Why does obesity occur in diabetes mellitus? Losing weight and maintaining weight in diabetes Obesity in diabetics has its own characteristics

01/11/2019 | admin | No comments yet

Nutrition for diabetes and weight loss

What is the difference between type 1 diabetes and type 2?

There are more and more diabetics around the world every year. This diagnosis is given to people who have chronically elevated blood glucose levels. If there is an energy reserve, the cells of the sick person’s body do not receive nutrition, and metabolism suffers. Such patients with decompensation cannot lead a normal life. As you know, there are 2 types of disease: how to distinguish the first type from the second?

Development mechanisms

Modern science has studied in detail the mechanism of development of diabetes mellitus. The same disease develops in two different types. Accordingly, the treatment tactics for the etiological factor are completely different. So, there are type 1 and type 2 diabetes. Diseases differ in mechanism, causes, dynamics of development, and the nature of the manifestation of symptoms. Knowing the mechanics of the disease, prescribing treatment is much more effective.

In order to understand the differences between one diabetes and another, it is necessary to analyze in detail the mechanism of glucose uptake by the body's cells.

Glucose is an energy source for nutrition at the cellular level. When it enters a cell, it is broken down to release energy. The processes of oxidation, nutrition, and utilization in the tissues of the body occur intensively. To penetrate cell membranes, glucose needs a conductor. Insulin serves as such in the human body and other living beings.

Insulin is a protein substance, a hormone that is produced in the pancreas. More precisely, in beta cells, or islets of Langerhans, it is released into the blood, its level is maintained at a constant level, this is normal. Upon arrival, food is digested in the gastrointestinal tract. Sugar then enters the bloodstream in a digestible state. The task of glucose is to provide energy reserves for other processes:

• transport;
• divisions;
• cellular respiration;
• immune processes;
• creating a stock;
• detoxification.

Glucose is unable to penetrate the cell wall due to its chemical structure. The molecule is heavy and has many hydrogen atoms. To pass to the mitochondria, carry out the phosphorylation process, and nourish the cell, it needs to gain access. It is insulin that makes the membrane permeable to such complex substances, that is, the membrane becomes glucose-sensitive and allows sugar to enter the cell.

Diabetes mellitus type 1

From all of the above it follows that with a lack of insulin, the cell does not receive nutrition for its vital functions and diabetes mellitus develops. As scientists have found, type 1 diabetes is insulin dependent. The amount of insulin produced by the gland is sharply reduced for several reasons.

1. Heredity. It has been established that the gene for insufficient insulin production is inherited.
2. Physical problems with the pancreas: operations, tumors, injuries.
3. Toxic effects: hazardous industries, alcohol, viral, autoimmune processes.

Most often, several factors are combined: hereditary, autoimmune or toxic. Type 1 diabetes mellitus is a disease that depends on the level of insulin production, that is, insulin-dependent. You can suspect this type of disease in a patient based on fundamental signs:

• young or even childhood;
• blood glucose levels are significantly higher than normal;
• weight loss, maybe even quite dramatic;
• disorders of the central and peripheral nervous system;
• complications arise secondary.

As already mentioned, type 1 diabetes is an insulin-dependent disease, usually genetically determined. Pathology occurs at an early young age, and the percentage of cases among children is growing. Drugs that lower blood sugar levels do not work. Treatment is only with insulin injections. These can be prescribed up to five times a day.

The supply of insulin from the outside alleviates the patient’s condition and allows the body to carry out all the necessary metabolic processes with natural precision. There are several pitfalls here.

1. It is necessary to constantly monitor blood sugar levels: several times a day.
2. Carefully, very carefully select the dose of insulin.
3. Frequent injections lead to muscle atrophy at the injection site.
4. Possibility of infection of injected loci, since patients with diabetes have reduced immunity.
5. The body gets used to one type of drug; replacing it with another, for example, for financial reasons, can be fraught with unpredictable consequences.

The problem of this type of diabetes is also the fact that children and adolescents often suffer. A developing, young organism is subject to changes of a more severe nature. There is practically no organ or system that is not affected by the disease.

Children lose their vision, the hormonal system suffers from insufficient energy supply, therefore, there is a delay in physical and sexual development, and muscle failure. The constant need to administer insulin drugs limits the child’s freedom of action, the ability to travel and study.

Diabetes mellitus type 2

This disease is also diabetes mellitus, but develops completely differently. If in the first case it is genetically or physically caused by insufficiency of the insulin apparatus, then there are differences with type 2 diabetes. The second type of disease has the following symptoms.

1. Appears after the age of 35–40 years.
2. The background is nutritional pathologies: obesity, bulimia.
3. There are provoking factors: nervous tension, overeating, alcohol abuse, smoking.
4. Blood insulin levels are normal or even elevated.

In order to develop type 2 diabetes, a lot of time must pass, during which the patient regularly overeats, especially fatty, sweet, and starchy foods. Nervous tension is accompanied by the release of stress hormones into the blood, which force the body to work several times faster, energy reserves are used up in emergency mode.

If this situation is repeated regularly, then imperceptibly, gradually the cells cease to perceive insulin and become insensitive and resistant to it.

Glucose enters the blood, but insulin also circulates in the bloodstream at normal levels. However, cell membranes do not react to this presence properly; glucose does not enter the cellular space. To alleviate the patient's condition, in this case, hypoglycemic drugs are used. They regulate the amount of blood glucose, bringing it to an acceptable level.

