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Diabetes and Weight Loss: Finding the Right Path

If you've got diabetes, losing weight can get you off insulin and other medications. Create a safe diabetes weight loss plan with the help of experts.
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Go for the Right Balance in a Diabetes Weight Loss Plan

Christine Gerbstadt, MD, a spokeswoman for the American Dietetic Association, warns: "You don't want to run the risk of high or low blood sugar while you're dieting," she tells WebMD. "You want tight glucose control while you lose weight."

Gerbstadt suggests cutting 500 calories a day, "which is safe for someone with diabetes," she says. "Cut calories across the board -- from protein, carbohydrates, and fat -- that's the best way." She recommends that people with diabetes maintain a healthy ratio of carbs, fat, and protein. The ideal:

  • 50% to 55% carbs
  • 30% fat
  • 10% to 15% protein

Watch the Carbs in a Diabetes Weight Loss Plan

For people with diabetes, a refresher course on carbs may also be in order, Gerbstadt says.

That's because carbs have the biggest effect on blood sugar, since they are broken down into sugar early in digestion. Eating complex carbs (whole-grain bread and vegetables, for example) is good because they are absorbed more slowly into the bloodstream, cutting the risk of blood sugar spikes, Gerbstadt explains.

"Worst case scenario is sliced white bread," she says. "Whole-wheat bread is an improvement. Adding a little peanut butter is even better."

Simply cutting lots of carbs -- a common dieting strategy -- can be dangerous, Gerbstadt says. When your body doesn't have carbs to burn for fuel, your metabolism changes into what's known as ketosis -- and fat is burned instead. You'll feel less hungry, and eat less than you usually do -- but long-term ketosis can cause health problems.

"Ketosis decreases oxygen delivery to the tissues, which puts stress on eyes, kidneys, heart, liver," Gerbstadt says. "That's why the low-carb, high-protein Atkins diet is not really safe for people with diabetes. Diabetics need to try to stick with a more balanced diet so your body can handle nutrients without going into ketosis."

Special Challenges When Following a Diabetes Weight Loss Plan

"For anyone, losing weight is challenging enough," Luigi Meneghini, MD, tells WebMD. Meneghini is director of the Kosnow Diabetes Treatment Center at the University of Miami School of Medicine. "For people who inject insulin, it's even more difficult because they have to eat when they have low blood sugar. When you have to reduce calorie intake, prevent overmedication, and eat to correct your low blood sugar, it's very challenging."

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