The Fit Diabetic
Living well and longer with diabetes does not require major weight loss.
Having diabetes increases your risk for a number of health problems. It also has the potential to rob you, on average, of more than twelve years of your life and to greatly reduce your quality of life for more than twenty of those years! A lesser quality of life can result from many physical ailments, but with diabetes, it often results from a compromised physical capacity, partial limb amputations, loss of mobility, chronic pain, blindness, chronic dialysis, and/or heart disease. For each of the 38.5 percent of average females born in the year 2000 or later predicted to develop diabetes, diabetes will cut her life short by 14.3 years if she is diagnosed by the age of 40 and reduce her quality of life for 22 of the years she does live.
These grim statistics are not meant to depress or frighten you, but rather to convince you that before that scenario becomes your future, your primary goal needs to become the prevention, reversal, or effective control of insulin resistance and blood glucose levels. The good news is that their prevention with good blood sugar control is entirely possible, and most of the same strategies used to control diabetes and its complications will also reverse a prediabetic state and potentially prevent diabetes from ever occurring in the first place.
Is excess body fat the only culprit in your insulin's diminishing effectiveness? The diabetes epidemic is closely following on the heels of the obesity problem in the Unites States and worldwide. Undeniably, there is a link between excess body fat and some of these health problems that is not fully understood or defined, but since many people who are over fat are still insulin sensitive and have normal levels of blood fats, obesity is not necessarily to blame. Many different factors can affect your relative state of insulin resistance, and most scientists are guilty of incorrectly assuming that the co-existence of obesity with conditions such as high blood pressure, insulin resistance, and type 2 diabetes proves that excess body fat is their direct cause even though some evidence suggests otherwise. For instance, isolated fat cells (i.e., taken out of the body) can respond normally to insulin even when insulin action is impaired in the nondiabetic people the cells were taken from. Following endurance training without much weight loss, fat cells also become more responsive to insulin, as do muscle cells – and both types of cells are thought to contribute heavily to insulin resistance.
The latest research confirms that diabetic people do not have to lose significant amounts of body fat to be healthy. Is that to say, then, that there is no point in ever losing any weight or that it won't benefit your health at all? Absolutely not! Losses of as little as 5 to 7% of body weight (10 to 14 pounds of fat for a 200-pound person) result in significant improvement in diabetes control in most individuals; however, it also proves that the obsessive focus placed on significant weight loss is unnecessary. In fact, people who continually lose and regain large amounts of weight frequently end up fatter than ever, and with a greater risk of developing heart disease. Moreover, substantial weight loss is extremely ineffective as a diabetes treatment since very few (only 5 to 10%) dieters successfully lose and keep off extra body weight over time.
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My diabetes is changing. Until a few years ago, my morning readings were reasonable and within the desired range of under 100 mg/dl. About two years ago, they started slipping upwards into the less-desirable but apparently not-worrisome range of 100-110 mg/dl. Now, this was what was recorded by my Abbott Freestyle Lite meter, which is known to record at the lower end of the home-glucometer variability range, but with my A1c firmly in the high 5s and low 6s, the meter's tendency to...