The link between weight and diabetes

by Michelle Talley, RD, LDN, Christian Hospital Diabetes Institute

Obesity is now more prevalent than ever before. The National Center for Health Statistics reports that 66.3 percent of Americans are now overweight or obese.

Being overweight or obese is one of the major factors that increase the risk of type 2 diabetes and other health problems, such as hypertension, heart disease, breathing problems, arthritis, some cancers and premature death. It’s estimated that 20.8 million Americans have diabetes, and 41 million have pre-diabetes, which means blood glucose levels are higher than normal, but not high enough to diagnose diabetes. Research has shown that weight loss and lifestyle changes not only improve glycemic control for diabetes, but are the greatest influence to help prevent type 2 diabetes.

Type 2 diabetes is a result of insulin resistance and lack of adequate insulin production from the pancreas. Insulin resistance is strongly linked to being overweight or obese, but a sedentary lifestyle and aging are other contributors as well.

Carrying excess body fat, especially in the middle, causes the body to resist insulin, which results in higher glucose levels and more free fatty acids in the blood stream.
Fat cells in the abdominal area are more closely associated with insulin resistance because they have a higher turnover rate and greater release of free fatty acids.

Initially, the pancreas can compensate for the body’s resistance by producing more insulin, but eventually the pancreas wears down and is unable to produce an adequate amount to achieve glycemic control.

Losing 5 to 15 percent of one’s body weight can decrease insulin resistance and improve the body’s response to insulin. For someone who weighs 200 pounds, this would be a 10- to 30-pound weight loss. Besides improving blood glucose levels, weight loss helps to lower blood pressure and blood fats (cholesterol and triglycerides), reduces stress on joints and improves mobility, and increases energy levels.

A moderate amount of weight loss can also help prevent or delay the diagnosis of diabetes. In 2001, the National Institutes of Health completed the Diabetes Prevention Program (DPP), a clinical trial designed to find the most effective ways of preventing type 2 diabetes in overweight people with pre-diabetes.

The researchers tested two different methods to prevent diabetes: a lifestyle change and a diabetes medication, metformin. The lifestyle changes involved
30 minutes of exercise per day five days a week, usually by walking, and lowered total fat intake and calories. By the end of the study, members of this group reduced their risk of getting type 2 diabetes by 58 percent. In the first year of the study, people lost an average of 5 to 7 percent of their total weight (about 15 pounds).

Lifestyle change was even more effective in those age 60 and older, who reduced their risk for diabetes by 71 percent. Members of the group receiving metformin reduced their risk by 31 percent.

Achieving and maintaining a healthy weight is key for those who are overweight with diabetes and for those who wish to prevent or delay the onset of diabetes.
Following a lifestyle of healthy eating, cutting calories and fat, and exercising at least 30 minutes most days of the week are general guidelines for getting started on a weight-loss plan.

Need help with diabetes management?

Diabetes education services for employees are available across BJC. For information, call:

• Alton Memorial Hospital, 618-463-7647

• Barnes-Jewish Hospital, 314-TOP-DOCS (314-867-3627) or, toll free, 866-867-3627; or Center for Advanced Medicine, 314-362-3184

• Barnes-Jewish St. Peters Hospital Healthwise Center, 636-916-9653 or 636-916-9320

• Barnes-Jewish West County Hospital, 314-996-3151

• Boone Hospital Center, 573-815-6206

• The Diabetes Institute at Christian Hospital, 314-653-4545, or Edwardsville, 618-659-8592

• Missouri Baptist Medical Center, 314-996-5170

• Missouri Baptist Hospital-Sullivan, 573-468-4186

• Parkland Health Center, 573-760-8396

• St. Louis Children’s Hospital, 314-454-6000