The latest clinical trial for diabetes relief found that nearly two-thirds (64%) of people who lost more than 10 kilograms through the implementation of a weight management plan were relieved after two years. Obesity is an important cause of insulin resistance and a major risk factor in the development of type 2 diabetes. Therefore, weight management is of great significance for the prevention and control of diabetes.
BMI is the most convenient monitoring indicator
The root cause of obesity is that energy intake exceeds energy expenditure. If the body’s long-term energy intake is greater than the consumption, the excess carbohydrates will be converted into fat and stored as metabolic energy. Individuals with insulin resistance will accumulate more fat due to hyperinsulinemia. If the subcutaneous adipose tissue is saturated, the newly synthesized excess fat will accumulate in the liver, causing insulin resistance and hyperinsulinemia, further promoting the increase of fat synthesis, forming a vicious circle. This shows that correcting energy imbalance can improve obesity and type 2 diabetes.
BMI (Body Mass Index, the most important indicator of weight management, is the number of kilograms of weight divided by the square of height meters) is the most convenient monitoring indicator for patients to manage their own weight. At present, the World Health Organization treats adults with overweight and obesity The definition of is based on BMI. The obesity standard for Chinese adults is generally considered to be: BMI ≥ 24 for overweight, BMI ≥ 28 for obesity, both slightly lower than the international cut-off point. The “Guidelines for the Prevention and Treatment of Type 2 Diabetes in China” (2010 Edition) recommends that the weight goal for pre-diabetic patients is: make the BMI of obese or overweight people reach or close to 24, or reduce their body weight by at least 5% to 10%; the comprehensive control target for confirmed patients That includes BMI<24.
Comprehensive measures to control weight
Methods of weight control include lifestyle intervention, weight-loss drugs, and surgical treatment.
Lifestyle interventions After being identified as type 2 diabetes, patients should improve their lifestyle, increase the time and frequency of physical exercise, and pay attention to improving diet. Patients should ask a specialist to help calculate the normal daily intake of calories, distribute them among the three meals, and have a balanced diet. The daily carbohydrate intake (rice, white noodles and various cereals, etc.) should account for the total daily energy intake 50% to 55%, which can not only ensure the supply of calories and nutrients, but also effectively avoid the increase in blood sugar after meals. Secondly, the vegetables are mainly leaf and stem vegetables. If you eat potatoes, sweet potatoes, yams and other starch-rich vegetables, you must reduce your intake of staple foods accordingly. Furthermore, dried fruits can be eaten, but they need to be limited: the amount of dried fruits that each person holds in his palm is the amount he needs in a day. It is recommended to choose chestnuts, broad beans, white melon seeds, and peanuts, as their fat content is relatively low. Finally, the intake of fruit varies from person to person. Patients with better blood sugar control can eat some fruits with low sugar content, and try to arrange the eating time between meals.
Medication If the improvement of obesity and diabetes-related symptoms is not obvious after adjusting their lifestyle and eating habits for a period of time, under the guidance of a doctor, oral hypoglycemic drugs that can reduce weight can be taken orally. For example, metformin can effectively promote the utilization of glucose by tissue cells such as muscles, inhibit liver gluconeogenesis, and effectively reduce glycogen output; GLP-1 receptor agonist, it can reduce fasting and postprandial blood sugar, significantly reducing Weight, low risk of hypoglycemia, lower blood pressure, reduce fasting and postprandial blood glucose fluctuations; α-glucosidase inhibitor, it can reduce postprandial blood glucose, light weight loss, there is no risk of hypoglycemia alone, can reduce other lowering The risk of hypoglycemia caused by sugar drugs; SGLT-2 inhibitors, which can lower blood sugar, significantly reduce weight, and reduce the risk of cardiovascular disease.
Surgical treatment of patients with obesity and a clear diagnosis of type 2 diabetes; body mass index> 27.5; age between 16 and 65 years old; diabetes course less than 15 years, you can consider weight loss surgery. Bariatric surgery is a kind of benign surgery, and it is the only means to obtain long-term and stable weight loss for severely obese patients. Bariatric surgery not only can effectively reduce the weight of patients, but also can effectively improve the coexisting blood glucose metabolism disorders in most patients. At present, there are two most commonly used bariatric surgery in China, one is sleeve gastric surgery, commonly known as “stomach becomes smaller”; the other is gastric bypass surgery, which makes the stomach smaller while “less absorption”. These two operations are suitable for obese and diabetic patients with different conditions.
