Relationship between weight loss & diabetes

To maintain & upkeep your health, having an active & healthy lifestyle is important. This is specifically relevant for people predisposed or suffering from type 1 diabetes since maintaining a healthy & optimal weight can help them improve their insulin sensitivity & reduce the chances of attracting other life-threatening diseases such as cardiovascular disease, cancer, diabetes to psychological conditions such as depression. However the reasons go beyond weight management. Fat is seen less as a static source of energy & more as an organ with endocrine functions. Adipose or fat cells can impact various physiological processes. Specific fat profile in terms of its location plays the most important role. Visceral fat which surrounds your internal organs is considered to be more riskier than having excess subcutaneous fat.

If you are overweight or obese, you must be figuring out what should be your weight loss strategy & what important parameters you should consider. The following paragraphs explains all important factors in detail:

1. Diet: We obtain energy from the food we eat. Calorie is the unit of measure of energy we obtain from our diet. Our optimal calorie intake will depend upon various factors such as age, gender, height, weight, genetic make up & activity level. So you must be wondering if this is true then how we have that extra belly or fat around our organs? Extra energy consumed by us is stored as fat. Please do not confuse this with the notion that if you  consume fat you will become overweight. Fat is another source of energy we get. We will discuss this in a later part of this blog in detail. For weight loss, it is essential that you maintain a calorie deficit( however it does not mean that you can eat anything even if you have a calorie deficit since consuming junk & sugary stuff has a negative impact on your overall health, insulin, inflammation & immune system). If you create a calorie deficit, your body will resort to your stored fat to meet the minimum energy requirement. Again this does not mean that you consume more saturated fats or refined carbs even if you are maintaining a calorie deficit. The idea is to strike a balance between your weight loss & maintaining a healthy gut (health discipline). It is often said that to burn 1 pound body weight, you need to create a calorie deficit of 3500 calories. However, this does not mean that if you start creating a deficit of 500 calories daily, you could achieve 1 pound ( 0.5 kg) of weight loss in a week. It is important to note here that people with higher initial body fat would require higher accumulated energy deficit per unit weight. Carbs & proteins offer 4 calories per gram which fat offers 9 calories per gram. So does that mean that macronutrient distribution does not matter since calorie after all is calorie. However, it is important to understand that metabolisable energy is different from gross energy & accounts for differences observed in weight loss successes on diets that vary in macronutrient distribution. The macronutrient distribution is also dependent upon your genetic predisposition to fat, carb & gluten sensitivity. Although it is a known fact that calorie deficit plays an important role in weight loss, other factors such as your macronutrient distribution aligned with your genetic makeup plays a much vital role in your weight & fat loss.

2. Exercise: Workout uses energy or fuel generated through food you consume. Therefore exercising regularly (60 minutes everyday) can help you facilitate & augment fat burn. However for significant weight loss (specifically for people who are obese or overweight), dietary intervention & calorie deficit is required. It is also important to note that intensity of workout has a profound impact on your weight loss journey.

There are some considerations which people suffering from type 1 diabetes should take into account while embarking on a weight loss journey. We will discuss about role of insulin in weight management & how modifications in your diet & lifestyle can help you overcome this life-threatening disease.

What is insulin?

Insulin also known as transport hormone is one of the important hormones. It helps in transporting energy (generated through food we consume) to different tissues (including muscle tissues & fat cells). It is also referred to as fat-storage hormone, since it facilitates storage of extra energy into fat (adipose) cells. Insulin facilitates starts of the process wherein glucose (formed from the food we eat, energy generated from food) is transported to different cells to be used for energy. When this glucose or energy intake exceeds our energy expenditure, the surplus is stored as fat. This is the reason why people suffering from type 1 diabetes should modify their insulin levels /insulin dose in tandem with their changing lifestyle. If an individual makes dietary & workout intervention aligned with their genetic makeup, they would reduce their insulin dose accordingly. If we do make appropriate changes, individuals would have to compensate for extra insulin with glucose (to treat hypoglycemia) else it will impact their weight loss journey. 

So do you know if you need to adjust your insulin dose/levels? You should be able to track your blood glucose levels & progressively reduce the medications as weight loss occurs. This happens due to improved insulin sensitivity as a response to weight loss genetically aligned diet & workout. It is important to set basal insulin dose. If your insulin dose is too high, you will end up feeding it with extra glucose/food that it  does not need. Hence it is imperative that basal insulin level is fixed appropriately & adjustments be made as & when needed aligned with weight loss & lifestyle change.

Besides, it is important that with weight loss & changes in diet & exercise, it is important to adjust the dose of fast acting insulin to cover up for food & meals & correct high blood sugar levels.

Some ticks for diabetic people to kick start their weight loss journey

1. Plan you meals: Populate your daily meals with nutrient dense & whole foods & home made snacks. Stock up a lot of protein such as fish, eggs, chicken ( lean breast), a lot of green & non-starchy veggies & fruits. Add lot of fibre in your meal as well as minimise the consumption of carbohydrates during dinner( specifically for those who have high number of melatonin receptors). 
2. Choose drinks wisely: Prefer avoiding  beverages which can add up sugar in your diet & are high in calories. Prefer consuming a lot of water, unsweetened tea & coffee. Minimise consumption of alcohol.
3. Undergo a genetic test: Doing a genetic testing can help you understand your genetic predisposition to various nutrition, lifestyle & workout related parameters. These insights will help you personalise your nutrition & workout plan.
4. Adjust insulin dose frequently: As mentioned above, adjusting your insulin dose with your weight loss & lifestyle changes can help you achieve your weight loss on a sustainable basis. Taking more insulin than required can impact progress of your weight loss.

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