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Why are overweight people at higher risk?

I am not understanding why would the fact that a person is overweight put them at higher risk for diabetes.

Lets say we have 2 people A and B.

A:  150lbs muscle + 20lbs fat = 170lbs total
B:  150lbs muscle + 50lbs fat = 200lbs total

Lets say they both eat a meal with the same amount of carbs, the insulin response of the muscle cells is higher than that of the fat cells so they both absorb the same amout of glucose with their 150lbs of muscle each.

Now fat cells still help absorbing the glucose even though not as much as muscle.

So 'A' absorbs some more glucose with his 20lbs of fat, but 'B' should absorb even more with his 50lbs of fat?

So seems like the heavier person would actually absorb more glucose out of their bloodstream? Then why are they at higher risk?
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Avatar universal
Thank you,

I really hope this is not genetic since nobody in my family is diabetic and that I caught whatever is causing my glucose levels to be higher than normal early enough so that I can completely reverse it without any major diet modifications.

Thanks.
Helpful - 0
231441 tn?1333892766
Hi Rincer.
Agree that the way to go is by making small changes.
You are doing what we call "Eat to your meter".  So you will adjust what and how you eat based on your meter readings.

I find that if I eat high calorie foods one day, my blood sugar the next morning will be high.

Lucky for me, I also found that a glass of wine at night, will reduce the following day's blood sugar.

You are on the right track. Keep up the good work.
Helpful - 0
Avatar universal
Hi,

Personally I feel pretty good and healthy with my current diet, so the goal is to make small incremental changes rather than a sudden transition to a low carb, or high fat diet.

Cutting out the simple carbs was the first step, thats why I wanted a way of monitoring my progress to be able to reach a decision point if further diet changes are required.

I want to try and bring my fasting blood glucose down from the 100-110 range it is in now to somewhere in the mid 80s.

I think I am beginning to see a correlation between what I have for dinner and the meter readings in the morning. High carb meals like pasta or pizza seem to result in higher readings, but I haven't done enough tests to be sure.
Helpful - 0
231441 tn?1333892766
Hi,

here is the latest recommendation on low carb diet.  I also follow a low carb diet and find it very effective (when I follow it).  I do my best to avoid grains, and also eat very little fruit.  Mostly non-starchy veges, and meats.


http://www.diabetesincontrol.com/articles/diabetes-news/17323-why-a-low-carb-diet-should-be-the-first-approach-in-diabetes-treatment

http://www.diabetesincontrol.com/articles/diabetes-news/17136--very-low-carbohydrate-low-saturated-fat-diet-for-type-2-diabetes-management-

http://www.diabetesincontrol.com/articles/53-/16701-low-carb-diet-recommended-for-type-1-and-2-diabetes-patients
Helpful - 0
4851940 tn?1515694593
I have looked at the UK Diabetic website that explains about the high fat diet and all the diets.  Because this web site does sell products I am not able to post a web link.  It doesn't say which diet is the best though.

The link below does explain about the different fats.
http://www.nhs.uk/Livewell/Goodfood/Pages/Fat.aspx

The classes I attended were more focused on the "healthy eating plate" and different foods were portioned out, for example more veg on your plate, a deck of cards size portion of meat and so on.  No food was excluded.  It talked about portion sizes and making healthy choices.



Helpful - 0
4851940 tn?1515694593
You can post links as long as they are not adverts for selling products.

I am interested in knowing about this latest research.  I see a qualified dietician and have attended  healthy eating sessions that talked about the different carbs, fats, sugars, reading food labels, exercise etc., and they certainly were not promoting any diet that was high on fats.  There are different types of fats, good and bad.  Our body does need fat to help absorb the fat soluble vitamins, but to say we have to have a high fat diet - I cannot buy this.  

Same when you talk about low carb diet.  What is a low carb diet?  Fruit and veg are carbs as are breads, cakes.  Rice, pasta and potatoes have recently been referred to as starchy carbs.  

