diabetes, it’s just being controlled by diet and exercise alone. So, if you are overweight, losing weight will definitely benefit you in terms of diabetes, in addition to having a host of other health benefits as well.

I’m really curious what you’re new problem is that’s making you wish you’d never lost weight.

5

Fat, the substance, is the drunken uncle at the family reunion. He may be a bit of a loudmouth and pick the occasional fight, but he makes a hell of a margarita and he’s rich, so you’ve got to invite him in case you’re in his will. You need some fat in your diet and you need some fat in your system, but past a certain point, it’s too much of a good thing.

Fat, the condition, is an indicator of a number of metabolic processes and life choices. Some of the processes you have a little control over, and most of the choices you have a lot of control over. The doctors who have tried to get you to lose weight have skipped a very important part of the discussion: Rather than just saying you need to lose weight because a big number pressing against the bottom of your feet is bad, they should have pointed out that in order for you to lose weight and keep it off, you need to make some changes.. You need to pick a different diet and stick with it. You need to change your exercise levels and stick with it. You need to change a bunch of things and stick with those changes in order to lower your weight, and those changes will help keep you alive.

In my own case, I lost 25 pounds in 2 weeks when I became a diabetic. Over the next year or two I lost another 25 pounds. When I got down to 145 (which I haven’t weighed since I was a skinny nerd in high school), they put me on insulin and I slowly gained some of the weight back. I have never been able to get my A1C below 7, regardless of diet, medication or exercise.

6

I’m just curious by the way, I have a friend who is around 55 years old and has a very pronouced “pot belly”. He was feeling very sluggish the other day and it got to the point he felt the need to get to a hospital. They tested his blood sugar and it was 18.0.

I was floored. I figured that was high enough such that he should be dead. The highest mine has ever been was 11.0. But with medication, it got down to 5.0.

Anyway, my friend saw a doctor (up until that time he had been taking all his advice from the wife of a pharmecutical’s assistant - if you can believe that).

7

Thank you for your input. It sounds completely correct to me. My current problem is a long story. I will try to answer. But I think it would be much better if I took some time and composed my thoughts and then wrote my post offline.

But since you ask, I feel like I’d like to comply.

I originally went to my new doctor because I suffered a some terrible back pain due to an accident I had many years ago. The pain was close to the most painful experience I had ever had - namely a dislocated shoulder.

Anyway, this new doctor prescribed - Not Oxy Contin - but the small form, I forge the name. Maybe it starts with “P”? Oh. Percoset and Percodan.

Anyway, over the course of several years, I got a tolerance to the pain medication and eventually, slowly but surely, he kept increasing the dosage until my pharmicist told me that he had only ever seen one other person who was taking such massive doses of that pain med. By that time, I had graduated from about 15 or 20 mg of Percoset to huge amounts of Oxy Contin.

Well, one of the things my doctor kept telling me was that if I lost weight, it would reduce my back pain to the point where I would not need as much pain med. OK. Fair enough.

Well, after I lost all the weight he was so happy. He told me he was real proud of me and it was now time for him to slowly but surely reduce the amount of pain meds I was taking.

But, my back pain did not decrease and reducing the pain meds have just made the pain intolerable. I get a renewal every 4 weeks and the last time, I spent about 6 days straight lying in bed suffering from excruciating pain. No matter how much I have begged and pleaded with him, he keeps telling me not to worry and that it will get better - all the while he keeps reducing the amount of pain meds. Because of this, my life has become a living Hell. I would be happy to stuff my face and put all the weight back on. But I’m pretty sure if I did that, he would not increase my pain meds.

So, I don’t know what to do.

There is plenty more to this story but it would probably be best to discuss it privately. I don’t think the rest of this forum would be interested.

Sorry. I gotta go lie down now.

8

Hie thee to a orthopaedic specialist.

9

Muffin,

Sorry I should have been able to figure out what you meant when you entered,

“Hie thee to a orthogaedic specialist.”

Did you mean to say, “Get thee to a orthopaedic specialist.”

Thanks.

10

Yes.

11

Is your doctor an endocrinologist? If not, you should be seeing one . . . along with an orthopedic specialist for your back.

12

Your doctor sounds a little nutty.

13

I have lost about 60 lb since I was diagnosed with diabetes nearly 10 years ago. My blood glucose level is about 5.5 (= 99 in the US) and A1C is around 5.5%. Those two numbers, although entirely different dimensionally, seem to always be about the same. My physician DIL tells me that they are too low for someone my age. Her reading of the latest research is that people my age do better if they are around 6.5, even 7. She wants me to talk to my doctor about taking me off metformin. On the other hand, she thinks I should keep the weight off (but not lose more) and continue regular walking, since again, slightly overweight (BMI around 27) seems beneficial.

14

I’m a thin, lightweight person - always have been - eat little sugar or refined carbs, yet I have high blood sugar.
I wonder if losing weight helps your blood sugar if you are heavy, but* being thin all along does not help your blood sugar? That is, it’s the losing-something *part that does the trick?
But that’s like claiming that smoking but then quitting is better than never smoking at all.

15

Maybe you should find a new doctor.

16

I think this may be an instance where association and causation may be being confused. In particular, yes, low glucose levels and low A1Cs can be associated with worse outcomes overall in type II DM. However, “the thinking” is that applies only when they are so low as a result of either insulin use or sulfonylurea use (eg. glyburide), with both those particular treatment modalities potentially causing (possibly occult) episodes of hypoglycemia (low blood sugar).’