The differences for patients between the first and second types are that with the first type of disease there is almost no alternative to insulin administration. In the second type of disease, drugs that reduce sugar to normal levels are the basis of treatment.

Principles of diabetes treatment

It should be noted that today diabetes mellitus is a lifelong diagnosis. Unfortunately, there are no cases of cure for this disease. However, there is absolutely no reason to despair upon hearing this diagnosis. It is necessary to put discipline in the first place, then the highest results in ensuring the quality of life are achievable.

Every patient should remember that it is very important to monitor blood glucose levels. He must learn to do this on his own, at home. Fortunately, there is a large selection of portable glucometers. Determining the type of diabetes is the basis of treatment. Only a doctor can make a correct diagnosis, prescribe an etiological treatment, and most importantly, choose the dose of a hypoglycemic drug or insulin with maximum accuracy.

Diabetes mellitus of both types implies the appearance of quite serious concomitant diseases and complications over time. On the part of the visual analyzer, a cataract appears, which develops faster than in people who do not suffer from diabetes. A terrible complication of the course of the disease is atrophy of the optic nerve, up to complete loss of vision.

Thrombophlebitis, varicose diseases lead to a deterioration in blood supply, this is especially pronounced in the lower extremities. There is even the concept of "diabetic foot", which is important for diabetic patients. It is necessary to monitor the condition of the skin of the legs especially carefully, because of the loss of sensitivity, the skin of the feet is often injured, macerated, the wounds do not heal for a long time, which greatly complicates the daily life of patients.

Frequent mood swings during the day are explained by the lability of the nervous system. Patients need prophylactic sedatives.

Prevention

You can try to avoid diabetes. Especially if there are patients with such a diagnosis in the family, you need to understand that there is a genetic tendency to develop type 1 diabetes. Maintaining a normal, regulated lifestyle, balanced nutrition, rational distribution of physical, especially emotional stress, regular monitoring of one's health, playing sports - all these are means of preventing diabetes mellitus of both the second and first types.

Weight in diabetes

Diabetes mellitus is an endocrine disease that can affect the functioning of the entire body. In fact, it is a destructive disease that threatens the occurrence of dangerous complications. The disease affects a person’s body weight, so controlling weight in diabetes is necessary. In some cases, diabetes causes weight loss, while in other people, on the contrary, weight gain occurs. What is the reason for such changes in the body?

• Causes of weight loss in type 1 diabetes
• Causes of weight gain in type 2 diabetes
• How to gain weight with diabetes?
• How to lose weight with diabetes?
• Physical training
• Operation
• Nutrition for type 1 diabetes
• Nutrition for type 2 diabetes
• Weight loss medications for diabetes
• Siofor
• Glucophage
• Conclusion

Causes of weight loss in type 1 diabetes

Weight loss in diabetes mellitus is due to the following reasons:

• malnutrition;
• impaired absorption of food;
• active breakdown of proteins, fats and carbohydrates;
• high energy consumption.

A characteristic sign of diabetes is weight loss along with good and plentiful nutrition. Stressful situations and psychological problems can aggravate the situation.

Weight loss is a characteristic symptom of type 1 diabetes, in which the body does not produce insulin. This is a consequence of an autoimmune reaction in which pancreatic cells are perceived as foreign.

Lack of insulin is another reason for weight loss. In this case, the body blocks attempts to use glucose as a source of energy. The body needs another source of energy and for this purpose it begins to use subcutaneous fat.

In diabetes, the water-salt balance is disturbed, a paradoxical situation is observed: a person loses weight, but at the same time he retains an increased appetite. The body spends a lot of effort and energy on breaking down food, so it still doesn’t gain weight.

As for type 2 diabetes, in this case the body is more resistant to insulin, which is why weight loss is less noticeable. Here we see a different picture – patients, on the contrary, gain weight.

Causes of weight gain in type 2 diabetes

Factors that lead to obesity in diabetes are associated with genetic predisposition, lifestyle and age. According to statistics, in eighty to ninety percent of cases, patients with type 2 diabetes are diagnosed with obesity.

Weight gain occurs in people who take insulin. The following pattern is observed: the more insulin you take, the more glucose is absorbed by the cells of the body. It turns out that glucose is not eliminated from the body, but is converted into adipose tissue, which is the cause of weight gain.

How to gain weight with diabetes?

If you want to bring your weight back to normal, then first of all change your diet:

• eat more often, but in small portions. Break your usual three meals into smaller ones;
• The foods consumed must have high nutritional value. Eat more vegetables, fruits, dairy products, cereals, nuts, lean meats;
• Do not drink liquids immediately before eating. Maintain at least a half-hour interval;
• Use the following foods as snacks: avocados, dried fruits, cheese, nuts;
• increase your carbohydrate intake. Here we are talking about complex carbohydrates, not easily digestible ones. “Good” carbohydrates will provide the body with energy, and there will be no sugar spikes: whole grains, legumes, yogurt, milk;
• Fats will also help you gain weight. There are polyunsaturated and monounsaturated fats here, but in no case trans fats. Eat nuts, seeds, avocados. In cooking, use olive and rapeseed oil.

It all depends on the mood of the person, so it is important to set a goal and go towards it:

• first, find out what the weight should be in your case. Because many people have a vague idea of ​​what a healthy weight is, they strive for the wrong goals. Be sure to calculate your body mass index;
• control your calorie intake. If you want to gain weight, then food should be high in calories;
• moderate physical training. Exercise helps build muscle mass, which will contribute to weight gain. Appetite also improves after training.

