Most Type II Diabetics Should Lose Weight, Even If They Are Not Overweight


Most type II diabetics are overweight, but about 15 percent are not overweight. About 25 percent of children with type II diabetes are not overweight (JAMA Netw Open, 2022;5(12):e2247186). A study presented on September 23, 2022 at the European Association for the Study of Diabetes meeting in Stockholm found that 70 percent of normal-weight type II diabetics went into remission when they lost 10 percent of their body weight.

In this study, 20 normal-weight type II diabetics spent 2-4 weeks on an 800-calorie/day diet of soups, shakes and non-starchy vegetables, followed by 4-6 weeks of weight maintenance. They lost 10 percent of their weight and kept it off for six months to a year. Fourteen out of twenty people went into remission, with their HbA1c (a blood test that measures high blood sugar levels) returning to normal, and MRIs showing that the amount of fat in their liver had dropped to normal.

Excess Liver Fat is the Cause of Most Cases of Type II Diabetes
Everybody’s blood sugar rises after they eat, and if blood sugar rises too high, sugar sticks on the outer membranes of cells. Once sugar is stuck on a cell, it can never get off, and the sugar is converted by a series of chemical reactions to sorbitol, which destroys that cell. This damage to cells can cause blindness, deafness, dementia, loss of feeling, loss of muscle control, heart attacks, strokes, kidney failure and all of the other horrible consequences of uncontrolled diabetes.

Insulin is supposed to prevent a high rise in blood sugar, but people with type II diabetes are unable to respond completely to insulin.
• When blood sugar rises, insulin lowers blood sugar by driving sugar from the bloodstream into the liver.
• However, if the liver is full of fat, the liver does not accept the sugar and releases even more sugar to drive blood sugar levels higher.
• The term “insulin resistance” usually means that the liver is full of fat.

Skinny People Can Have Too Much Fat in Their Liver
Foods that cause a high rise in blood sugar are the ones most likely to cause excess fat to be deposited in your liver.
• You can store sugar in your liver and muscles, but these organs can store only a very limited amount.
• After your liver and muscles are full of stored sugar, almost all extra sugar is converted by your liver into fatty triglycerides.
• Excess blood levels of triglycerides can cause clotting, so your good HDL cholesterol carries the triglycerides into your liver.
• The higher your blood sugar rises after meals, the more triglycerides you form and the more fat you store in your liver.
• Having excess fat in the liver is the main cause of insulin-resistant diabetes.
• Having a fatty liver can make you diabetic, even if you don’t store much total fat in the rest of your body and so are not considered to be overweight.

My Recommendations
More than 70 perecnt of North Americans will eventually become diabetic or pre-diabetic, so virtually everyone should restrict all foods that cause high rises in blood sugar.
• Sugared drinks cause the highest rises in blood sugar
• Flour, made from ground-up grains, can cause high rises in blood sugar, so you should restrict bread, spaghetti, macaroni, pretzels, bagels, most dry breakfast cereals, crackers, cookies, and so forth
• Check the list of ingredients on food labels and try to avoid foods and drinks with added sugars
Mammal meat can cause a high rise in insulin that increases risk for cell damage.
Try to eat lots of foods that contain soluble fiber: vegetables, whole grains, beans, nuts and other seeds. Fruits contain sugar, but you can eat reasonable amounts because they also contain soluble fiber, which is converted to short chain fatty acids (SCFAs) that help to lower high blood sugar levels.