Losing weight when you have diabetes can be a good news-bad news thing. The good news is that dropping even a few pounds can help reduce your need for diabetes medications. When adults with diabetes lose just seven percent of their body weight (only 14 pounds if you weigh 200), their insulin action improves by around 57 percent—more than you can get with most diabetes pills. The bad news is that some of those meds are sabotaging your efforts to drop the pounds you need to lose to get there.
You may also be undermining your ability to lose weight and manage diabetes if you eat too much food in the evening and even overnight—called Night Eating Syndrome. In that case, your self-control may be overridden by an inappropriate or inadequate release of leptin, melatonin, and serotonin in your brain that is not your fault.
Here are 7 strategies that you can try to manage both your weight and your diabetes:
- Cut back on certain types of meds. Diabetes pills like Glucotrol and DiaBeta may cause weight gain, so talk to your doctor about cutting back on your doses or taking different meds. If you must take these, use Glucotrol XL or Amaryl. Insulin sensitizers like Actos and Avandia also cause you to gain extra pounds.
- Keep the metformin. Most adults with type 2 diabetes take metformin to keep their morning blood glucose levels in check that won’t cause you to gain or lose weight. Just take some vitamin B12 to prevent a metformin-induced deficiency.
- Try a different insulin regimen. If you use basal insulin, go with Levemir as it causes less weight gain than NPH or Lantus. If you take rapid-acting insulin like Apidra with meals, inject it immediately after eating or within 20 min from the start of your meal based on what you actually eat and not what you planned to.
- Check out some of the newer meds. While the latest diabetes meds are often expensive, they may help you lose a lot of weight. Look into DPP-4 inhibitors like Januvia, Galvus, Onglyza, and Tradjenta and SGLT-2 inhibitors like Invokana.
- Consider other injectables. Although they have to be injected, Byetta, Bydureron, Victoza, and Symlin all cause you to eat less and drop pounds. They can also be combined with metformin use.
- Manage your depression. Prescribed meds to treat depression, especially ones that keep serotonin levels in the brain high, can help curb nighttime overeating. Doing relaxation exercises and seeking help from a behavioral therapist may also help you learn alternate strategies for coping with painful emotions.
- Get your beauty rest. Improving your sleep with medications (including over-the-counter melatonin supplements) can reduce nighttime eating. If you have sleep apnea, getting it treated will likely improve your ability to sleep without interruption and naturally keep you from eating at night as well.
In conclusion, losing weight is one of the keys to controlling diabetes and reducing the number and doses of diabetes medications that you need to take. Managing your medication use and adopting a healthier lifestyle that includes a positive outlook, better sleep, regular physical activity, and healthier eating will help you lose all the weight you want to—and keep it off for good. - by: Dr. Sheri Colberg
Dr. Sheri Colberg is professor of exercise science at Old Dominion University. She co-authored The Diabetes Breakthrough with Dr. Osama Hamdy of the Joslin Diabetes Center (Harlequin, 2014). www.TheDiabetesBreakthrough.com.