Don't forget that if you make adjustments to your diet, then monitor your glucose levels. It is unknown how this or that change may affect your health. Talk to your doctor about the best steps to take to gain weight.

How to lose weight with diabetes?

To begin with, it is better to contact an endocrinologist or nutritionist. The diet must be clearly and competently outlined. Meals should be taken at approximately the same time.

If you want to normalize your weight, then eat foods with a low glycemic index:

• exclude fried, fatty, spicy, smoked, and alcohol from your diet;
• use sweeteners instead of sugar;
• reduce your intake of fats and carbohydrates;
• eat fried, stewed or baked food.

Separately, I would like to say about the role of fiber in the patient’s diet:

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• promotes better digestibility of carbohydrates;
• reduces the absorption of carbohydrates in the intestine;
• reduces glucose levels;
• cleanses the body of harmful substances.

The following foods are used as the basis for a diabetic's diet:

• cucumbers;
• cabbage;
• tomatoes;
• zucchini;
• pumpkin;
• Bell pepper.

As for fruits and berries, it is better to give preference to unsweetened varieties:

• apples;
• cherry;
• currant;
• plum;
• cranberry;
• cowberry.

Take a closer look at the list of foods that improve digestion processes:

• bread with bran and coarse grinding;
• cereals, except rice and semolina porridge;
• low fat soups and broths;
• low-fat dairy products;
• lean fish;
• greenery.

Weight loss should be smooth, no more than five kilograms per month. Rapid weight loss is dangerous for diabetics.

Physical training

Physical exercise has a positive effect on the diabetic body:

• increase muscle activity;
• increases the body's sensitivity to insulin;
• facilitate the transport of glucose into cells;
• reduce the need for insulin;
• maintain normal glucose levels.

Before you start exercising, be sure to consult your doctor. If intensive training is allowed with type 2 diabetes, then with the insulin-dependent type it is not. In this case, you should start with an active lifestyle, walking, cycling.

Operation

Surgery is a last resort in the fight against excess weight. In some cases, only such a radical measure can help get rid of obesity and cope with the problem of overeating.

Nutrition for type 1 diabetes

Patients are prescribed a low-calorie diet. Let's consider the basic rules of nutrition for type 1 diabetes:

• eliminate simple carbohydrates and completely eliminate sugar;
• It is forbidden to consume fruit juices, grapes and raisins;
• You should be very careful with sweet fruits and dried fruits;
• It is mandatory to keep a count of bread units when eating vegetables and fruits.

Nutrition for type 2 diabetes

Patients are prescribed a subcalorie diet. There are certain rules in dietary nutrition for type 2 diabetes:

• animal oil, margarine, milk, cream, sour cream, sausage, smoked meats should be sharply limited, or better yet completely eliminated;
• For protein foods, it is better to give preference to low-fat fish, chicken and turkey;
• consume more whole grain cereals, as well as vegetables and fruits;
• Limit your consumption of offal and eggs.

Weight loss medications for diabetes

To normalize weight, weight loss pills are produced. Such drugs have a number of advantages, but they also have contraindications and side effects. That is why, before starting treatment, consult your doctor and strictly follow the prescribed dosage.

The most popular drug is Siofor. Glucophage slow-release tablets have a greater effect on the patient, but they are more expensive.

Such drugs increase the sensitivity of body cells to insulin, which leads to a decrease in its amount in the blood. They prevent the active accumulation of fat and facilitate the process of normalizing weight.

Siofor

The active ingredient of the tablets is metformin. The drug is taken with food. Siofor reduces glucose levels. Doctors usually prescribe the drug to diabetics whose disease has developed due to obesity.

Siofor performs two important functions:

1. Restores insulin sensitivity.
2. Reduces weight.

As can be seen from the reviews, after starting to use the tablets, the craving for sweets decreases. Besides. Siofor is a good protection against attacks of hypoglycemia, which can pose a danger to the patient’s life.

Even those patients who do not follow a diet lose weight with Siofor, albeit not so quickly, but there will be results. It is worth remembering that the tablets are intended specifically for diabetics. If healthy people start taking them, it will lead to metabolic disorders.

Treatment begins with a minimum dosage of 500 mg. If you find it difficult to give up sweets in the evening, take the medicine before bed. If you are not on a diet, you can take Siofor at lunch. At the same time, do not forget about the risks of dyspeptic disorders.

If you are going to be doing a lot of physical activity, it is better to skip taking the pills. High temperature, shortness of breath, diarrhea - all this is a contraindication to the use of the drug. Siofor is not compatible with other weight loss drugs, as well as diuretics and laxatives. Pregnant women are strictly prohibited from taking the pills.

Glucophage

Take the tablets three times a day before meals. Glucophage reduces the absorption of carbohydrates and insulin levels. Taking the drug should be combined with a diet. Take the medicine in courses of no more than three weeks.

Pregnancy and breastfeeding are contraindications to the use of Glucophage. Experts do not recommend using the medicine for elderly people or those engaged in heavy physical labor. The drug is contraindicated for people with cardiovascular pathologies and kidney diseases.

Glucophage can cause side effects from the digestive tract: changes in taste, bloating, refusal to eat, even disgust. As the reviews show, the development of allergic reactions is possible. To avoid the development of such complications, strictly follow the prescribed dosage.

Urinalysis plays an important role in diagnosing diabetes. Experts pay attention to the specific gravity that protein and glucose increase. For example, an experienced doctor may suspect the presence of diabetes only by polyuria and a urine density reading of 1030-1035. Massive glucosuria can provoke an increase in relative density to 1040-1050.

