Is It Just The Weight Or Does Body Fat Come Into It?

[MikeyBikey]

I am not trying to start any debate on people's weight but discussing weight vs medication.

As is commonly known increased weight means increased diabetes medication. But is it as simple as that?

My current BMI is 26.6 on the calculator for tall people (it's higher on the NHS one). In the last two years my average total insulin dose has come down around 20%. The first 10% was as I lost 10lb in the first 6 - 8 months after escaping the care home. The foot was calorific, carby, fatty and basically carp! The choice was also limited with allegedly Covid to blame (utter tosh!). If you asked for a diabetic meal you usually got an omelette and salad - zero understanding and they would ;let me sit in on a diabetes training (misconceptions) session. The reason for the calorific food was allegedly to get calories into the frail and those with dementia.

Back to my story. After six months lout I finally had revision surgery after an eighteen month delay and two months later restarted physio. Although my weight has remained constant my insulin dose has gone down a further 10%. Whilst some can be put down to increased activity (not really that much) I think most is dure to decreased body fat as my waist, stump, wrist have al reduced in size as I muscle up.

So is body fat reduction more important than overall weight loss?

 

[Bruce Stephens]

So is body fat reduction more important than overall weight loss?

My guess would be yes.

 

[Lucyr]

So is body fat reduction more important than overall weight loss?

Yes I’d say it is

 

[everydayupsanddowns]

Interesting question @MikeyBikey

Over the years reading people’s experiences has affirmed the connection between lower weight and lower insulin resistance / more efficient use of meds in people of all types of diabetes (doses often needing to be reduced as weight comes down) but I’m not sure I have much information about whether the key driver of that is ‘being smaller’ or ‘percentage of body fat’. With the exception of T2 where loss of visceral fat around organs in the abdomen seems to ‘kickstart’ them.

 

[JamietDE6]

Hi, interesting thread. I attended a diabetes course a few months ago, one chap had lost almost 90 kg. Yes I said 90 over a period of a year. His HbA1c increased! Go figure that one. From my own perspective I was never significantly overweight which is why I was thought to be T1D initially ( still no wiser). I recently had an Ultrasound though which did confirm a fatty liver. Visceral fat is believed by many to be more relevant to our condition in terms of insulin resistance so perhaps overall weight is not the main factor to need for medication?

 

[MikeyBikey]

Hi, interesting thread. I attended a diabetes course a few months ago, one chap had lost almost 90 kg. Yes I said 90 over a period of a year. His HbA1c increased! Go figure that one. From my own perspective I was never significantly overweight which is why I was thought to be T1D initially ( still no wiser). I recently had an Ultrasound though which did confirm a fatty liver. Visceral fat is believed by many to be more relevant to our condition in terms of insulin resistance so perhaps overall weight is not the main factor to need for medication?

A friend who was well in the normal BMI range was initially diagnosed with Type II but didn't respond to increasing doses of Metformin. Once he got his GP (who diagnosed the Type ii) to refer him him he was diagnosed Type 1.5.. Are you under a clinic?

 

[helli]

I’ll start by saying I have no medical training and haven’t studied biology since i was 13 (a few years ago.
If your fat is “converted” to muscle, your fat percentage will go down but your weight probably won’t. However, I would expect, your insulin needs to be lowered. To maintain that muscle, you will be doing more exercise which will increase insulin sensitivity but I think it will be more than just the effect if the exercise.