Diabetes, like so many diseases, is a complex disorder. When it comes to what we usually call type 1, or insulin dependent diabetes, we really aren’t sure how it begins. Some researchers believe it is genetic, others believe it begins with an infection that attacks the pancreas, thus causing insulin-producing cells to cease to function.
Whatever the cause, the disease results in high levels of blood glucose, unable to be moved into cells by insulin, which (over time) causes progressive damage to the nervous system, cardiovascular system, kidneys and eyes as the small molecules clog small arteries and kill the tissues they supply.
In a similar manner, type 2, or non-insulin dependent diabetes, is no simple disease. In this condition, pancreas cells make insulin, but don’t make enough. Likewise, other cells don’t respond as well to insulin as in non-diabetics. This is called “insulin resistance.”
The result, as with type 1 diabetes, is that glucose stays in the bloodstream rather than being taken into the cell and metabolized. The same patterns of damage occur, as the glucose molecules progressively clog very small arteries. However, what seems clear is that in type 2 diabetes, obesity makes it more likely to arise and harder to control.
This connection between obesity and type 2 diabetes is well known. Weight loss can make a significant difference in controlling blood glucose and preventing complications in type 2 diabetics.
However, what is equally well known is that while weight loss can make a remarkable difference, weight loss is incredibly difficult. Part of this is likely due to the fact that the disease tends to occur in adulthood when our levels of activity are less and our metabolisms slower. But the other part is that, well, food is good, relaxation is nice, and exercise is often simply no fun. Quite the opposite, it’s often uncomfortable.
America is a country with a lot of diabetes. In fact, there are about 37 million diabetics in America, of which about 95 percent are type 2, or non-insulin dependent, diabetics. As such, no small amount of research has gone into finding ways for diabetics to control their blood sugar — and, in the case of type 2, into finding new ways for diabetics to lose weight in order to control their disease.
There are several ways for diabetics to lose weight. They vary from diet and exercise to new medications, all the way to surgical procedures of varying complexity. In next month’s column, I will discuss current thoughts on the best ways for type 2 diabetics to lose weight in a healthy and sustainable manner.
Until then, if you’re diabetic, talk to your physician regularly, take your medication, eat healthy (and less), and just keep moving.
More to come.