Managing the Diabetic Dilemma

There exists a paradox in the management of diabetes with respect to body weight, which I call the "diabetic dilemma". First, while diabetes is caused by being overweight, one of the cardinal symptoms of diabetes is weight loss. Second, successful medical treatment of diabetes is often accompanied by weight gain, which as we know can worsen diabetes. What's going on here?

Normally when we eat, carbohydrates are absorbed from the stomach and travel in the blood stream to be delivered to the liver and skeletal muscles and deposited therein. This deposition is guided by insulin, to the action of which diabetics are resistant. So in diabetics, carbohydrate calories are absorbed from the stomach and travel in the blood stream for a longer time, failing to be deposited into the liver and skeletal muscle, and thereby raising the blood sugar as measured by fingerstick. Eventually, this blood sugar is delivered to the kidneys, filtered out of the blood and excreted in the urine.

Now on average, 65% of our total daily caloric intake comes from carbohydrates. If these calories end up in the urine, they do not contribute to our total daily caloric intake, which is why out of control diabetics will lose weight. If, for example, we eat 2000 calories a day, absorb 1000 calories into our liver and muscle and excrete 1000 calories in the urine, we are effectively eating only 1000 calories per day and will lose weight.

Successful treatment of diabetes with medication will optimize the absorption of blood sugar into the liver and skeletal muscle, evacuating that sugar from the blood and lowering our fingerstick readings. However, this also increases our effective daily caloric intake, which might then contribute to weight gain.

This is why we can't just treat diabetes with medication alone; diabetics treated thusly will eventually gain weight, which will increase their resistance to insulin and thereby worsen their diabetes. In response, more medication will be prescribed and the paradox deepens and treatment becomes self-defeating.

A healthful calorie restricted diet along with a regular cardiovascular exercise program will help defeat the diabetic dilemma. Regular exercise will train the body to use more ingested calories for energy so less are deposited into the body. And resultant weight loss will reduce the body's resistance to insulin, which would allow for the treatment of diabetes with less medication.

Fine Tune Your Meal Planning to Lose Weight

Look, it's 2011 now...we all know what to eat and what not to eat. The ability to lose weight, then, it not necessarily related to food choices so much as meal planning - portion size and timing.

Believe it or not, eating more frequently during the day actually stimulates the metabolism. The process of breaking down and absorbing food uses calories, so eating more actually helps us burn more calories per day. On a 2000 calorie per day meal plan then, you'll lose more weight eating five 400 calorie meals daily than two 1000 calorie meals.

In addition, your metabolism is the most rapid in the morning; coming off the overnight fast, your liver and muscles require replenishment of their energy stores, so ingested calories are deposited as useful short term energy forms. Later in the day, when these stores are repleted, excess calories are deposited into your long term energy repository, i.e. the fat stores. Therefore, we should ingest our largest meals earlier in the day - large breakfast, modest lunch, smaller dinner.

Fine tuning your meal planning in this way will recharge your weight loss efforts.