Everyday Health: How does weight affect diabetes?

Ping H. Wang, MD: Excess weight can present health risks for anyone, not just people with diabetes. But this excess weight, in combination with other indicators such as high blood glucose (hyperglycemia), high blood pressure, and high cholesterol/triglycerides (known as metabolic disorder) is implicated in heart disease and can be life threatening to patients with diabetes. Losing weight and lowering blood pressure and lipids reduces the risks associated with metabolic disorder. In addition, losing weight can "reverse" diabetes in some individuals whose excess body fat prevents the body from effectively using its own insulin (insulin resistance).

Melissa Meredith, MD (with assistance from Barb Uselman, RN/CDE, and Carol Sargent, RD/CDE) : The most common form of diabetes, type 2 diabetes, is characterized by 2 main defects. First, the pancreas is unable to produce enough of the hormone insulin. Insulin allows the body's tissues to use glucose for energy. When there is not enough insulin, blood sugars will rise. Second, what insulin is produced does not work effectively in people with type 2 diabetes. This is referred to as insulin resistance. When a person has insulin resistance, it takes more insulin to lower the blood sugar. Weight is the major factor that contributes to insulin resistance. Excess weight will lead to worsened insulin resistance. Conversely, weight loss will improve insulin resistance and therefore less insulin will be needed to control the blood sugar. As little as a 10 pound weight loss can markedly improve insulin resistance and make it much easier to manage blood sugars!

Theresa Garnero, APRN, BC-ADM, MSN, CDE: Extra weight (being overweight or obese) affects the body's ability to effectively use the hormone called insulin (also known as insulin resistance). If your body doesn't use the insulin well, whether you make it naturally or need to inject it, your blood sugar (glucose) will go up. Also, extra weight is hard on the heart. It increases the likelihood of high blood pressure ? and thus the risk for a heart attack or stroke. It is important to know you can be fit at any weight. Just get your doctor's clearance before starting a program. Even a 5-percent weight loss can improve diabetes and lessen the risk for heart disease.

Gretchen Scalpi, RD, CDE: Being overweight or obese significantly increases the risk for developing diabetes, and in people who already have diabetes, a possible worsening of their condition. Weight that accumulates around the abdomen affects the body's cell sensitivity to insulin. An overweight or obese individual can gradually develop resistance to their own insulin. Insulin resistance leads to persistently high levels of blood sugar, and, eventually, type 2 diabetes.

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