Weight and Diabetes

Weight and Type 1 Diabetes

Undiagnosed or untreated, type 1 diabetes can make people lose weight. In type 1 diabetes, the body stops producing the hormone insulin, which is needed to use glucose, the main type of sugar in the blood.

Glucose comes from the foods we eat and is the major source of energy needed to fuel the body's functions. In type 1 diabetes, the body can't use glucose properly, so flushes the glucose (and the calories) out of the body in urine.

As a result, kids who develop type 1 diabetes can lose weight despite having a normal or increased appetite. Once they're diagnosed and treated, their weight usually returns to normal.

Excess body weight can occasionally be a problem for people with type 1 diabetes as well. Some are overweight before they develop the disease. And some may become overweight after diagnosis if they don't maintain healthy eating and exercise habits.

Developing type 1 diabetes isn't related to being overweight, but because lots of body fat can make it harder for the body to use insulin properly, overweight kids with type 1 diabetes also can have trouble controlling their blood sugar levels.

Weight and Type 2 Diabetes

Most people are overweight when they're diagnosed with type 2 diabetes. Being overweight or obese increases the risk for developing type 2 diabetes, and if someone who already has type 2 diabetes gains weight, it will be even harder to control blood sugar levels.

People with type 2 diabetes have a condition called insulin resistance. They're able to make insulin but their bodies can't use it properly to move glucose into the cells. So the amount of glucose in the blood rises. The pancreas then makes more insulin to try to overcome this problem.

Eventually, the pancreas can wear out from working overtime and may no longer be able to produce enough insulin to keep blood glucose levels within a normal range.

People with insulin resistance are often overweight and don't exercise very much. But weight loss, eating healthier foods and controlling portion sizes, and getting exercise can actually reverse insulin resistance. For people with type 2 diabetes, doing so makes it easier to reach target blood sugar levels and, in some cases, the body's ability to control blood sugar may even return to normal.

People who don't have diabetes can have insulin resistance, but they're at a higher risk for developing the disease. For overweight people without type 2 diabetes, losing weight and exercising can cut their risk of developing the disease.

Helping Kids Reach a Healthy Weight

Being at a healthy weight is good for everyone — parents included! When kids with diabetes reach and maintain a healthy weight, they feel better and have more energy. Their diabetes symptoms may diminish, their blood sugar levels may be easier to control, and they may be less likely to develop complications from diabetes, like heart disease.

A doctor can judge whether someone's weight is healthy by using the body mass index (BMI). If your doctor recommends that your child lose weight to control diabetes, a weight management plan may be prescribed. Even if your child's BMI is in the healthy range, the doctor can help you create a meal and exercise plan for your child.

Your emotional support can be an important part of helping your child get to a healthy weight. Overweight kids can have low self-esteem or feel guilty about having diabetes. Try to stay positive. Don't talk about feeling "fat" or "thin" — talk about being "healthy." Help your child understand that all healthy people need to actively manage their weight — even you.

And remember that kids pick up on parental attitudes about weight and eating — after all, you buy the food and cook the meals. By buying healthy foods and cooking nutritious meals, you'll provide the tools that your child needs to get to a healthy weight.

Being a good role model for your child is key. If you're overweight, talk to your doctor about beginning a weight management program so you can set a good example.

The diabetes meal plan already helps guide what your child eats, so reaching a healthy weight may simply mean adding more physical activity. Getting more exercise will make your child feel better and help with diabetes and weight control, so encourage your child to get moving every day.

Meeting Challenges

Reaching and maintaining a healthy weight can be a challenge for some kids and teens, just as it can be for adults. Here are some common problems to watch for and discuss with your doctor:

• Oversnacking. Some kids with diabetes eat too many snacks because they or their parents are very fearful of hypoglycemia (low blood sugar). Be aware of the snacks in your home and how quickly they're eaten. If you have questions about appropriate snacks, talk to your doctor or a registered dietitian. Also, talk with your child about the importance of following the diabetes meal plan.
• Sneaking snacks. Kids or teens may sneak extras of the candy or sweets that they're supposed to eat in moderation, which can elevate blood sugar levels. Parents may respond by giving the child higher doses of insulin. This cycle can lead to excessive weight gain. Be sure your child understands why it's important to follow the meal plan, and ask questions if your child's blood sugar levels seem unexplainably high.
• Extreme dieting. Some kids with diabetes — especially teens — may try to lose weight with fad diets or other extreme measures. These aren't good for anyone, but they're especially unhealthy for people with diabetes because they throw blood sugar levels off track.
• Skipping insulin. Teen girls, in particular, sometimes skip insulin injections to lose weight. Talk to your child about why this is a dangerous tactic — it can lead to very high blood sugar levels and even diabetic ketoacidosis. Teens who do this may need counseling from a mental health professional to address an eating disorder or other body image or emotional problem.

By following the doctor's advice about food and exercise, your child can reach and maintain a healthy weight. Kids who reach a healthy weight feel better and find that diabetes management is easier. They feel like they're more in control of their diabetes, their bodies, and their health.

If either you need help along the way, just ask — your diabetes health care team can offer tips and advice on coping with weight-control challenges.

Reviewed by: Steven Dowshen, MD
Date reviewed: May 2011