But the lower the weight, the better. Over time, it may lead to health problems such as fatigue, malnutrition and decreased immunity. The correct way is to let obese people lose weight, let thin people gain weight, and finally let patients return to normal weight.
Ideal weight of diabetic (kg)= height (cm)- 105. Generally speaking, patients are advised to control their actual weight within 95~ 105% of their ideal weight.
Clinically, diabetic patients often come to consult because of their obvious weight loss. Here, I will briefly introduce this issue.
1 Poor blood sugar control.
Under normal circumstances, glucose is the main energy source of the body. Due to insufficient insulin secretion and/or insulin resistance, glucose cannot be fully absorbed and utilized by the body, and the body can only provide energy by decomposing fat and protein, resulting in excessive consumption of fat and protein, so patients will become thinner and thinner. In addition, because the patient's blood sugar is lost with urine, although the patient has a large appetite, his hunger is still very obvious.
2 diet control is too strict
Diabetes needs diet control, but it cannot be overcorrected. Some diabetics go to extremes in diet control, go hungry every day, eat vegetarian meals three times a day and dare not eat anything. The calorie intake is seriously insufficient, and the nutrition is seriously lacking, resulting in a thin figure.
3 excessive exercise
Some diabetic patients did not increase their food intake after the increase of exercise, and their calorie consumption was obviously greater than their calorie intake, which led to a significant weight loss after a long time.
4 the role of some hypoglycemic agents
It has been proved that SGLT-2 inhibitors, GLP- 1 agonists, metformin and other hypoglycemic drugs have certain weight-reducing effects, which is undoubtedly a gospel for obese patients with type 2 diabetes. But for those non-obese diabetic patients, the use of these drugs will lead to further weight loss.
5. Diabetes complications or complications
1) Diabetes complicated with autonomic neuropathy leads to "gastroparesis" or "functional diarrhea". Patients often have anorexia, early satiety, abdominal distension, vomiting, chronic diarrhea and other symptoms. In the long run, they will lose weight because of malnutrition.
2) Diabetes complicated with hyperthyroidism, a disease with high metabolism and high consumption, will inevitably lead to further weight loss.
3) Diabetes complicated with tumor.
4) Diabetes complicated with infection, severe infection can lead to a large number of protein decomposition, making patients in a state of negative nitrogen balance. If nutrition can't keep up, it will inevitably lead to weight loss of patients.
When diabetic patients are obviously emaciated, they should ask about the medical history and physical examination in detail, and combine the necessary laboratory examination and imaging examination to clarify the specific reasons for emaciation, and then take targeted countermeasures.
If it is caused by poor blood sugar control, we should actively control blood sugar; If it is caused by pharmaceutical factors, it is necessary to stop using hypoglycemic drugs that can cause weight loss and try to switch to insulin or insulin secretagogue; If it is caused by strict diet control, it is necessary to appropriately increase the calorie intake so that the calorie intake is greater than the consumption, and at the same time supplement the patients with high-quality protein such as lean meat, eggs and milk, and pay attention to the diversification of diet structure; If it is caused by some complications or complications, we should actively treat these complications or complications (such as gastroparesis, hyperthyroidism, infection, etc. )
There is a limit to everything. For diabetics, obesity should be paid attention to and intervened. But excessive emaciation is not necessarily a good thing, especially unexplained emaciation, and other diseases are likely to lurk behind it, such as hyperthyroidism and tumors. Therefore, diabetics should pay more attention to their weight changes. When their emaciation cannot be explained, they should go to the hospital for consultation and examination in time. (This article is the first endocrine channel in the medical field)