Diabetes and Weight Loss: Don't Lose Sight of the Goal

I was reading an article this morning, written by a doctor, which called into question the value of exercise in weight-loss programs. He pointed out that exercise really isn't all that important, in terms of weight loss, and he isn't wrong.

But, while reading this article (which I'm not linking to, since the article, itself, isn't the actual focus of this post), I found myself hoping that, despite its truth, no newly-diagnosed diabetics were reading it. My reasons for this are two-fold:
 

  1. Whether it impacts weight loss or not, exercise can definitely impact blood sugar levels.
  2. Diabetics who are trying to lose weight in order to achieve better glucose control sometimes lose sight of which of those two things is the actual goal.

Exercise can decrease blood sugar. For some of us, it's crucial to achieving and maintaining healthy blood sugar levels. Change the timing, the specific exercise, the particular diabetic, and/or the pre-exercise state, and exercise can make blood sugar go up. In either case, exercise is an important aspect of managing diabetes. 

Overweight diabetics are frequently told that losing weight will help them to control their blood sugar levels. Some diabetics maintain that weight loss has, indeed, helped them. Others insist that losing weight made not an iota of difference. Whether weight loss is beneficial to diabetics or not, however, is irrelevant to my point:

If you are trying to lose weight in order to improve your blood sugar levels, you cannot allow weight loss to become the primary goal.

It's all too easy to let your weight loss goal eclipse your blood sugar goal. Why? Because you'll get far more positive reinforcement for reaching the former than you will for achieving the latter. Friends, relatives, and casual acquaintances will notice when you've dropped several pounds. They'll tell you how good you look, and how great it is that you've gotten smaller, and some will even ask how you did it.

On the other hand, very few people in your life will know, or understand what it means, when you've brought your A1C down from 8.7 to 5.5. Most of them simply won't get the significance of going from a fasting blood sugar of 333 mg/dL to a two-hour postprandial of 85.

And plenty of folks will be willing to tell you that you're doing it wrong, even when you have the numbers to back you up.

Those numbers -- the ones on your glucose meter -- are your closest friends. They are (or should be) your trusted advisors, letting you know -- without the influence of cultural trends, conventional "wisdom", or personal biases -- if you're doing what you need to do in order to prevent both diabetic complications and progression.

The numbers on your scale should be the neighbors whose company you enjoy, but whom you don't trust enough to leave the keys with. When they're happy, you're happy. But they certainly aren't more important than your closest friends.

To reiterate:

  1. As they relate to diabetic complications and disease progression, blood glucose is more important than body weight. The numbers on your glucose meter are more important than the numbers on your scale.
  2. Exercise can be an important tool in controlling blood sugar levels, whether it's important to weight loss or not.