Diabetes and Weight Loss: The Right Path
If you've got diabetes, weight loss can get you off insulin and other medications. But diet safely, with the help of experts.
Watch the Carbs on a Diabetes Weight Loss Diet
For people with diabetes, a refresher course on carbs may also be in order,
Gerbstadt says. With diabetes and weight loss, dietary changes must be made
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
"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 for a diabetic diet, 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."
Exercise, Diabetes and Weight Loss
One of the benefits of exercise is that it helps keep your blood sugar in
balance, so you won't have to cut as many calories.
"Walk an extra 20 minutes a day, and you can eat a little bit more,"
Gerbstadt explains. So instead of cutting 500 calories, "you can cut back just
200 or 300 calories, and still get excellent results in weight loss. You'll
also control your blood sugar. And the weight will be more likely to stay off
if you lose it slowly, safely."
Keep in mind: Each type of exercise affects blood sugar differently.
Aerobic exercise -- running or a treadmill workout - can lower your blood
Weight lifting or prolonged strenuous exercise may affect your blood sugar
level many hours later. This can be a problem, especially when you're driving.
It is one of the many reasons that you should check your blood sugar before
driving. It's also a good idea to carry snacks such as fruit, crackers, juice,
and soda in the car to help your diabetic diet.
"With physical activity, you burn blood sugar as well as sugar stored in
muscle and in the liver," explains Luigi Meneghini, MD, director of the Kosnow
Diabetes Treatment Center at the University of Miami School of Medicine.
"People using insulin or medications to stimulate release of insulin should
closely monitor blood sugar levels when they begin exercising more. Over time,
as you exercise regularly, you can reduce doses of medications and