Living with diabetes is a challenge. Adding to that challenge is trying to attain and maintain a healthy weight. Why bother? Is it worth the struggle? The evidence suggests an overwhelming yes!
Maintaining a healthy weight is beneficial, as it:
- Helps you better manage your diabetes.
- Reduces the risk of arthritis and allows you to move more freely and be more active.
- Reduces the risk of diabetes complications.
- Improves your cholesterol and blood pressure.
- Reduces the risk of sleep apnea.
- Improves your general feeling of well-being and your energy levels.
Let’s look more closely at each of these benefits of achieving and maintaining a healthy weight.
Reduced risk of developing diabetes and improved diabetes management
Firstly, if you don’t yet have diabetes but have impaired glucose tolerance (a major risk factor) for type 2 diabetes), then being at a healthy weight is one of the best protections from transitioning sooner to type 2 diabetes. Type 2 diabetes develops when the amount of insulin in your body is not sufficient to maintain blood glucose control.
There is a direct correlation between the amount of insulin needed and the amount of weight a person carries. The less weight, the less insulin is required. So being at a healthy weight will prolong the amount of time before developing type 2 diabetes. If you have type 2 diabetes, having less fat tissue will allow you to use less insulin (either from your body or from injections). This means there will be fewer swings in glucose and it will allow for easier management of blood sugar.
If you struggle to achieve your healthy weight and have not succeeded, achieving any weight loss can be of benefit. For example, loss of 5% of body weight (e.g. 4-8 kg) can reduce the risk of developing type 2 diabetes if you have prediabetes, or improve glucose control if you already have type 2 diabetes.
The above also can apply to type 1 diabetes. We know that the cause of type 1 diabetes is different than type 2 diabetes. In type 1 diabetes, there is an absolute need for insulin injections. However, if a person with type 1 has a family history of, or risk factors for, type 2 diabetes and if they are above their healthy weight, just like people with type 2 diabetes, they can develop insulin resistance. This means the insulin they are injecting doesn’t work as effectively. When larger amounts of insulin are needed, this can lead to less predictable action as the insulin is absorbed and can also lead to unpredictable fluctuations in blood glucose.
Reduced risk of arthritis
Did you know that an increase in weight of just 10 pounds increases the force on the knee by 30 to 60 pounds with each step? Part of managing diabetes is to be active and this is difficult if you have arthritis. Osteoarthritis is a common condition, especially in people who are not at their healthy weight. The good news is that joint pain can be reduced by maintaining a healthy weight. Regular activity can also help with glucose management.
Reduced risk of diabetes complications
Many studies have shown a correlation between being above a healthy weight and certain diabetes complications. These include having protein in the urine (a sign of kidney complications), heart disease and peripheral neuropathy . Being at a healthy weight will reduce heart disease risk factors such as high blood pressure and cholesterol. Losing weight to attain a healthier weight has also been shown to reduce the risk of end stage kidney disease by 31%.
Reduced risk of sleep apnea
Obstructive sleep apnea (OSA) is a 2-way street. Those who have it have trouble with increased insulin resistance, as well as difficulty losing weight due to abnormal sleep patterns and changes in obesity hormones. On the other hand, if you are above your healthy weight, you are more likely to have sleep apnea. OSA risk continues to increase with rising body mass index. Even a 10% weight gain is associated with a 6-fold increase in OSA risk. One study (The LookAHEAD trial), which included a lifestyle intervention goal of losing 5% body weight in people with diabetes, showed a decrease in sleep apnea.
Improved quality of life and reduced depression
The LookAHEAD trial was a multisite randomized controlled study of more than 5,000 participants with type 2 diabetes who were above their healthy weight. Through lifestyle changes, the intervention group was able to maintain a significant weight loss over 8 years (from 4% to 8% of their body weight). The results showed an improvement in this group, compared to the control group, in depression, as well as an improvement in their quality of life.
Maintaining a healthy weight for people with diabetes therefore has some very real benefits, such as day-to-day glucose management, as well as more subtle improvements in mood and quality of life.
What is a healthy weight for you?
If you are not sure what a healthy weight is for you, speak with your diabetes healthcare team to help you answer this question. Body mass index and waist circumference, although not perfect tools, can be helpful. Remember, even small changes can improve glucose management and reduce risk factors.
