Weight and Diabetes

A balanced diet and an active lifestyle can help all kids maintain a healthy weight. For kids with diabetes, diet and exercise are even more important because weight can affect diabetes and diabetes can affect weight.

This is true for kids and teens with type 1 diabetes or type 2 diabetes.

Weight and Type 1 Diabetes

In diabetes, the body doesn't use glucose properly. Glucose, a sugar, is the main source of energy for the body. Glucose levels are controlled by a hormone called insulin, which is made in the pancreas. In type 1 diabetes, the pancreas does not make enough insulin.

Undiagnosed or untreated type 1 diabetes can cause weight loss. Glucose builds up in the bloodstream if insulin isn't available to move it into the body's cells. When glucose levels become high, the kidneys work to get rid of unused sugar through urine (pee). This causes weight loss due to dehydration and loss of calories from the sugar that wasn't used as energy.

Kids who develop type 1 diabetes often lose weight even though they have a normal or increased appetite. Once kids are diagnosed and treated for type 1 diabetes, weight usually returns to normal.

Developing type 1 diabetes isn't related to being overweight, but keeping a healthy weight is important. Too much fat tissue can make it hard for insulin to work properly, leading to both higher insulin needs and trouble controlling blood sugar.

Weight and Type 2 Diabetes

In type 2 diabetes, the pancreas still makes insulin, but the insulin doesn't work in the body like it should and blood sugar levels get too high. Most kids and teens are overweight when they're diagnosed with type 2 diabetes. Being overweight or obese increases a person's risk for developing type 2 diabetes. Also, weight gain in people with type 2 diabetes makes blood sugar levels even harder to control.

People with type 2 diabetes have a condition called insulin resistance. They're able to make insulin, but their bodies can't use it properly to move glucose into the cells. So, the amount of glucose in the blood rises. The pancreas then makes more insulin to try to overcome this problem.

Eventually, the pancreas can wear out from working so hard and might not be able to make enough insulin to keep blood glucose levels within a normal range. At this point, a person has type 2 diabetes.

Insulin resistance gets better with a combination of weight loss and exercise. For people with type 2 diabetes, getting to a healthy weight and exercising regularly makes it easier to reach target blood sugar levels. And, in some cases, the body's ability to control blood sugar may even return to normal.

Insulin resistance can happen in people without diabetes, but it puts them at a higher risk for developing the disease. For overweight people without type 2 diabetes, losing weight and exercising can cut their risk of developing the disease.

The Importance of a Healthy Weight

When kids with diabetes reach and maintain a healthy weight, they feel better and have more energy. Their diabetes symptoms decrease and their blood sugar levels are better controlled. They also may be less likely to develop complications from diabetes, like heart disease.

Doctors use body mass index (BMI) to determine if a person's weight is healthy. If your doctor recommends that your child lose weight to control diabetes, a weight management plan can hel. Even if your child's BMI is in the healthy range, the doctor can help you come up with a healthy meal and exercise plan.

How Can I Help My Child?

Your emotional support is an important part of helping your child get to a healthy weight. Overweight kids can have low self-esteem or feel guilty. Try to stay positive and talk about being "healthy" rather than use terms like "fat" or "thin." Help your child understand that all healthy people need to actively manage their weight — even you.

And remember that kids pick up on parental attitudes and actions about weight and eating — after all, you buy the food and cook the meals. By buying healthy foods and cooking nutritious meals, you provide the tools your child needs to get to a healthy weight.

What Else Should I Know?

Here are some common problems to watch for and discuss with your doctor:

• Oversnacking. Some kids with diabetes eat too many snacks because they or their parents worry about hypoglycemia (low blood sugar). Keep track of the snacks in your home and how quickly they're eaten. If you have questions about healthy snacks, talk to your doctor or a registered dietitian. Also, talk with your child about the importance of following the diabetes meal plan.
• Sneaking snacks. Kids or teens may sneak extras of the candy or sweets they're supposed to eat in moderation, which can raise blood sugar levels. Parents may respond by giving the child higher doses of insulin. This cycle can lead to excessive weight gain. Be sure your child understands why it's important to follow the meal plan, and ask questions if your child's blood sugar levels seem unexplainably high.
• Extreme dieting. Some kids with diabetes — especially teens — may try to lose weight with fad diets or other extreme measures. These aren't good for anyone, but they're especially unhealthy for people with diabetes because they throw blood sugar levels off track.
• Skipping insulin. Teens, in particular, sometimes skip insulin injections to lose weight. Talk to your child about why this is a dangerous tactic — it can lead to very high blood sugar levels and even diabetic ketoacidosis. Teens who do this may need counseling from a mental health professional to address an eating disorder or other body image or emotional problem.
• Exercise. Many parents worry about low blood sugars and so are nervous about how much kids with diabetes should exercise. But there's no need to limit physical activity. Your diabetes health care team can help you form a plan to avoid low blood sugars through changes in medicine or timed snacks.

By following the doctor's advice about food and exercise, your child can reach and maintain a healthy weight. Kids who reach a healthy weight feel better and find that diabetes management is easier. They feel like they're more in control of their diabetes, their bodies, and their health.

For any help along the way, just ask — your diabetes health care team can offer tips and advice on coping with weight-control challenges.