Diabetes sufferers may be able to give up their cake and eat it, too. According to a new study, people who lost weight in the 18 months after being diagnosed with type 2 diabetes experienced sustained benefits even if they regained the weight later. They were up to twice as likely to reach their targets for blood pressure and blood sugar as those who didn't lose weight, although by the end of the four-year study, most of them had regained the weight they had lost.
Researchers speculate that "metabolic memory" may help explain the results; that is, achieving early metabolic control may have a long-term effect on clinical outcomes. Or it could be that the study didn't last long enough: "One possibility is that if we'd looked further out, the benefits would go away," says Greg Nichols, a researcher at Kaiser Permanente Center for Health Research who coauthored the study, which appeared online today in the journal Diabetes Care.
Whatever the reason, the study simply adds more weight, as it were, to the existing recommendation that those newly diagnosed with type 2 diabetes shed some pounds. "You only need to lose 5 to 7 percent [of your body weight] to have a major impact on glucose levels," says Om Ganda, a senior physician at Joslin Diabetes Center and an associate clinical professor at Harvard Medical School.
If you've recently been diagnosed, there's more you can do to reduce your risk of complications. Here are six other tips, besides losing weight, based on American Diabetes Association recommendations:
- Get a primary-care physician. If you don't already have one, sign up with a primary-care physician who can work with you on an ongoing basis to keep your blood pressure, blood sugar, and cholesterol levels within recommended guidelines. Check out my recent story about studies that offer hints on how to prioritize your efforts. Most newly diagnosed patients don't need a physician who specializes in diabetes, says John Buse, an endocrinologist who's president for medicine and science at the ADA.
- Get educated. Find a diabetes educator in your area to help you learn about the disease. Working with an expert can make you feel more in control. "When someone gets a diagnosis of diabetes, it's a little like cancer," Buse says. "They have some understanding but lots of fear."
- Exercise. The ADA recommends 30 minutes of moderately vigorous physical activity most days of the week. Even if you don't lose weight, exercise can help improve your blood sugar levels.
- Take the drugs you need. Get a prescription for metformin. This generic, inexpensive drug can help get your blood sugar under control, with few side effects. If you've got high cholesterol, you should have a prescription for a statin as well. If you're over 40 and have heart disease, take a baby aspirin every day.
- Make a plan for regular specialist checkups. At a minimum, you'll need annual eye and foot exams and a dental exam every six months.
- Get family members on board. "It's impossible to make these lifestyle changes if everybody in the family is doing something else," says Buse. In other words, it's tough eating vegetables if everyone else is having chips. Besides, it's a lot more fun to go for a daily walk with someone else than all by yourself.