September 20, 2004
Type 2, Weight and Weight Loss
Question from Boise, Idaho, USA:
I’ve read most articles discussing type 2 diabetes saying that it can’t be cured. I have also read that gastric bypass has cured diabetes and I’ve read that some people have “normal glucose levels” from diet and exercise. At the same time, I get the understanding that diabetes progresses and more aggressive treatment is the norm. Is it a fact that diabetes will always progress?
Does the group that controls with diet/exercise find that they will probably need medication down the road (due to progressive nature of diabetes) or CAN (is it possible?) the normal levels be a lifelong accomplishment. Where can I find success examples of people that truly have kept glucose in control for long periods of time without medications? If bypass surgeries seem to have such high rate of success, why wouldn’t low calorie diets have the same result? Does the obese person that loses a lot of weight have a better chance of permanently getting the glucose to normal levels since there is so much room for improvement? Example: If a 300 pound person loses 100 pounds, there is a 100 pounds less to compete for the insulin. But, a person that is 250 pounds and loses 50 pounds has reduced only half as much. They both now weigh 200 pounds, but does the former 300 pound person stand to benefit more and have more chance to keep from having to get on medications?
Answer:
The marked weight loss associated with bariatric surgery is an example of facilitating weight loss. This helps to decrease insulin resistance. However, if weight is regained, the insulin resistance returns. Since patients also have abnormalities in insulin secretion, the sugars will again rise. The same can be said for people who lose weight with diet and exercise. There are many patients who do well for long periods of time on stable doses of medications. These tend to be people who are also working at maintaining a healthy lifestyle. Changes in health, decrease in exercise, all can make the sugars rise.
I sense a degree of desperation in your question. I would say that the bottom line is the blood sugar. If kept under control, prospects for maintaining good health are very good. However, poor sugars result in worsening health and even worse control.
I would suggest you contact your local diabetes educator at your hospital or physicians’ office. There are many support group services available around the country where people can share their experiences with you.
JTL
