Ask Leyla: I’m diabetic; what’s the best way to shed stubborn weight?

| By Leyla Muedin MS, RD, CDN

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I'm diabetic; what's the best way to shed stubborn weight?

Q: I am a 46-year-old male, weighing 260 pounds at 5’9” tall. I was diagnosed with type 2 diabetes several years ago. My most recent Hemoglobin A1c (HgbA1c) was 8, and I currently take Metformin, Lantus, and Altace.

I am having a great deal of trouble losing weight and I want to get off these medications. I do not want to have bariatric surgery for weight loss. What are my alternatives?

A: Obesity and type 2 diabetes often go hand in hand, as 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 like grains, fruit, and other sugars—a very poor antidote to type 2 diabetes, not to mention, weight loss.

All those carbs require 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 required for weight loss.

Your HgbA1c reveals poor blood sugar control. The recommendation is to achieve an HgbA1c of less than 7.0. This is almost impossible to do while eating a high carb diet.

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 moderate in proteins, including such foods as grass-fed meats, poultry, eggs and butter, fish, avocado, nuts and seeds, and good quality olive oil. Your allowed carbohydrates are low-glycemic vegetables—mostly green leafy ones. Salad greens, kale, spinach, collards and cruciferous veggies should be your mainstays.

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 appropriate. Only with this approach will you reach your weight loss goals and improved blood sugar control.


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