A decrease in specific gravity indicates a decrease in the concentrating ability of the kidneys and polyuria. A decrease in density to 1005-1010 may indicate the presence of diabetes insipidus.

Conclusion

Diabetes mellitus affects the patient's weight. Thus, with the insulin-dependent form, in most cases, weight loss occurs, and with the non-insulin-dependent form, fat accumulation occurs. If you want to gain weight, eat high-calorie foods high in healthy fats and carbohydrates. If your goal is to lose weight, then clearly control the amount of calories you consume, as well as fats and carbohydrates. In any case, do not forget about prohibited foods, including fatty, spicy, fried, smoked foods.

Proper nutrition is the key to health not only for diabetics, but for every person. Think about your body today by eating healthy foods, and it will thank you tomorrow by giving you health and strength!

Weight loss for diabetes

• 1 Sharp weight loss with diabetes: causes and consequences
• 2 What is the danger?
• 3 What to do?
• 4 How to lose weight with diabetes and obesity?
  • 4.1 Diet for diabetes
  • 4.2 Foods and diabetes
  • 4.3 Drinking regimen for diabetes
  • 4.4 Should KBJU be taken into account?
  • 4.5 Sample menu for weight loss with diabetes

Rapid weight loss with diabetes is no less dangerous than rapid weight gain. Each of these pathologies poses a danger to the body, so if the scale needle deviates sharply, you should immediately go to the doctor. Weight in diabetes mellitus is subject to strict control. Physical exercise and a low-carbohydrate diet help you lose weight; thinness can also be treated with nutritional correction.

Sharp weight loss with diabetes: causes and consequences

Sharp weight loss in type 2 diabetes is caused by a cessation of insulin production. This hormone provides the body with energy reserves. When it is not enough, the body takes energy from adipose tissue and muscles.

You should definitely consult a doctor if you lose weight accompanied by the following symptoms:

• tingling in the legs or arms, legs become numb;
• decline in visual function;
• frequent urge to urinate, especially at night;
• strong thirst;
• peeling and decreased sensitivity of the skin, slow wound healing.

Another reason for weight loss is the development of anorexia nervosa in diabetics. Doctors are increasingly faced with this problem; women are most susceptible to it. An eating disorder such as anorexia greatly complicates the course of the disease. Therefore, more and more often, the doctor adds psychopharmacotherapy to the patient, as well as cognitive-behavioral psychotherapy, in the complex of measures for the treatment of diabetes mellitus. The consequences of anorexia in diabetes can be severe.

Obesity in diabetes appears almost always, because insulin contributes to the accumulation of fat. Extra pounds mainly accumulate in the abdomen, around the organs. However, diets do not give the desired results. It is important to understand that overweight itself can become a factor in the development of the disease. About obesity and diabetes, their relationship, options for dealing with extra pounds, read further in our article.

📌 Read in this article

The link between diabetes and obesity

Obesity in diabetics has its own characteristics:

• fat is deposited mainly in the abdomen and around the internal organs (visceral type);
• low-calorie diets are ineffective, after which there is a re-gain of even more body weight;
• in the blood, in addition to high glucose levels, the level of adrenal glands is also increased;
• deposition of fat not only under the skin, but also in the liver, which further impairs the metabolism of carbohydrates and lipids, increases insulin resistance (insulin resistance).

Excess weight not only increases the likelihood of illness, but also diabetic complications, contributes to an increase in blood pressure, and the progression of atherosclerosis.

All this explains the earlier appearance:

• with renal failure;
• with loss of vision;
• syndrome with threat of amputation;
• angiopathy with acute conditions (,) or chronic disorders of cerebral and coronary circulation.

Why is it so difficult for a diabetic to lose weight?

Excess calories in the diet lead to them being stored as fat. Fat tissue cells (adipocytes) increase in size and divide rapidly to create space for this storage. Large cells react poorly to insulin, and the formation of substances that cause inflammation increases in them. In turn, these compounds increase the resistance of insulin receptors and interfere with the action of the hormone in all other tissues.

Excess fatty acids formed during the use of fats destroy pancreatic cells and stimulate the formation of new glucose molecules in the liver. In obesity, liver tissue cannot bind insulin normally; it remains circulating in large quantities in the blood. Its excess further increases insulin resistance (tissue insensitivity).

Adipose tissue itself is capable of producing hormones. First of all this. It prevents:

• fat accumulation;
• attacks of hunger;
• overeating;
• excess cortisol in the blood;
• low cell response to insulin.

Watch the video about adipose tissue and the causes of obesity:

With obesity and diabetes, resistance to its action occurs. As a result, fat is deposited in muscle tissue, heart, pancreas and liver. The following also have an inhibitory effect on weight loss:

• tumor necrosis factor (inhibits the response of adipocytes to insulin and leptin);
• interleukin-6 (produced by fat cells of internal organs);
• low levels of adiponectin and its decline precede diabetes;
• resistin – interferes with the action of insulin and the absorption of glucose by tissues.

Therefore, adipose tissue is far from passive cells, and obesity is not a cosmetic defect, but a hormonal disease. In diabetes, their actions mutually enhance.

Without reducing body weight, glucose-lowering therapy is ineffective, and complications of the disease arise and progress in the body.

What will weight loss do?

If you reduce your body weight by just 7%, you can expect:

• reducing blood pressure, the need for drugs to normalize it;
• reducing blood glucose levels on an empty stomach and after meals;
• approaching normal levels of glycated hemoglobin;
• improving fat metabolism, reducing cholesterol and the risk of plaque formation in blood vessels;
• increasing life expectancy;
• prevention of tumor processes in the body, early aging.