However, since metformin does not cause hypoglycemia (in even overdose), I do not believe the results your DIL are referring to are relevant in your case.

(NB - not only is hypoglycemia per se dangerous, but the body’s response to it causes bursts of adrenalin and it is the latter (possibly in tandem with the low sugar) that can kill (especially an older, type II diabetic with a poor circulation)

17

I have been to a few different doctors and this doctor is head and shoulders above the others. If it sounds like he is not up to snuff, that is probably my fault in the way I described him.

Let me tell you one brief example. Last year I found myself severely addicted to modern nasal sprays. It turns out this is a very common problem and there are several threads on this board about it. Many people develop this problem.

The current nasal sprays sold in pharmacies come with a warning. But that warning is not clear. If you use a modern nasal spray more than 4 days in a row, you will become severly addicted. Let me know if you can’t find any of the threads describing that problem. There are about half a dozen on this board.

Well, I went to another doctor for some help with that addiction because my current doctor was out of town. This other doctor listened to me for about 15 seconds and then started talking and would not stop talking despite the fact that I tried to interrupt him several times to tell him that I didn’t think he understood. Here is what he said.

"Well my boy (I am 60 years old and he is about 40), sounds like a clear case to me of vitamin deficiency. What you need is to get yourself on a daily regimen of multi-vitamins. I will write you out a list of what to get. But that is your problem. He then began to write a list.

I wanted to just stand up and tell him that he was out of his bleeding mind and he should find a new line of work. But I didn’t want to get a reputation among doctors as a problem patient. I decided that I had already wasted the afternoon so I would just listen to him and see how bad he was. He was terrible.

I have talked to some other people in my city and there are plenty of wack jobs like that practicing medicine today. My current doctor is actually very well educated. He really knows his stuff. I have tested his knowledge several time and he really knows what he is doing. So, I’m just kind of stuck. I guess I really don’t know what to do.

But I thank you all for listening and I truly do appreciate your advice. I found some really good advice here from some people that I have corresponded with via PMs and I’m going to take that advice.

Thanks again.

18

I had gastric bypass surgery 3 years ago, and went from 270 pounds to 190. My diabetes (type 2, diagnosed around 1999) meds went from 3 very expensive ones to an almost-free dose of metformin. I feel great and can easily run further than ten yards without losing my breath – yes, ten yards was my limit before I lost weight, sometimes even five yards. But now I can go perhaps a tenth or even a fifth of a mile.

I was very fortunate to have experienced almost no downsides to this, but I CAN understand that you might not be so lucky. I am much more sensitive to cold than before. All my life people joked to me that my fat insulated me, and I never understood that, because the nerve cells are on the surface of the skin, so fat shouldn’t make a difference. But now I understand that it DOES help maintain internal temperatures.

Similarly, all the padding is gone. Bones are much closer to the surface, so bumps and falls hurt more than it used to. Could this have anything to do with your back pain? If your back is worse because of the lack of cushioning, then I say it is okay to blame it on the weight loss. But do consider the possibility that the timing is a mere coincidence, and that other factors caused your back pain.

Good luck!

19

There are different causes of type II diabetes. The way that weight often gets involved is that the extra fat molecules floating around in your body block off some of the insulin receptors in your cells. This makes your pancreas work harder to produce enough insulin to properly regulate your body’s blood sugar levels. At some point, your pancreas gets overworked and the cells that produce the insulin start to die off. These cells are never replaced. Once they are gone, that’s it. When they are damaged to the point that they can no longer produce enough insulin, then your blood sugar is no longer able to be properly regulated and now you have type II diabetes (that’s one way you can end up with it, anyway).

What happens when you lose weight is that all of those fat molecules stop blocking the insulin receptors. This eases the load on your pancreas. Even though your pancreas may still be permanently damaged, it may be able to handle the easier load and you may need less medicine to keep your blood sugar in check or you may even be able to go completely without meds. It all depends on how much damage was done to your pancreas while the extra fat was there.

A lot of other things factor into it. Some people, just due to genetic luck or whatever, happen to have a greater number or a lesser number of available insulin receptors on their cells. Those that have fewer receptors are more likely to have problems when they gain weight simply because as the fat starts blocking the receptors then they have even fewer available. Someone with more receptors could gain as much weight, or maybe even more, and not develop diabetes because they have plenty more receptors that still work. Some people may have stronger pancreases to start with too. This is why (or at least partially why) some folks gain a lot of weight and don’t get diabetes and other people gain less weight but end up with it.

There’s a lot more that goes into it, and IANAD so I don’t pretend to understand anywhere near all of it, but that’s basically how weight comes into play and how losing weight can improve your sugar levels.

A lot of folks like to say that they’ve lost weight and “cured” their diabetes. It’s probably better to say that they’ve managed to cure their symptoms and have their disease under control, because the damage done to their pancreas is permanent. It’s just that at the lower weight with less fat molecules blocking their insulin receptors, their damaged pancreas is able to fully regulate their blood sugar without requiring meds. The damage to the pancreas is still there, though, so it’s not really a “cure”.

20

Since the OP is asking for opinions, let’s move this to IMHO.

Colibri
General Questions Moderator