I have often read that overweight is a risk factor for Type 2 diabetes. Yet in my own family I have seen that, over the long term, diabetes itself appears to cause weight loss. And despite being reduced to half their size, they are still unable to get rid of the condition. Why is this so? Why does Type 2 diabetes cause people to lose weight? And why doesn’t this help control the condition?
When the cells of the human body get stuffed with fat they stop responding to insulin. This is referred to as insulin resistance. In Type 2 diabetes most patients are overweight and thus insulin resistant. That is why they are only able to gain control of their condition with oral agents (drugs). Now if the person follows a healthy diet and regular exercise plan, he will lose the “fat weight, which makes him insulin sensitive again. But if the diabetes is uncontrolled and blood sugar is high, then the body bums muscle to obtain energy, because insulin is unavailable to break down carbohydrates into glucose. This leads to muscle loss, which makes the body weak and the diabetes remains high and out of control.
So the key is to lose fat and not muscle weight. Individuals whose diabetes is poorly regulated may have lost a lot of weight but they never get cured. Whereas those that lose fat by virtue of intense exercise and a good diet, will get more insulin sensitive and thus are able to overcome their diabetic condition.

I am 73. I am an exercise freak accustomed to regular early morning walks coupled with mild aerobic exercise. Of late, while walking or standing for a long time I experience numbness in my toes, wobble, and lose my balance. An MRI revealed that there is “circumferential disc bulge and posterior disc protrusion at L-4 to L-5 levels, L5-S1 level with compression on S1 nerve root.” I was put on spinal chord rehab which has given only 50% relief. I am continuing the exercises, but not walking as much as I used to, with the result my weight is increasing. At this advanced age with coronary heart disease, is spinal surgery an option, or is it advisable to battle it out as I am doing now? Can I use an exercise bicycle to stay in shape without any damage to the spine?
You have a mechanical problem of spine degeneration with bone formation in the discs and joints. A spine surgery to decompress is acceptable even at your age, as this is a problem of ageing. The surgery will give you considerable pain relief. Still, you will need to exercise prudence to prevent the other discs from deteriorating. The exercycle is unfortunately unkind to the knees. For the present you’ll have to rely on a judicious diet to keep your weight down.
Do keep in mind that when you decide on the surgery, it should be undertaken by a Spine/Neurosurgeon and not a general/ orthopedic surgeon.

I have been a diabetic for 30 years. The diabetes is under control but a urine test last year showed Albumin levels at +3. With medication the level has dropped to +2 but does not go lower. Sometimes I also get Edema. I would like to know exactly how diabetes damages the kidney, what I can do to prevent it and how to control the albumin level.
Diabetes is known to cause some end-organ problems eventually as it has been present for so long. Proteinuria is the earliest sign of the kidneys being affected. Loss of protein in the urine causes the protein level in the blood to drop, and as a result there may be edema of the face in the mornings and of the feet in the evenings. Good control of diabetes is essential. Minimize your intake of sugar and sugar products; fried, spicy, salty and sour foods; tea; coffee; alcohol. Although some of these are healthy foods, they may aggravate water retention. Avoid tobacco and limit the use of pain killers and antibiotics, which could damage the kidneys. There is no drug or other substance that can reverse kidney damage once it has occurred. The best medication can do is retard/stop the deterioration. None of the alternative medicines have a cure for this condition although they claim that they can do miracles.