Overweight Diabetic

Do you have related health problems because of your weight? Do you suffer with diabetes, joint problems, breathing difficulties or other health issues? If so, ask our experts your questions here.

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talkhealth
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by talkhealth on Thu Jan 16, 2014 11:21 am

Overweight Diabetic

What would your advice be in answering this question:

I'm diabetic and very overweight. I want to avoid insulin. Are there any treatments that might help me lose weight?"
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Paultheother1
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by Paultheother1 on Thu Jan 16, 2014 11:57 am

Re: Overweight Diabetic

I'm in a very similar situation myself but with the additional complications of having a heart condition, high blood pressure, high cholesterol (all of which I am taking medication for) and, just to add the icing on the cake, a re-occuring hernia. All these combined make it almost impossible to do any 'meaningful' exercise so my only/main option is diet but I've tried numerous things most of which haven't worked (or, frankly, they've had so little effect that, over time, my (admittedly quite low!) will-power has given in to my cravings (main beer and regularly snacking).

My GP has been trying to get me on to insulin for ages now (my blood sugar is averaging in the low 20's) but I know this is going to be a life changing committment so I really want to think of this as a last resort.
I'm 54 years old and weigh seventeen and a half stone but my GP's only advice when it came to dieting was to 'cut out' bread, potatoes, rice and pasta which leaves pretty much nothing left but salad and fruit.
In this day and age is there really nothing 'sensible' (or remotely exciting to the palet) to help people to lose drastic weight (I'm also told that going on to insulin is likely to put weight on!)?

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Julie Thompson
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by Julie Thompson on Thu Jan 16, 2014 9:48 pm

Re: Overweight Diabetic

Hi Paul

Changing habits is one of the most challenging tasks you can have, so don't feel down at your 'lack of willpower'. The best way of trying to manage your weight would be to do so by changing habits slowly over time. You have to choose your goal for change carefully and it has to be smart. I hope you don't mind me using beer as an example, smart means

S - specific, for example 'I want to lose weight' is not specific, 'I wish to stop drinking beer or reduce the amount of beer I drink' is better.

M - measurable, how much beer do I drink? How am I going to measure how much I am drinking and how much I have reduced? You need to be able to see the effect to feel great about your achievement.

A - achievable - Can I really reduce my beer intake? How easy is it going to be? What is going to get in the way? Try to choose changes that you feel are much easier to achieve, this will give you lots more confidence to try the harder changes. For each change ask yourself the following question

‘on a scale of 1-10, 1 being very easy and 10 being very difficult – what would I score the ease of making this change?’ Try the ones that score lower initially, as achieving easier goals will give you confidence to continue.

Also you need to plan for the things that might get in the way as these can lead to a lapse, which is likely to happen. What to do if you lapse is really important, you need to put it behind you, look at all the good things you have achieved and start again.

R - realistic, think about if you can really achieve what you have planned – if it’s just too difficult to do, you will be setting yourself up to fail. Sometimes we can’t change some aspects of our lives, it is fine to accept this and PUT IT TO ONE SIDE, don’t keep focussing on what you can’t achieve. Another question to ask would be, is it the right time for me to make this change? Perhaps leaving it and choosing something else would be better.

T - time focussed how long is it going to take? It may take a minimum of three weeks to change some aspect of your life and thinking how long you will need will help you to keep focussed.

Changing our lives, what we eat or how much exercise we do is a challenge, we all behave in a way that makes it easier to live our lives, but think about your symptoms – if you always do the same thing you will always get the same result – ask yourself do you want this to continue? Once a goal has become a new habit you then need to start the process again and choose another goal to change another habit. This method of lifestyle change can take some time to achieve but it is possibly a different way for you to try and alter your weight. Any dietitian should be able to help you with this and it is better to try with help - I would advise you before you try this to ask your GP to refer you to a diabetes dietitian who will be able to guide you through. I hope this helps.
Julie Thompson
Gastroenterology Specialist Dietitian - BSc (Hons) Dietetics

http://www.talkhealthpartnership.com/on ... ompson.php

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Gary Turner
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by Gary Turner on Fri Jan 17, 2014 11:50 am