Even losing 5 kg per year reduces the risk of prediabetes becoming diabetes by 60%.

Features of obesity correction in type 1 diabetes

Insulin promotes weight gain. Its main effect is aimed at storing fat and accumulating glycogen in the liver. In patients on insulin therapy, body weight naturally increases. When the concentration of sugar in the blood decreases, its loss in the urine decreases, since glucose is excreted by the kidneys only after the renal threshold has been overcome. As a result, all calories consumed are saved.

One of the risk factors for weight gain is a drop in sugar - an attack of hypoglycemia. Such conditions require emergency intake of simple carbohydrates (sugar, honey), which are high in calories and increase appetite. With frequent episodes, patients may significantly exceed the energy value of the diet. However, true obesity is extremely rare.

In order to reduce body weight, patients need to reduce the proportion of carbohydrates in the diet - reduce the daily amount of bread units. Accordingly, the calculated dose of the administered hormone will be low, fat will not accumulate in the body. In most cases, additional drug treatment is not required.

Treatment for type 2 diabetes

Approaches to weight loss are traditional, but there is one important feature. Diabetes requires a combination of lifestyle changes and medications, as they are not effective on their own.

Diet

Calculation of the required calorie intake is based on weight, height and activity level. On average, an adult man normally requires approximately 2500 kcal with a standard urban lifestyle, and for a woman - 2000 kcal. To reduce body weight, you need to subtract from 500 to 750 kcal from the calculated individual indicator, depending on excess weight.

The basic rules for building a diet include:

• the predominance of non-starchy vegetables on the menu - zucchini, cauliflower and white cabbage, cucumbers, broccoli, greens, eggplant, tomatoes, bell peppers. If possible, they should be fresh in the form of a salad; it should be eaten at least 2 times a day;
• To obtain protein, boiled fish, chicken and turkey fillets, cottage cheese 2-5% fat, fermented milk drinks (a glass per day) without additives up to 2%, seafood, egg whites are suitable;
• Porridge is acceptable once a day, boiled in water. Carbohydrate products should have a low glycemic index and not provoke sudden rises in sugar;
• you should give up fatty meat, all sweets, including diabetic ones, flour products, potatoes, bananas, grapes, store-bought juices, sauces, canned food, broths, snacks that stimulate appetite, alcohol;
• limit the menu to table salt (3-5 g), butter (up to 10 g), vegetable oil (up to 15 g), dried fruits (1-2 pieces), nuts and seeds (up to 20 g), bread (up to 100-150 G);
• Instead of sugar, stevia and Jerusalem artichoke syrup are used.

The result of a properly selected diet is a reduction in body weight by 500-800 g per week. A faster pace leads to changes in blood sugar, increased weakness, and digestive disorders.

If you cannot lose 0.5 kg, then fasting days are recommended once a week. They help speed up metabolism and increase the sensitivity of tissues to their own insulin. To carry them out, cottage cheese, kefir, fish, vegetables in the form of salad or soup without potatoes and cereals are used.

Physical exercise

One of the prerequisites for weight loss is an increase in the overall level of physical activity. It has been proven that dietary restrictions work better in men, and increased energy expenditure as a result of exercise works better in women.

If the goal is to lose weight, then therapeutic exercises, walking, swimming, and dancing should take at least 300 minutes per week. The initial intensity of training is determined by the patient’s physical fitness, and then a regular and gradual increase is recommended. At the same time, it is important to reduce the time spent in a static sitting position.

Pills

Although all the rules for constructing a menu and the benefits of physical education are known to all patients, in practice up to 7% adhere to them. Therefore, endocrinologists often prescribe medications that reduce body weight - Xenical, Reduxin, Saxenda. All hypoglycemic drugs are divided into groups according to their effect on body weight:

• neutral – Starlix, Novonorm, Galvus;
• slightly reduced - Metformin, Siofor, Glucobay;
• help lose weight - Victoza, Invokana, Jardins;
• increase weight - Insulin, Pioglar, Avandia, Minidiab.

When drawing up a treatment plan, it is taken into account that body weight also increases when using medications with antidepressant, anticonvulsant effects, hormonal contraceptives, and some antiallergic drugs.

Metabolic surgery

If the body mass index is extremely high (from 35), as well as the ineffectiveness of diet therapy and physical activity, the issue of surgery is considered. They are aimed at reducing the size of the stomach. A significant decrease in metabolic disorders was noted in 65% of those operated on; in the rest, it was possible to reduce the doses of medications for the treatment of diabetes.

What to do for fatty liver and diabetes

The condition of the liver is no less important for carbohydrate metabolism than the function of the pancreas. With excess body weight, its cells intensively produce new glucose molecules, which worsens the course of diabetes. The formation of glycogen reserves decreases, and the proportion of low-density lipoproteins involved in vascular occlusion increases.

To prevent fatty liver degeneration, the following are recommended:

• exclusion of simple carbohydrates and foods with a high glycemic index (desserts, sweet fruits, sugar, processed cereals, potatoes);
• building a menu based on vegetables and fish, some low-fat dairy and meat products are acceptable;
• physical activity at least 40 minutes daily.

The use of medications includes the following groups:

• hepatoprotectors (Essentiale, Gepabene);
• normalizing intestinal microflora (Laktovit, Linex);
• weight loss products (Reduxin-met, Victoza);
• alpha lipoic acid (Berlition, Thiogamma);
• ursodeoxycholic acid (Grinterol, Ursofalk).

