November is Diabetes Awareness Month, and it is the time of the year to set some goals. These often include losing weight, eating healthy, and exercising. If you are an individual with type 2 diabetes, improving blood glucose levels may be one of your important goals to prevent complications.
First and foremost, talk with your healthcare provider to make sure that any diet or exercise regimen is safe for your medical conditions. The internet can be a good resource, but it is important to remember that quality information comes from peer-reviewed scientific journals rather than opinion articles.
Yes, reversing type 2 diabetes is possible and may be defined as being able to stop all medications and keeping glucose levels in a normal range. Recent published studies confirm what we have observed here at JCMG Weight Treatment Center: people with type 2 diabetes enrolled in a medically supervised weight loss protocol can reverse diabetes and decrease the need for medications. It has been shown that the pancreas and liver – two organs central to blood glucose control – improve in function after weight loss. Other studies show that weight loss via a medically supervised very low-calorie regimen has similar results as bariatric surgery, but without the risk of surgery. Not only do patients see improvement in type 2 diabetes, but also other conditions such as high cholesterol, high blood pressure, and sleep apnea. Fortunately, an individual may also save money with the discontinuation of oral medications and perhaps insulin. Weight loss may lower the risk of heart and kidney problems along with a reduced risk of early death. Studies in our patients even show improvement in physical and mental function in everyday life.
So, what should you eat? Scientists at the NIH have convincingly shown that weight loss is achieved by a reduction in calorie intake, like a low-fat or a reduced carbohydrate diet, and reducing ultra-processed foods. It is adherence to caloric reduction and consistency of the selected dietary pattern that is most important rather than percentages of macronutrients in fats or carbohydrates. These studies also show that with a long-term commitment to behavior changes, the risk of weight regain is reduced. Discuss healthy eating habits and consider a target number of calories per day that would enable weight loss. One may visit The Body Weight Planner at http://niddk.nih.gov/bwp to get an estimate of caloric intake for weight loss. If you are prescribed a medication that enables weight loss, consult with your provider about a diet that is sufficient in quality protein to minimize excessive muscle loss. Finally, even with weight loss of 3-5% of body weight, glucose, and cholesterol levels may improve, and often quality of life improves.
The American Diabetes Association suggests eating a wide variety of non-starchy vegetables, at least half your plate for lunch and dinner, plus a quarter plate size portion of lean protein, and whole grains or beans. It is recommended to minimize sodium intake and try to obtain as few calories as possible from beverages. Snacks are often not necessary but could include berries, light cheese or yogurt, or a small portion of almonds. Another goal is to consider higher fiber intake: aim for 25-30 grams of fiber daily from whole foods. Try to minimize ultra-processed foods and reduce portion size. Any food may be enjoyed in moderation, but all calories count.
Unfortunately, exercise alone has not been shown to consistently cause weight loss, however, it is essential for heart and mental health, reducing blood glucose levels and weight loss maintenance. If your health care provider agrees, then you could exercise at home or the gym, inside or outside, aiming for 150 minutes per week of moderate-intensity exercise such as walking. These minutes may be divided into 30 minutes 5 days a week or even smaller, more frequent intervals. Adding muscle-strengthening exercises is also beneficial to avoid muscle loss associated with aging. For people with diabetes who experience high blood sugar levels after a meal, exercise afterward can help lower glucose spikes.
During the month of November and in the new year keep these important resolutions to put diabetes into remission.
By Dr. Christopher Case, MD
