Q: I have Type 2 diabetes, and my doctor is always bugging me about losing weight. Now I hear that people with Type 2 who are overweight live longer than those who have Type 2 and are “normal” weight. If that’s true, whoopee, no more diets! What do you think? – Jan D., Naples, Florida
A: News about the new study you’re referring to has caused a lot of confusion, because it’s been reported as proving you’ll live longer if you’re overweight with Type 2. That’s the wrong take-away.
When you compare people with Type 2 diabetes who are a healthy weight when diagnosed and people with Type 2 who are overweight or obese when diagnosed, you probably are comparing two distinct subsets of Type 2 diabetes. Those who develop it when they are a healthy weight may well have a more dangerous form of the disease than those who don’t develop it until excess fat and metabolic changes create bodywide inflammation that interferes with using glucose for fuel.
Also, the study looked only at outcomes following a “cardiac event.” Although overweight and obese participants with Type 2 diabetes were more likely to have “an event” compared with normal-weight patients with Type 2 who also had a cardiac event, they had a better survival rate. However, this also may indicate that Type 2 diabetes in folks who are diagnosed at a healthy weight is more damaging.
Also, heart disease isn’t the only complication associated with Type 2 diabetes. Conditions such as diabetic nephropathy and dementia can be life-threatening and made worse by metabolic changes associated with excess weight.
If you have Type 2 and are overweight, and your goal is to reclaim your health, there is NO QUESTION that losing weight is step No. 1. Shedding 5 to 10 percent of your body weight may stabilize blood sugar, reduce blood pressure and allow you to become more active. That, in turn, can slash your risk for kidney, eye and nerve problems. So dig into healthy foods in healthy portions and start a walking routine, heading for 10,000 steps a day. Then you can say “Whoopee!”
© 2015 Michael Roizen, M.D. and Mehmet Oz, M.D.
Distributed by King Features Syndicate, Inc.