Obesity and diabetes mellitus have common causes. Disorders of carbohydrate and fat metabolism complement and reinforce each other. Weight loss helps restore tissue sensitivity to insulin and prevent vascular complications of diabetes. With the first type of disease, you need to reduce the proportion of carbohydrates in the diet.

An integrated approach to treatment for type 2 consists of diet, physical activity, and medications. If ineffective, surgery to reduce the volume of the stomach is recommended.

Sudden weight loss is the main symptom of insulin-dependent diabetes. In the non-insulin-dependent form, patients in most cases do not lose, but rather gain, body weight. In this article we will look at why people with type 2 diabetes lose weight.

Weight loss

Attention! In the International Classification of Diseases, 10th revision (ICD-10), non-insulin-dependent diabetes is designated by code E11, and insulin-dependent diabetes by E10.

The cause of type 1 diabetes mellitus (T1DM) is not fully understood. T1DM is an autoimmune disease in which the body produces antibodies that are not directed against foreign substances or pathogens, but against cells or components of the pancreas. As a result, the body's immune cells attack the cells that produce insulin. When pancreatic cells are destroyed, the amount of insulin released decreases, which leads to increased glycemia. It is believed that hereditary predisposition and additional environmental factors may contribute to the onset of the disease.

Today, more than a hundred genetic markers are known that contribute to the development of diabetes. There is a connection between type 1 and type 2 diabetes. However, type 1 diabetes is less heritable than type 2. Hereditary factors are likely to have a decisive influence on the development of diabetes. 95% of type 1 diabetics carry predisposing genes for antibodies against insulin-producing cells in the islets of Langerhans. Immune blood cells (white blood cells) invade the insulin-producing tissue and cause inflammation in the pancreas. Inflammatory processes destroy the islets over several months or years. If 80-90% of the insulin-producing islets are destroyed, diabetes occurs.

Researchers suspect that infectious diseases may contribute to the development of autoimmune diseases of various etiologies. These include mumps, measles, rubella, and diseases caused by coxsackie viruses. Even people whose immune systems overreact to ultraviolet radiation are at greater risk of developing insulin-dependent pathology.

Some risk factors may increase the likelihood of developing T1DM:

• Too short a period of breastfeeding after birth
• Early consumption of cow's milk by children;
• Eating gluten-containing foods too early;
• Use of nitrylamines.

Recent research also suggests that damaged nerve cells in the pancreas may be involved in the onset of the disease.

Symptoms

T1DM most often affects children, adolescents and young people under 20 years of age. But even older patients can develop predominantly type 1 diabetes (LADA diabetes). The disease begins suddenly and is very difficult. In addition to the symptoms caused by increased blood glucose levels, serious complications (diabetic ketoacidosis or coma) may occur. In some cases, ketoacidosis can lead to the death of the patient.

The following symptoms may occur due to hyperglycemia:

• Excessive thirst (polydipsia);
• Frequent urination (polyuria);
• Dry skin;
• Weight loss;
• Fatigue;
• Blurred vision;
• Poor wound healing;
• Infections in the genital area.

Chronic hyperglycemia has adverse effects on blood vessels and the cardiovascular system (CVS). In T1DM, in addition to hyperglycemia, there is also absolute insulin deficiency. Therefore, the body's cells do not receive enough glucose. Insulin deficiency also disrupts fat metabolism. It often leads to heart attacks, strokes and a number of other indirect injuries.

As a result of impaired fatty acid metabolism, more substances can be produced that increase the acidity of the blood (lowering the pH value). This leads to the formation of acidosis, which can cause diabetic coma. In diabetics, the condition is called diabetic ketoacidosis, which is characterized by:

• Colic;
• Nausea;
• Vomiting;
• Deep breathing;
• Cloudiness or loss of consciousness;
• Smell of acetone (on exhalation or in urine).

Diabetic ketoacidosis can be life-threatening, so patients need to call an ambulance as soon as possible and be treated in an intensive care unit.

Severe hypoglycemia may occur when a very large dose of insulin is administered. Excessive concentration of insulin in the blood leads to an excessive decrease in glycemia. If your blood glucose drops below 50 mg/dL, your doctor says you have hypoglycemia.

The main causes of hypoglycemia:

• Too high a dose of insulin or other antidiabetic drugs;
• Low carbohydrate food;
• Alcohol;
• Vomiting or diarrhea;
• Weakness of the pituitary gland, adrenal glands or thyroid gland.

Signs of mild hypoglycemia include:

• Paleness, sweating, tremor;
• Flutter;
• Fear, nervousness;
• Tingling;
• Headache.

When hypoglycemia occurs, the brain is the first to be affected. Hypoglycemia causes irreversible damage to the nervous system within a relatively short time. Severe hypoglycemia leads to loss of consciousness, coma, or death.

With the help of glucose, the doctor can stabilize the patient's glycemia in a short time. Injecting glucagon into subcutaneous fat tissue can also rapidly increase blood sugar levels and reverse hypoglycemia.

Thanks to medical advances, women who suffer from diabetes can have childbirth without complications. It is important to understand that you can bear a child only if your blood sugar levels are well adjusted before pregnancy and remain within normal limits.