Helpful - 0
231441 tn?1333892766
I have to disagree slightly with Jemma. There is a big use to testing and understand how your blood sugar works, even in prediabetes.

A blood meter is absolutely your best tool for seeing the impact of food on your blood sugar.  Using this you will absolutely learn control.  Yes of course the reading will depend on what you ate.  That is why you are testing.

Test as follows (you may test a different meal on a different day).  Fasting.  This will show impact of the previous day's calories, food choices, exercise.  1 1/2 - 2 hours after eating (this should give your maximum blood sugar after any particular meal), before the next meal (this will tell you if your blood sugar has come down, ideally back to fasting level.

To avoid so many pricks, you may want to test just 1 meal a day.  Vary that between breakfast, lunch, dinner.  YOu will soon learn what does and doesn't work.

Not all meters are very accurate, but they are the best tool you have.  And it puts the control and immediate feedback in your own hands.

The latest research and state of the art approach on diabetes recommends a low carb diet, NOT a low fat diet.  Unfortunately I am not allowed to give you links here.    But you can easily research this.
Helpful - 0
4851940 tn?1515694593
It is still reliable for you to monitor and chart your blood glucose.

Just remember that the reading will vary depending on what you have eaten, when you took the test, before or 2 hours after your food, and so on.

I don't monitor myself, as my doctor feels I don't need a monitor.  My husband has one because he had a problem to stabilise his diabetes and it was very high.  He is on injections of insulin and tablets now.  

Speak with your doctor or the diabetic nurse when your see her.  Ask your doctor to refer you to a diabetic nurse who will have more time to discuss your issues with her than the doctor.  They will explain to you when to do your self monitoring at home and may even have a chart for you to fill in.

When I feel unwell with foggy vision, I usually ask my husband to test my sugar levels using his monitor.  

Do bear in mind also that if you have an illness or ever have any steroid injections, your sugar levels will go up.  But will come back down again when you are well.

Best wishes.
Helpful - 0
Avatar universal
Hi,

Thats excellent diet advice, but I am wondering how can I monitor my progress at home to see if the changes I am making are actually having an impact?

So is the meter test basically not reliable enough?



Helpful - 0
4851940 tn?1515694593
Don't forget when the laboratory analyses the blood sample for the HbA1C test, this gives the AVERAGE reading over a period of 9-12 weeks.

When you are doing a home monitoring check this gives you the blood glucose reading what it is at the time you have taken the blood test.  

The monitor testing will always be different depending on when and at what time you take the blood prick test, what you have eaten and any exercises that you have done.

When your next HbA1C blood test is done and it shows that you are still at the pre diabetic stage or have crept to the diabetic stage, you doctor may consider prescribing a low dose of Metformin slow release tablets.

The other further changes that you would need to consider is cutting down on the amount of food that you eat.  You should find on the web the right portion sizes that we should eat.  A calorie for a man would be 2000 if you want to count calories.  But you don't need to count calories.

Remember portion sizes, cut down on your fat intake; use healthy oils; bake, poach, grill or boil and don't add butter to your food.  Don't eat too much of the starch carbohydrates.  East wholemeal seeded bread instead of white.  If you buy ready made meals and have restaurant meals, watch for hidden fats and sugars.  Read food labels to see how much fat and sugar there is.  Cut down on your intake of the unhealthy fats.  Low fat foods are not necessarily healthy - they may contain more sugar.

Ask our doctor to refer you to a dietician who will be able to help you more with regard eating portion sizes.
Helpful - 0
Avatar universal
That last sentence should've read:

"Assuming I take a reading every morning, and see no drop in the fasting glucose level,  any idea how long would it take for me to establish that perhaps further changes are required?"
Helpful - 0
Avatar universal
Hi,

I got a glucose monitor already its one of the Aviva brand ones. I haven't done many readings, but it seems to pretty much agree with the lab results. Fasting levels are between 98-109, seems like the later in the morning I take the reading the lower it is, but I am not sure there is an actual correlation.

