Q: I am a 46-year-old male, weighing 260 pounds at 5’9” tall. I was diagnosed with type 2 diabetes six years ago. My most recent Hemoglobin A1c (HgbA1c) was 8. My current medications are Metformin, Lantus and Altace.
I am having trouble losing weight and I want to get off this medication. I do not want to have surgery. Are there alternatives to help assist my weight loss while still managing my diabetes?
A: Obesity often is a cause of type 2 diabetes as it may be in your case. Type 2 diabetes is a condition of carbohydrate intolerance (hence, glucose intolerance). You were likely prescribed the so-called “diabetic diet,” which includes a lot of carbohydrates such as grains, fruit and other sugars—a very poor antidote to type 2 diabetes and weight loss. This then requires the use of insulin (Lantus) in an effort to bring down your blood sugar. However, the continued consumption of carbohydrates and the required use of insulin to metabolize those carbohydrates keep you in a fat storage metabolism rather than the desired fat burning metabolism (lipolysis/ketosis) required for weight loss.
Your HgbA1c reveals poor blood sugar control. The recommendation is to achieve an HgbA1c of less than 7.0. Hard to do if you’re eating a lot of carbs.
The true antidote to type 2 diabetes and some much needed weight loss is a very low carbohydrate diet, which is high in healthy fats and proteins such as grassfed meats, poultry, eggs and butter, fish, avocado, nuts and seeds, and good quality olive oil. Your allowed carbohydrates are low-glycemic vegetables—mostly green ones.
Embarking on a diet and exercise program requires supervision from a qualified nutritionist and your physician who can monitor your medications and reduce dosages—especially insulin, as necessary. Never do this yourself.
To your health!