Pregnancy changes the body's metabolism. Insulin requirements continue to increase throughout pregnancy. Typically, pregnant women need five insulin injections. Diabetics need to check their blood sugar levels before and an hour after main meals to maintain glycemia in the normal range. If life-threatening hyperglycemia occurs, the pregnant woman should be hospitalized immediately. A diabetic coma usually ends in death for the unborn child.

Why do people with diabetes lose weight?

Do people with diabetes lose weight or gain weight? Chronic and uncontrolled hyperglycemia leads to nutrient deficiency in cells. The body tries to compensate for the lack of glucose by breaking down fats, which can lead to very rapid weight loss. Because glucose does not rise as quickly in T2DM as in T1DM, patients usually do not lose weight.

Sugar, or glucose, is the most important source of energy for the human body. Because of diabetes, the body's cells can no longer absorb sugar without insulin and use it to create energy. Instead, it circulates in the blood aimlessly. Patients develop severe weakness and fatigue.

Diabetics often lose weight very quickly, even though they eat a lot. The reason for this is that without insulin, the body's cells cannot absorb and burn sugar to produce energy. That's why the body looks for alternative sources of energy - it begins to burn fat, protein and muscle mass.

Often the weight decreases due to very frequent urination. The logical consequence of increased urination is that the body slowly loses fluid. Dehydration manifests itself as dry, cracked and itchy skin. Dry skin and mucous membranes, poor circulation and high blood sugar can in turn lead to infectious disorders. Even wounds that are difficult to heal can be a sign of diabetes. Poorly healing leg wounds can lead to diabetic foot syndrome and even amputation.

Fighting weight loss

Many people ask: how to gain weight with type 1 diabetes? Diabetics need to treat not anorexia, but the underlying disease. The main methods of treating sudden weight loss:

• Medicines: In diabetes, insulin is used, which, among other things, increases the patient's appetite. Proper treatment of diabetes will help increase appetite and prevent weight loss;
• Psychotherapy: Mental disorders such as depression can be treated with antidepressants. Cognitive behavioral therapy is often used to treat eating disorders;
• Surgery: In some cases, such as bile duct occlusion due to adhesions, tumors, or gallstones, surgery is necessary;
• Regular meals: It is recommended to eat at the same time every day to prevent anorexia;
• Movement: Exercise, especially outdoors, stimulates the appetite. Even a longer walk can help increase your appetite;
• Ginger increases appetite: it is recommended to drink ginger water throughout the day - it promotes digestion and appetite;
• Bitter taste makes you hungry: bitter substances stimulate digestion. It is recommended to consume half a grapefruit in the morning, and arugula or chicory salad at lunchtime.
• Seasonings: As we get older, our sensory abilities decrease and our sense of taste also decreases. Especially older people don't like food anymore. For this reason, the spice can improve appetite;
• Very often, weight loss is associated with stress. Relaxation techniques can help improve your appetite, from progressive muscle relaxation to meditation or tai chi.

Patients are interested in: how to get better with medications? Gaining weight using pills is not recommended. Pancreatin, some antidepressants and antipsychotics can cause a strong appetite. However, in the long term, antipsychotics can lead to pancreatitis, worsening diabetes (as is the case with Zyprexa or quetiapine), loss of libido and other disorders.

According to WHO, more than 200 million people worldwide suffer from diabetes. And these are only official statistics, which do not take into account patients who do not seek medical help. More than 80% of people with diabetes are also overweight. The topic of obesity in diabetes has long been studied. Hundreds of articles, scientific dissertations and theses have been written on how to deal with this problem. However, in practice, people cannot get rid of extra pounds, and their life turns into a continuous pursuit of slimness and health.

What is diabetes mellitus?

Diabetes mellitus comes in two types. The nature of obesity largely depends on the type of disease. Types of disease:

• Type 1. This type of disease is characterized by insufficient production of the patient’s own insulin. In a healthy person, insulin is produced in the pancreas with the participation of beta cells. If for various reasons these cells die en masse, insulin production decreases, which causes an increase in blood sugar. Most often, such patients are traditionally prescribed insulin therapy.
• Type 2. Insulin is produced by the body, but tissue cells stop absorbing it. As a result, the hormone does not perform its main task, which leads to an increase in blood sugar. In advanced forms of the disease, insulin may stop being synthesized and then the need for insulin therapy arises, although initially there was no need for an artificial hormone.

Obesity in type 1 diabetes

With any type of diabetes, a serious hormonal imbalance occurs in the patient's body. The first type is considered the most dangerous disease, but it is not associated with excess weight. With proper nutrition, adequate physical activity and a stable emotional background, you can live a full life with this type of diabetes, reduce the dosage of medications to a minimum and even give up insulin altogether. Read more about this in the section. A low-carb diet for type 1 diabetes is not aimed at losing weight, but at lowering blood sugar.

Obesity in type 2 diabetes

This type of diabetes is diagnosed in approximately 80% of cases of the total number of patients with this disease. With this type of pathology, there is a strong increase in body weight up to extreme obesity. The same insulin is to blame for fat deposition, which is responsible not only for supplying cells with glucose, but also for storing fat reserves in case of insufficient nutrition. Insulin also inhibits the breakdown of this fat, preserving its reserves in the body. Thus, increased insulin levels provoke obesity.

How to lose excess weight with diabetes

So, where does the fight against obesity in diabetes begin? The main weapon in this war against fat should be proper nutrition. Many patients mistakenly believe that the fewer calories the better. However, in reality everything is completely different. There should be enough calories in a person's diet. The main enemy is not calories, it is carbohydrates! It is they who provoke a sharp jump in insulin in the blood, which begins to store fat in the abdomen, thighs and buttocks. For patients who do not understand these simple nutritional rules, life will go something like this:

Feeling of hunger - a large meal - a sharp jump in sugar - a sharp jump in insulin - the conversion of glucose into fat deposits - a drop in sugar - a feeling of hunger.

