Type II Diabetes Mellitus & Weight

Type II or Adult-Onset diabetes is a disease of elevated blood sugar related to
insulin resistance. Over 85% of people diagnosed with type II diabetes are
overweight and drastic weight control through bariatric surgery has been shown
to virtually cure the illness in many patients. The mechanisms by which obesity
influences type II diabetes are complex, but even modest weight loss through
simple exercise or dietary modification often causes significant improvement of
the disease. Nevertheless, type II diabetes is a complex illness and not all type
II diabetics are overweight and by no means do all overweight people develop
diabetes.


There are a number of
important risk factors for
type II diabetes including
family history, low HDL
cholesterol level,
hypertension, ethnicity that
is African American, Native
American and hispanic
American; but more
significant than any of these
is obesity. This makes
weight loss among the most
important medical goals for
type II diabetic people.

With weight loss, type II
diabetes usually improves so
that insulin dependent
people can often lower or
even eliminate their need for
injections and patients
taking oral medication
likewise can take less and
even sometimes no
medications.
We treat many diabetic patients in our practice. Not only are they elligible for
medical weight control therapy, they are among the best candidates since they
stand to gain such a dramatic improvement in health with weight loss.
Generally Dr. Holland wants diabetic patients to be under the care of a primary
physician for their diabetes and wants to see that a patient's blood sugar
levels are being adequately controlled by medication before starting them on
weight control medications. He asks that his diabetic patients monitor their
blood sugar level at home, usually daily, while losing weight.

Special Note About Metformin and Byetta

Metformin is an oral medication used to help control blood sugar in type II
diabetics and it can often have the side effect of producing some weight loss.
Byetta, which is discussed in more detail on another page of this website, is a
very unusual injectible drug used in the treatment of type II diabetes,
approved by the FDA in 2005, that lowers blood sugar and sometimes produces
remarkable weight loss. Dr. Holland encourages his diabetic patients to discuss
these medications with their primary care physicians if they are not already
taking them.

Conclusion:

Obesity is a major, if not THE major risk factor for type II diabetes and the
treatment of obesity is therefore a critical goal in the management of that
disease. Medical weight control, including the use of appetite medication can
often be undertaken in people with diabetes provided that their health and
blood sugar levels are good.
Molecular Model of Insulin
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