- Relationship to Diabetes
- At risk of diabetes
If a person with type 2 diabetes wants to start losing weight quickly, to work towards remission, it's important to make sure it’s safe and clinically appropriate, especially if they have other health conditions.
If a person is on insulin, sulphonylureas such as Gliclazide and Glipizide, or medication for their blood pressure, a review with their healthcare professional is vital to ensure that it’s clinically appropriate. Also, they may need to reduce or stop any diabetes medications such as insulin or sulphonylurea, before they begin losing weight, as blood glucose levels are likely to lower rapidly. For people on blood pressure medication, this may need to be stopped, or the dosage reduced, before starting an intensive diet such as a low-calorie meal replacement diet, as blood pressure is likely to fall.
There are circumstances when it is unsafe to lose weight to work towards remission, which include the following:
Pregnancy and breastfeeding – Intentional weight loss during pregnancy or while breastfeeding is not recommended. The rapid weight loss would harm the baby developing in the womb and adversely affect breast feeding. Some women experience weight loss as a side effect of breastfeeding.
If a person is on insulin, sulphonylureas such as Gliclazide and Glipizide, or medication for their blood pressure, a review with their healthcare professional is vital to ensure that it’s clinically appropriate. Also, they may need to reduce or stop any diabetes medications such as insulin or sulphonylurea, before they begin losing weight, as blood glucose levels are likely to lower rapidly. For people on blood pressure medication, this may need to be stopped, or the dosage reduced, before starting an intensive diet such as a low-calorie meal replacement diet, as blood pressure is likely to fall.
There are circumstances when it is unsafe to lose weight to work towards remission, which include the following:
Pregnancy and breastfeeding – Intentional weight loss during pregnancy or while breastfeeding is not recommended. The rapid weight loss would harm the baby developing in the womb and adversely affect breast feeding. Some women experience weight loss as a side effect of breastfeeding.
- Previous diagnosis of an eating disorder
- Active cancer
- Heart attack or stroke in last 6 months
- Severe heart failure (defined as New York Heart Association grade 3 or 4)
- Severe renal impairment (most recent eGFR less than 30mls/min/1.73m2)
- Active liver disease (not including NAFLD)
- Active substance use disorder