October 29, 2002
Weight and Weight Loss
Question from Lexington, Kentucky, USA:
I have had type 1 diabetes for almost 32 years, I’ve had no diabetic complications whatsoever and have always maintained good glucose levels. However, for the past ten years, I have been overweight, and at this point I could easily lose 50 pounds. My physician is less concerned about the weight problem as long as my blood glucose levels remain low.
I have tried to lose weight by simply lowering food intake and adjusting my insulin, but doing this I can only lose (very slowly!) at less than 1,000 calories per day. I have found that by eating only one meal per day (evening), keeping my current walking regimen and adjusting my insulin down, I have been able to lose almost 10 pounds over the past two months. One dietitian told me that there is no way to remain healthy by eating one meal per day, but as long as my blood sugars are okay, what’s the harm?
Answer:
It is a more complicated situation. For instance, when your body doesn’t receive enough calories, it draws on calories stored in fat and also from protein. The concern is that you so few calories you lose protein mass. That is the problem. There is also a problem with eating one meal a day. First, you tend to overeat at the meal you do eat. Second, there is a caloric benefit to metabolizing your food.
That said, it is probably better to eat multiple smaller meals than one large meal. One last thought is that if you are trying to have tight control, with a hemoglobin A1c less than 7%, you need to have some protection from hypoglycemia.
JTL
