A Patient Journey for Diabetes

Why is your weight important?

A person’s weight is affected by a number of things, such as your age, eating habits, amount of regular exercise taken and overall health. By the time you reach middle adulthood, your weight should remain quite stable from year to year.

While losing or putting on a few pounds here and there is normal, a weight loss of 10lbs (4.5 kilos) or 5% of your body weight over six to twelve months or even quicker, and without trying, can be a warning sign of diabetes and you should consult your doctor, who will be able to determine if it is undiagnosed diabetes and the best way to treat the problem.

Many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. Sometimes referred to as pre-diabetes, if your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased.

Diabetes is a lifelong condition that causes a person's blood sugar level to become too high and there are two main types of diabetes:

• Type 1 diabetes, where the body's immune system attacks and destroys the cells that produce insulin. Type 1 diabetes can develop quickly over weeks or even days.
• Type 2 diabetes, where the body doesn't produce enough insulin, or the body's cells don't react to insulin. Many people have Type 2 diabetes for years without realising it and around 90% of people with diabetes have Type 2.

Unexplained Weight Loss

Unexplained weight loss is often noticed in some people prior to a diagnosis of Type 1 diabetes but it can also affect people with Type 2 diabetes. Insufficient insulin prevents the body from getting glucose (sugar) from the blood into the body's cells to use as energy and so the body resorts to burning fat and muscle for energy, causing the reduction in overall body weight.

Other symptoms include:

• Feeling very thirsty, particularly when combined with some of the following symptoms
• urinating more frequently than usual, particularly at night
• Feeling very tired
• Loss of muscle bulk
• Cuts or wounds that heal slowly
• Blurred vision

It is important that you visit your GP as soon as possible if you experience unexpected weight loss or any of the other symptoms.

Having diabetes while being overweight

If you have been diagnosed with diabetes and are overweight or obese (a BMI of 30 or higher), you should set about losing weight by gradually reducing your calorie intake and becoming more physically active. Your doctor can measure your BMI (body mass index) and discuss a realistic target for you, such as losing 5-10% of your overall body weight over the course of a year.

You should continue to lose weight until you've achieved and are maintaining a BMI within the healthy range, which is:

• 18.5 - 24.9 for the general population
• 18.5 - 22.9 for people of south Asian or Chinese origin

To help you achieve changes to your lifestyle, you may be referred to a dietician or other healthcare professional, for advice tailored to your own diet and physical activity needs. Without this medical supervision, you risk problems such as lowering your calorie intake to a point that puts your long-term health at risk.

Diet

Eating well to maintain a stable weight is particularly important for people with diabetes. The good news is that you can eat many types of foods, but it might be easier to make small changes every week and you must limit certain foods.

You should aim to:

• Eat a wide range of foods - including fruit, vegetables, some starchy foods such as pasta and ask your GP/Dietician if you should increase the amount of fibre in your diet
• Keep sugar, fat and salt to a minimum
• Eat breakfast, lunch and dinner every day - don’t skip meals

Exercise

A little extra activity can benefit someone with diabetes more than just controlling their weight. It can also improve any sensitivity to insulin and help control your blood sugar level. It will also improve your sense of well being, reduce the risk of heart problems and help strengthen bones and muscles.

Whatever activity you take up, it’s important that you monitor your blood glucose levels regularly to help prevent reaching high or low blood sugar levels.

If you're thinking of taking part in exercise for more than 20 or 30 minutes, you may find you need to take in glucose or another form of carbohydrate to prevent your blood glucose levels from going too low. Therefore, it makes sense to discuss any classes or exercise plans you’re considering with your GP or your care team, who may adjust your insulin treatment or diet to keep your blood glucose level steady.

They can also help you work towards an achievable target for a long-term healthier weight, such as losing 1 to 2lbs (0.5–1kg) a week.

Regular activities that raise your heart rate a little can include:

• A brisk walk and going shopping (sorry, online doesn’t count!)
• Climbing flights of stairs
• Gardening, DIY and housework
• Dancing, yoga, Pilates and Tai Chi
• Active sports

talkhealth supports the charity Diabetes UK

Sources used in writing this article are available on request.

 

_{Last revised: 25 September 2017}

_{Next review: 25 September 2020}