My clients with pre-diabetes often think they need to drop loads of weight to prevent developing diabetes. A current study that supports previous research on weight loss and diabetes proves them wrong. 1, 2

A recent study published in The Lancet Diabetes & Endocrinology found that a small weight loss puts prediabetes in remission and may protect against type 2 diabetes.  In addition, it’s linked with better kidney and vascular function. 3

The study from the University of Tübingen in Germany was led by Arvid Sandforth, M.D, and colleagues evaluated how weight loss induced remission in people with prediabetes. The study included subjects in the Prediabetes Lifestyle Intervention Study (PLIS) and the Diabetes Prevention Program (DPP) study who were randomly assigned to participate in a lifestyle intervention or placebo and lost at least 5 percent of their body weight.

Subjects whose blood sugar returned to normal fasting levels had normal glucose tolerance and hemoglobin A1c (HbA1c) below 39 mml/mol after a year of lifestyle intervention or placebo or control intervention were considered responders.

The investigators discovered that in PLIS, over 25 percent of participants had a weight loss of 5 percent or more of their body weight from the start, and of these, 43 percent were responders

Within the 683 DPP subjects who lost a minimum of 5 percent of their body weight at baseline, 19 percent were responders. Despite BMI reduction being similar between responders and non-responders, responders had increased whole-body insulin sensitivity compared to non-responders.

Secretion of insulin was not different within groups over time or between the groups. Both responders and non-responders had reductions in intrahepatic lipid content, but visceral adipose tissue was reduced more in responders. Within two years of the intervention, a 73% lower risk of developing type 2 diabetes was observed compared to non-responders.

The authors advise that “remission of prediabetes should be the primary therapeutic aim for individuals with prediabetes”. 3

Below are tips for weight loss in those with prediabetes:

·        Eat at regular intervals (4-6 hours apart) to prevent frequent snacking.

·        Swap out sweetened drinks and fruit juice for low-calorie beverages including water, tea, or coffee.

·        Brush your teeth after dinner as a signal that “the kitchen is closed”.

·        Include foods high in protein with all meals and snacks. These are more satiating and help regulate appetite and blood sugar.

·        Eat carbs in your meal last. This has been found to lower post-prandial blood sugar in previous studies. 4

·        Eat larger meals, earlier in the day. Research suggests this improves blood sugar and may impact weight loss. 5

·        Reduce overall sugar intake including candy, pastries, ice cream, and sweetened drinks.

·        Stay active. Both cardio exercise and strength training improve insulin sensitivity. Walking just 15 minutes after meals reduces blood sugar. 6

·        Include more vegetables, whole grains, beans, and whole fruit in your diet for adequate fiber.

·        Losing weight is difficult. Offer support groups for those looking to lose weight.

Lisa Andrews, MEd, RD, LD

References:

1.      Diagnosis and Management of Prediabetes: A Review - PubMed (nih.gov)

2.      Diet and exercise in the prevention and treatment of type 2 diabetes mellitus - PubMed (nih.gov)

3.      Mechanisms of weight loss-induced remission in people with prediabetes: a post-hoc analysis of the randomised, controlled, multicentre Prediabetes Lifestyle Intervention Study (PLIS) - The Lancet Diabetes & Endocrinology

4.      Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels | Diabetes Care | American Diabetes Association (diabetesjournals.org)

5.      Dietary support in insulin resistance: An overview of current scientific reports - PubMed (nih.gov)

6.      Exercise restores brain insulin sensitivity in sedentary adults who are overweight and obese - PubMed (nih.gov)