Medical Questions & Answers » Diabetes

Weight Loss Due To Type 2 Diabetes

medicalquestions — Sun, 14 Jun 2009 06:00:05 +0000

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.

Know Your Diabetes

medicalquestions — Tue, 16 Dec 2008 11:13:01 +0000

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.

Neuropathy in Diabetes

medicalquestions — Wed, 07 May 2008 06:00:49 +0000

Question: I am a 57 year old diabetic and have been told that I have autonomic neuropathy. I hate summer, as I can’t bear direct sunlight, and over the past few years I have stopped sweating completely. Can you help me with my problem?
One of the complications of diabetes is the blocking of fine arteries. This may result in problems as diverse as gangrene of a toe to blindness.
If the tiny arteries supplying the nerves become blocked, that nerve does not receive the oxygen and nutrition it needs, and dies.
The autonomic nervous system performs most of the subconscious automatic tasks required by the body, including telling the sweat glands when to operate.
Neuropathy is a term that merely means nerve damage. Your auronomic neuropathy is thus damage to the autonomic nervous system caused by diabetes, and because these nerves have died and cannot send the appropriate signals, you cannot sweat.
This will make it very difficult for your body to maintain its correct temperature, and it is vital that you do not become overheated. Cool baths or showers, and an air-conditioned room in summer, would be appropriate.
You must keep your diabetes under careful control by taking your medication (Diamicron is one of a number of excellent drugs used to control diabetes in older people), having regular blood tests, and visiting your doctor when appropriate to prevent any further damage to your body.

Effect of Diabetes on circulation

medicalquestions — Tue, 06 May 2008 06:29:09 +0000

Question: I have been suffering from type 2 diabetes, and have recently developed numb feet, and pains down the arteries of the leg. Could you explain what effect diabetes has on circulation, and what sort of specialist should I see?
There are two main types of diabetes—type 1 diabetes which usually affects younger people and requires insulin injections for control, and type 2 diabetes which is far more common, usually affects the elderly, and is normally controlled by diet and tablets.
Both types of diabetes can affect the small blood vessels (capillaries) and restrict the flow of blood. The most commonly involved small blood vessels are in the feet and eyes. In patients with inadequately controlled diabetes, poor circulation to the feet may cause numbness, redness, sores that won’t heal, and finally gangrene. In the eye, deteriorating vision is caused by poor circulation.
If the diabetes is well controlled, it is far less likely for these complications to occur.
Control of diabetes involves regular medication, a careful diet, checking the blood or urine levels of sugar, and checking with the general practitioner or specialist.
If a GP detects any problems that are significant, s/he will refer you to an endocrinologist (gland specialist). Some endocrinologists are super specialists, and treat only patients with diabetes.

Diabetes Difference

medicalquestions — Tue, 06 May 2008 06:26:23 +0000

Question: What is the difference between the diabetes children get and that suffered by oldies ?
There are two very distinct types of diabetes—juvenile (type one) diabetes and maturity onset (type 2) diabetes. The juvenile form may develop at any time from birth to the thirties, but the most common is between 10 and 20 years of age. Maturity type can start at any time from the thirties onwards, particularly in obese people, but is more common over 60. Juvenile diabetes is more severe and harder to control. It almost invariably requires injections of insulin once or twice a day for the rest of the patient’s life, as well as a strict diet.
In the mature form, diet and weight loss alone are often sufficient to control the problem, but some sufferers require tablets to be taken regularly, and a small number need insulin injections.
Diabetes is caused by either the failure of the pancreas gland in the center of the abdomen to produce insulin, or a reduced sensitivity of the cells in the body to insulin. The former tends to be the cause in the juvenile form, and the latter in the mature.
Insulin is essential for cells to take sugar out of the blood and into the cell, and without it, excess amounts of sugar build up in the blood and the cells are starved of a vital energy source.

Hereditary Diabetes

medicalquestions — Tue, 06 May 2008 06:00:18 +0000

Question: I have a bad family history of late onset diabetes. How can this be detected? Would a routine blood test for cholesterol find it? Are there any lifestyle changes I can make to prevent it? What are the early symptoms?
Late onset (type 2, or maturity onset) diabetes is a totally different disease to juvenile (type 1) diabetes. The former can be controlled by diet and tablets, while the latter requires regular insulin injections. There is a family tendency to develop type 2 diabetes, but it is not inevitable that you will develop it just because close relatives have the condition.
Diabetes is diagnosed by a simple blood test for the presence of excess sugar, but a test for cholesterol will not reveal the presence of sugar and diabetes.
You can delay, or prevent the onset of this form of diabetes by reducing the amount of sugar and fat in your diet, and by keeping your weight within normal limits.
The early symptoms are excessive thirst, passing more urine than usual, tiredness, blurred vision and frequent skin infections. If you are concerned that you may develop type 2 diabetes in the near future, your general practitioner can arrange for a glucose tolerance test (GTT) to be performed by a pathology laboratory. This test takes a couple of hours to perform, and can tell more accurately if you have diabetes, and sometimes it can predict if you are likely to develop the condition in the near future.