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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Healthy diet and exercise can control type 2 diabetes

Anthony L. Komaroff, M.D. Universal Uclick

DEAR DOCTOR K: I was recently diagnosed with Type 2 diabetes. My doctor said the best thing I can do right now is to lose weight. Why?

DEAR READER: Type 2 diabetes usually starts after a person becomes an adult. It is by far the most common type of diabetes. It has been clear that people who are overweight are at much greater risk for developing Type 2 diabetes.

We used to think of fat as an inert layer of insulation. In recent years, we’ve discovered the special cells inside fat are not inert at all: They are hormone-producing factories. The hormones travel through the blood to the brain and other organs. They influence a person’s appetite and metabolism. They also influence the amount of sugar in the blood.

Your doctor’s recommendation is right in line with guidelines from the American Diabetes Association. They urge all people diagnosed with diabetes to lose weight as the first step to controlling their blood sugar.

A blood test called HbA1c estimates average blood sugar levels over the past two or three months. People with diabetes should aim for an HbA1c level of less than 7 percent. Losing weight and exercising more can decrease your HbA1c level by one or two percentage points. That may not sound like much, but a two-point reduction in HbA1c can put your blood sugar in the normal range.

How much weight do you need to lose? If you are overweight, losing just 5 to 10 percent of your starting weight can help you manage your diabetes. Even if your weight is in the healthy range, losing three to five pounds can help control your blood sugar.

What’s most important is the diet delivers fewer calories than you burn each day. That translates into weight loss.

So how can you cut calories? Eat smaller portions. Also, substitute lower-calorie alternatives for high-calorie ones.

It also helps to stick with a regular eating schedule. Plan meals and snacks that are no more than four hours apart.

I have known many patients who were able to control diabetes with diet and exercise alone. No medicine necessary.