Do you have any tips on managing (and or avoiding if possible) diabetes as a gainer? Not sure where to look or where to start.
One of my first jobs after I got my masters in medical anthropology was working on a team designing a culturally inclusive type 2 diabetes prevention program. I learned a lot from the nurses and doctors I worked alongside. I’ve also learned a lot from having diabetes for the last 10 years while also gaining about 300 pounds on purpose.
Prevention
A lot of this is also good advice for managing your blood sugar if you already have a diabetes diagnosis.
1. It’s not always possible if you are genetically predisposed. But you can definitely delay the onset.
2. Physical activity lowers blood sugar and decreases insulin resistance. It doesn’t have to be arduous, even just going for a walk a few times a week helps. Try to find something you enjoy. I like to swim laps at the gym.
3. Eating balanced meals and choosing complex carbs over simple ones. This means whole grains and making sure you have protein, fat and carbs in roughly equal amounts in each meal. It’s never a bad idea to have more veggies.
4. Don’t freak out about a pre-diabetic diagnosis. This is a controversial diagnosis and is not accepted by the WHO. About 50% of those who receive this diagnosis go on to develop diabetes. It’s about as predictive as a coin flip. The positive is that it can serve as an impetus to try some of these strategies to prevent or delay actual diabetes.
Management
1. Don’t freak out if you are diagnosed. This is an easy disease to manage.
2. Don’t neglect managing it. Uncontrolled diabetes has significant consequences like blindness, amputation etc.
3. Losing massive amounts of weight to “cure” diabetes doesn’t work. You may see a temporary return to normal blood sugars but you will regain the weight back just like 90% of dieters do. And when you do regain the weight your blood sugar control will likely be worse than before.
4. Ask your doctor for a continuous glucose monitor CGM. They are probably free through your insurance. They are a wearable device that transmits glucose numbers to your phone. They keep you from having to constantly prick your fingers.
5. You have many non injection options for medication. Lots of different pills.
6. Insulin works great. Many doctors will want to delay starting you on it or push weight loss meds. This is because most people gain weight on insulin. Another medication that works really well and also causes significant weight gain is Actos. This medication actually helps move visceral fat out of your liver and turns it into beneficial subcutaneous fat. When combined these can contribute to rapid weight gain and improvement in blood sugar levels.
7. You are the person who decides what medications and treatments you go on. Not your doctor. There may be limits set by your insurance but if you don’t want to take a particular medication and want to instead try something else you have every right to tell your doctor this. You can also tell them you are not interested in losing weight. You can also decline to be weighed at the doctor. They are providing you a service, they are not your boss even though they have power in the interaction. This is called patient’s right of refusal and you should exercise it.
8. Be patient and kind to yourself. Anxiety around a new diagnosis is normal. It will take you time to learn how to manage your diabetes. Managing other issues such as your mental health helps make controlling your diabetes much easier.