So, to break this vicious cycle, you need to prevent sudden spikes in blood sugar levels, and therefore insulin, which converts sugar into fat. This can only be achieved by frequent, fractional, low-carbohydrate meals, in which the body will feel full and sugar will not rise rapidly. The diet is based on reducing foods containing large amounts of fast carbohydrates in the daily diet. Mandatory requirements for the composition of products include the following proportions:

• Proteins – 25%.
• Fats – 35%.
• Carbohydrates no more than 40%.

To achieve such indicators, you simply need to exclude white cereals, baked goods, sweets, potatoes, fast food and sugary carbonated drinks from your diet. In addition, it is mandatory to eliminate cellular hunger using modern intracellular nutrition.

Myths about obesity and diabetes

The vast majority of people believe that diabetes and excess weight, constant companions, and fighting kilograms with this disease is a waste of time. Patients with diabetes take dozens of medications, look for alternative treatments, but do not want to deny themselves their favorite foods. They do not understand that frequent, fractional, is the first and irreplaceable step to recovery.

So, let's summarize. Only by breaking this vicious circle of overeating and increasing insulin can good treatment results be achieved, otherwise the body will continue to suffer, concomitant diseases will develop and you will not be able to lead a normal life full of joyful events.

Remember, the key to health in diabetes is not pills, but proper nutrition, adequate physical activity and giving up bad habits - food, water and head.

If you have diabetes and are trying to solve the problem of excess weight - fill out the form below - I will share with you my experience in solving this problem, tell you how to eat, and how to make sure that your body no longer suffers.

Rapid weight loss is understood as a loss of more than 5% of body weight within a month. This is an alarming symptom that indicates the presence of serious metabolic disorders. One possible reason is weight loss.

Reasons for losing weight

In type 1 diabetes, the body lacks insulin: the immune system attacks the beta cells of the pancreas responsible for its production. Changes in hormonal levels disrupt the process of natural cell nutrition.

Glucose plays the role of the main source of energy in the human body. It is absorbed into the blood after the breakdown of products in the gastrointestinal tract, and then spreads through the bloodstream to all tissues and cells. In this chain, insulin plays the role of a key that allows glucose access to cells.

With a lack of this hormone, two problems arise:

1. Cells have nowhere to take energy from, and they begin to look for a new source of it. They become muscle and fatty tissues, and the body wastes fat reluctantly - the muscles are the first to suffer. This is what causes weight loss in type 1 diabetes.
2. Blood glucose levels begin to rise. Without insulin, it cannot penetrate the cells and is left unspent. The body tries to cope with the excess, bringing it out with urine. Due to glucose, moisture also leaves the body. Dehydration develops, which also contributes to a decrease in body weight.

Weight loss in type 1 diabetes is also caused by indirect causes. Due to the onset of the disease, the patient’s appetite decreases, abdominal pain appears, and performance decreases. In this state, he begins to actually consume less food, which leads to even greater exhaustion.

Associated symptoms

Dramatic weight loss in type 1 diabetes is accompanied by:

• tingling in fingers and toes;
• frequent urination;
• rash, redness, decreased sensitivity of the skin.

If you notice similar symptoms, be sure to consult an endocrinologist.

Why is sudden weight loss dangerous?

Sudden weight loss is a big stress for the body. It has the following consequences:

1. increased blood toxicity;
2. digestive disorders;
3. decline in performance.

If the disease is not treated on time, its consequences will worsen. Complications can be either acute (loss of consciousness) or chronic (damage to the retina, kidneys, development of cardiovascular, nervous and dermatological diseases).

How to gain weight back

For type 1 diabetes mellitus, the patient is prescribed a special diet. Meals should be small and frequent - at least 5-6 times a day. Instead of sugar, you need to use honey and synthetic sweeteners.

Foods that increase insulin production are useful: goat's milk, garlic, Brussels sprouts, flaxseed oil and wheat germ. They can be consumed in any form, alone or as part of complex dishes.

The basis of the diet should be foods with a low glycemic index - low-fat natural yogurt, bananas, whole grain cereals, legumes. Do not forget about the sources of vitamins and minerals: tomatoes, cucumbers, walnuts, dried apricots, and figs are required in the diet. Alcohol should be limited, or better yet, eliminated altogether.

A uniform carbohydrate load throughout the day is important. The general distribution of nutrients should be as follows: 15% - proteins, 25% - fats, 60% - carbohydrates. During pregnancy, ketoacidosis and old age, the ratio is adjusted.

It is impossible to regain the previous weight with the help of nutrition alone in case of diabetes - special therapy is needed. The endocrinologist prescribes insulin injections and, if necessary, medications based on metformin (Glucophage,). The dosage and frequency of administration are calculated individually for each patient. Over time, the patient learns to identify them independently.

Cell sensitivity to insulin increases with physical activity, so regular training is needed. Simple exercises will strengthen muscles and help cope with chronic fatigue and weakness. Daily walks in the fresh air are beneficial.

Type 1 diabetes requires regular monitoring of sugar levels. The best option is to keep a diary in which you can note your daily glucometer readings. It is convenient to make notes in a notebook, notebook, or use specialized online services.

Lost weight must be regained gradually. Otherwise, sudden changes will result in new stress for the body.