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Asked by Michelle, Tallahassee, Florida
My husband has adult-onset diabetes. He is 43, but was diagnosed about five years ago. His mother is diabetic as well. Both are very small-framed people who are not overweight nor very muscular. There is no doubt the disease is genetic for them.
My husband takes Glucovance to help control his blood sugar. He also strives to stay physically active despite a sedentary desk job. What advice can you offer for type 2 diabetics who struggle to maintain their weight?
Are there supplements that he would benefit from? He does his best to emphasize protein and fruits/veggies in his diet, but carbs are still a weakness. Seems like all advice is geared toward obese diabetics or insulin-dependent type 1.
Diet and Fitness Expert
Dr. Melina Jampolis
Physician Nutrition Specialist
Hi Michelle. This is an excellent question, as maintaining weight is very important to controlling blood sugar and decreasing risk of heart disease, the leading cause of death in diabetics. Staying physically active is critical, particularly with a sedentary desk job, and it is essential to incorporate aerobic exercise and resistance training.
A study released last week in the Journal of the American Medical Association showed that the combination of both types of exercise was the best way to lower hemoglobin A1c levels, a marker of long-term blood sugar control. In addition, combining aerobics and strength training helped reduce fat mass and waist circumference, a measure of harmful belly fat, which can increase risk of heart disease.
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Since you mention that your husband is not very muscular, adding in strength training is especially important for controlling blood sugar and maintaining weight, as muscle burns more calories than fat and helps improve blood sugar control and decrease insulin resistance.
There are no supplements that would help significantly with weight control, but I do recommend that most of my patients take a multivitamin, fish oil and vitamin D supplement for optimal health. There are some studies that suggest that chromium may help with blood sugar control in some diabetics, but it does not appear to help with weight control. If your husband's blood sugar is not well controlled, he may want to discuss trying this supplement with his physician.
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Finally, lowering the glycemic index of your husband's diet may help with weight control by improving blood sugar control, controlling hunger and possibly improving metabolism.
The glycemic index is a measure of how a food increases blood sugar. High glycemic foods cause a rapid increase in blood sugar, making it more difficult to control blood sugar and requiring more insulin, which may lead to worsening of diabetes and weight gain. Low glycemic carbohydrates are generally less processed, lower in sugar and higher in fiber. For more information about the glycemic index, visit the American Diabetes Association website or http://www.glycemicindex.com/.
In general, eating mainly lean protein, low-fat or fat-free dairy, small portions of healthy fat, whole grains in moderate portions and lots of fruits and vegetables will ensure a low glycemic diet.
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