Re: Overweight Diabetic

I would also add, to make SMART SMARTER:

E - add the Emotion to the task. Attach a negative emotion to the way you used to be, and a positive emotion to the way you want to be. Think where your life will be if you carry on the way you've been, after one year, after five, after ten. Then think about changing the old behaviours to ones that satisfy you every bit as much physically, yet even more so emotionally, always in a way that is safest, healthiest and best for you. Then with these new behaviours in place, think where your life will be if you carry on this new way after one year, after five, after ten. Now you've seen the consequences of your actions - perhaps you are better placed to make the right choices now.

R - Repeatable. Notice the changes you are making. And the changes that work nicely. Then you can follow the same processes to make changes for the better elsewhere in your life too...

Habits are hard to break. You need to go "not this, this" a few times, in a few contexts, to get it to stick. You need to overwrite the old with a new that is stronger.

Alternatively, start the new habit BEFORE the old trigger. This way the new trigger sends you off on the right path before the old even gets started. Makes things easier.

Change is as hard as you want it to be. It can be easy, it can be hard, that's just how you choose to imagine it. Imagine it easy and the path will be far simpler...

In respect to insulin look to eat low GI, and even low carb in all circumstances. Eat from meat, poultry, fish, nuts, salads, non-root vegetables, mushrooms, berries, dairy (if tolerant, though be aware that dairy contains sugar in the form of galactose, so not too much!) and you generally won't go far wrong.

Hope this helps!
Gary Turner
Advisor to British Army School of Physical Training, World Champion Elite Sportsman

http://www.talkhealthpartnership.com/on ... turner.php

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Gary Turner
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by Gary Turner on Fri Jan 17, 2014 11:55 am

Re: Overweight Diabetic

Paul,

Insulin is a hormone that has many uses in the body, yet is generally anabolic, in other words building.

In respect to weight it helps to stimulate and maintain muscle growth. It also helps to set the environment in the body to take any excess carbohydrates from your system and store them as fat. And keep them there.

Think of insulin as the 'bad boy on the block' if you want to lose weight. It stores fat, and inhibits fat burning. So if you want to lose weight regulation of insulin is important, together with it's receptors, which is the issue with diabetes.

Carbohydrates create the insulin response, simple carbohydrates more so than complex carbohydrates. Protein creates just a nominal insulin reponse, fats negligible. So eating on the low GI here will help you not overload your system with insulin, and keep your body a little more 'stable'.

And as for food tasting nicer - start using herbs, spices and seasoning your food better! Even plain old chicken with broccoli can be whipped into something tasty by the right use of these! ;)

Hope this helps!
Gary Turner
Advisor to British Army School of Physical Training, World Champion Elite Sportsman

http://www.talkhealthpartnership.com/on ... turner.php

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Dr Masud Haq
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by Dr Masud Haq on Tue Jan 21, 2014 1:45 am

Re: Overweight Diabetic

Patients with type 2 diabetes are typically overweight or obese. The natural progression of the condition means many patients require additional oral treatment in a stepwise fashion with 30-40% eventually needing insulin. We now know that various gut hormones (incretins) are reduced in patients with type 2 diabetes. Injectable incretin (glucagon-like peptide-1) drugs are available that enhance or mimic the body's natural gut hormones. Their effects include suppression of the appetite centre in the brain, delayed gastric emptying which leads to patients feeling fuller after a meal, increased insulin secretion from the pancreas and inhibition of glucagon secretion. The combined effect is better glycaemic control with many patients losing weight. It's certainly worth considering but should be discussed with your GP to see whether your suitable.

Masud
Dr Masud Haq
Consultant in Diabetes & Endocrinology
Maidstone & Tunbridge Wells Hospital

http://www.talkhealthpartnership.com/on ... ud_haq.php

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