My eyesight has been checked over very thoroughly in the last month since this is actually what lead me to doing the glucose test. So far it seems to be unrelated to blood glucose.

I did cut all the simple sugars, but haven't done anything else about my diet. I also added more high intensity to my training, since I read it improves insulin sensitivity. So far the only change is that I actually got a bit leaner.

Assuming I take a reading every morning, any idea how long would it take for me to establish that perhaps further changes are required?

Helpful - 0
4851940 tn?1515694593
My dietician specialising in diabetes, said that it can take 5 to 10 years to develop Type 2 diabetes when you are pre diabetic or glucose intolerant.

My doctor does not believe that you need a glucose monitor if your levels are pre diabetic, nor if you become diabetic with HbA1C levels that show you are stable in the lower range, i.e 6.9 HbA1C.

I do not agree with a high fat diet and neither would any dietician.  

You doctor should give you advice how often to have an HbA1C blood test done.  It could be once a year, but this depends on your doctor.

Do look after your eyesight and get consider booking an appointment with an optician that offers diabetic eye screening.  Even with pre-diabetes or glucose intolerance, you can still get damage to the little veins in the eye as well as develop nerve problems.  If you notice you get foggy vision, this will mean you have too much glucose in your body from having eaten too much (and especially simple carbs - sugary foods).

Ask your doctor to refer you to a dietician.  There is lots of information on the web with regard to what and how much to eat, but seeing a dietician is very useful and you can also ask him/her questions and get lots of tips and information.
Helpful - 0
231441 tn?1333892766
Hello,

to make the most of whatever capacity your pancreas has and to try to normalize your Hba1c, you should adopt a low carb, moderate protein, high fat diet.

You should get a home blood sugar meter and keep track of your fasting, and your 1 1/2 - 2 hour post eating results.  Using these numbers as feedback on the effect of what you ate at a particular meal or the effect of exercise, you will see how you can bring your blood sugars down.

If you are actually developing diabetes, then this approach should stabilize you for a while (and also let you see if things are progressing or not).
Helpful - 0
4851940 tn?1515694593
To get out of the pre-diabetic range, cut out or cut down on the chocolates, biscuits, sweets, corn syrup and anything that is classed as a simple carb that also includes fizzy drinks that contain sugar and glucose.

Because you are exercising a lot, you need to eat a complex carb before your workout (half an hour to an hour before, whatever is the recommended time) and after your workout, you need some complex carb to give you back the energy.

A UK TV programme last week on foods and drinks did a study of comparing which fluid would hydrate you better, water, sports drink or milk.  The result was that milk hydrates you the best and the sports drink and water were on a level par.  

With eating healthily and doing your exercise you are still able to revert back to normal ranges.  You can still eat anything you want, but you do need to eat small portions of the simple carbs (sweets, cakes etc) as a treat rather than an every day thing.

Have a healthy breakfast, a mid morning healthy snack.  Healthy lunch, healthy mid afternoon snack, healthy evening meal, and a late healthy snack if you feel you need one.  Fruit is fine, but fruit drinks need to be drunk in small quantities.  The whole fruit although contains fructose (fruit sugar) also contains minerals and vitamins as well as fibre and the energy is broken down slowly in the body compared to the fruit juice.

Other healthy snacks are low sugar and low fat yogurts; unsalted nuts (a handful), any veg, peanut butter.  You can find more information and recipes on the web.

Eating smaller meals more often prevents your sugar levels dropping too low.  Hypoglycaemia (low sugar levels) can happen when you are a pre diabetic or glucose intolerant.   Symptoms could be extreme hunger sometimes to the point of vomiting, nausea, headaches.
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Avatar universal
yes, american charts are the same. I guess what I meant is that I would feel better if I was also out of the pre-diabetic range as well and by a decent amount too.
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4851940 tn?1515694593
According to the UK Diabetes web site the results of a fasting test for glucose levels in the body are:-

Normal levels are:     3.9 to 5.5 mmol/l  (70 to 100mg/dl)

Prediabetes or impaired glucose tolerance levels are:
                                   5.6 to 7.0 mmol/l  (101 to 126 mg/dl)

Diagnosis of diabetes the levels are:
                                    more than 7. mmol/l  (126 mg/dl)
Well in the UK they were until a couple of years ago when it was reduced to 6.9 mmol/l.

