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Diabetic Weight Loss Q and A
copyright 2006 by Greg Landry, M.S.





Q: What's the prevalence of type 2 diabetes in the U.S. right now and is the percentage of people with type 2 diabetes increasing? What is type 2 diabetes?

A: There are 13 million people in the US with diagnosed diabetes and another 5.2 million who don't know they have diabetes. 90-95% of diabetes is type 2.

Type 2 diabetes is considered an "epidemic" presently because of the increasing prevalence related to the increasing obesity of America. This is also showing in our children and teenagers. Type 2 diabetes is characterized by high levels of blood glucose/sugar resulting from defects in insulin production, insulin action or both. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. Over time the pancreas can lose its ability to make insulin. It is usually associated with older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity and race/ethnicity. African Americans, Hispanic/Latino Americans, Native Americans and some Asian Americans have higher incidence. Due to increasing obesity and lack of activity we are seeing the increased incidence in younger and younger people.

Q: What should a person do to decrease there chances of developing type 2 diabetes?

A: Maintain a reasonable weight, lose weight if you are overweight, and get moving - have regular physical activity, and make healthy food choices (which helps with weight loss and maintenance).

Q: When you first see a new type 2 diabetes patient what do you tell them about eating?

A: Stop the junk - eat less processed foods and "sweets", less fried foods, more whole grains, fruits and vegetables, lean meat. Portion size is also very important. Not just the right foods, but the right amounts.

Q: Is fiber important? If so, why?

A: Fiber has been shown to help improve blood sugar levels. The harder the body has to work on the food to get to the sugar, the less rapid rise in blood sugar levels. That is why fruit is a better choice than juice, whole wheat bread a better choice than white, 5 minute cooked oatmeal a better choice than micro-waved packets, etc. Fiber is also good for feelings of fullness, digestion and cholesterol.

Q: Should certain fruits be avoided.

A: All fruit is acceptable - it is the amount that is important. Portion size again is the issue. Serving size is that amount that equals about 15 gms of carbohydrate. Ex: 1 small apple, 1/2 cup canned fruit, 1 cup melon, 15 grapes, 2 Tbs raisins, etc.

Q: So it's important to eat small quantities of food at one time? 

A: Consistency in the amount of carbohydrate meal to meal is important. If you try to put 15 gallons of gas in a 10 gallon tank it just runs out on the ground. If you overeat at a meal your blood sugars can go too high and the extra calories are stored. Smaller amounts at regular intervals (4-5 hours) is a better choice for blood sugar control. Waiting too long between meals often leads to overeating because you feel so hungry.

Q: Are whole grains important?

A: Whole grains are higher in fiber. As mentioned previously - the more fiber the less rise in blood sugar. Read labels carefully for ingredients. For example, if whole grain/wheat is not the first ingredient in bread, it is really brown white bread.

Q: Is diet for a type 2 diabetic any different from a general very healthy diet?

A: focusing on fruits, veggies, whole grains, and lean meats? No, but attention to portion size makes a big difference in BS control.

Q: Can type 2 diabetes be reversed? Have you had patients that are successful with this?

A: Losing weight and getting 30 minutes of activity on most days makes a significant effect on blood sugar results. It is possible for many to reach and maintain normal blood sugars with weight loss, activity and a healthy meal plan, especially early in the disease. There are many that could decrease or stop medication with these consistent lifestyle changes.

Unfortunately, many do not make the necessary changes and underestimate the severity of uncontrolled blood sugars and the resulting complications. Yes, I have seen people successfully reach normal blood sugars without medication.

Q: Anything else?

A: Education is one of the greatest tools for blood sugar control. Know what diabetes is and what you can do about it. All people with diabetes should be doing self monitoring of blood sugars at home. The frequency is a minimum of 1-2 times per day, but depends on the individual's treatment plan and current level of control. The bottom line is healthy food choices - the right food in the right amount and a minimum of 30 minutes of activity 5 days per week and medication as ordered by your physician. Most important, don't ignore diabetes just because you "don't feel bad". Don't ignore other risk factors or complications like lipid (cholesterol) and blood pressure control.




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