Q: I’m diabetic and very overweight. I’ve
tried dieting and exercise but I just can’t seem
to lose weight. Any suggestions?
A: Sometimes it can be very challenging for people
with diabetes to lose weight. Diabetics either lack the
ability to make insulin or are insensitive to their own
insulin. For those who do not respond to insulin, weight
loss is especially difficult.
Insulin is a hormone released into the blood after eating.
Insulin binds to a receptor on a muscle cell and allows
blood glucose and amino acids to enter the cell. Once
bound to the cell receptor, the insulin itself is taken
into the cell and metabolized. Thus, insulin is cleared
from the bloodstream.
If a person is insensitive to insulin there is very little
receptor binding. Blood glucose levels stay elevated and
insulin is not cleared from the blood. The difficulty
with weight loss occurs because insulin directly inhibits
the enzymes that release fat from fat cells. When exercising,
the body releases fat to burn for fuel. If insulin levels
are high, this process is minimized.
The best strategy for weight loss would be to eat fewer
calories and to exercise when you’ve had the maximum
time to clear insulin from your blood. The best time would
be in the morning before you eat. In the morning your
insulin levels will be lowest because you’re farthest
away from your last meal. I suggest any exercise that
you can sustain for 30-60 minutes without getting too
winded. When it comes to weight loss, exercise duration
is more important than intensity. |