The American Diabetes Association reduced the level of diabetes diagnosis in the fasting test from 140 to 126 mg/dl in 1977.  They may have been reduced since then.

According to the UK Diabetic charts you are in the non-diabetic range.
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Avatar universal
Hi,

Thanks for all the info.

I am still wondering if there is still anything I can do to get my fasting glucose and a1c levels into a completely normal range?

From what I am reading on this forum. Low 80s for fasting glucose and a1c < 5.0 is the non-diabetic range.

Helpful - 0
4851940 tn?1515694593
You are fine.  If you continue to the exercises like you have been, you don't need to worry about your foods and carbs.  The body needs carbs for energy.   The types of carbs to watch are the simple carbs like cakes, sweets.  But as you are burning up the energy, your body needs it.

If your lifestyle changed, then you would need to cut out or cut down on the simple carbs.  Although fruit contains fructose (sugar in fruit), when you eat the whole fruit the energy is broken down differently because of the fibre.  
So the type of carbs to eat would be the slow release energy carbs, like porridge, wholemeal bread and so on.

With the fats, there are good fats and bad fats.  It is the trans fats that you have to watch.  Oil in fish, nuts, avocado, olive is the healthy oil.
Coconut oil is healthy and has antibacterial and antifungal properties, can be eaten off the spoon, used in cooking, used on the skin, in the scalp, get make up off, used in baking.  It is the only oil that does not change its composition when heated up.  Unfortunately it is a saturated fat like butter.

The reason your eye sight and your blood sugar was checked is that with high sugar levels in the body, this can damage nerves, cause peripheral retinopathy which is damage to the small blood vessels inside the eye, cause circulation problems.  

Not everyone gets symptoms of diabetes and damage can happen way before you even notice any symptoms.

Glad that you are fine.

Helpful - 0
231441 tn?1333892766
Hi,

to develop diabetes, you need the unhealthy lifestyle and genetic predisposition or environmental trigger.

I think your Dr is right that you don't need to worry too much at an A1c of 5.3.  However, it is definitely something to be monitoring to see if it progresses over time.  Of course you should be keeping up activity levels, and maintaining weight.  

Cutting carbs is really important to preventing progression of diabetes / controlling it if it does develop.  After all - what is diabetes - it is a defect in how the body handles carbs.


Low carb, moderate protein, high healthy fats.  There is currently a lot of research about ketogenic diets and endurance training.  Tim Noakes used to be a big advocate of carbs / carbo loading, but now has done a 180 degree turn and is very much advocating low carb, high fat diets for athletes.  You can certainly research this and should find it interesting.

Helpful - 0
Avatar universal
No, I am 48 yrs old and well inside my weight range for my height and I am an ex-marathon runner, I still exercise for at least and hour daily, 6 times a week.

Had a fasting BG test done recently because of some eyesight changes and it came back at 107, A1C was 5.3 I think.

Dr, said the eyesight changes were not due to BG and not to worry as long as I stay slim, and keep doing what I am doing, but I am concerned.

I am used to eating a lot of carbs for my training, so now I am cutting all the extra snacks, sweets, etc. Also trying to add back some high intensity sprints to my running routine since I read it increases insulin sensitivity.

Thing is I never had a BG test done before so I don't know whats normal for me.
Helpful - 0
4851940 tn?1515694593
Are you overweight and have been told recently that you have glucose intolerance or Type 2 diabetes?

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4851940 tn?1515694593
Only if you have glucose intolerance or Type 2 diabetes that is not too advanced.
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Avatar universal
I meant its a downwards spiral if nothing is done.

So can one do even more than just stopping it spiraling down? Can pancreas function and/or insulin resistance ever be restored to normal through lifestyle changes, exercise etc?
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