What weight loss strategies can my husband with T1D try at 39?

Question

Hello doctor,

My husband is 39 years old and has type 1 diabetes. He also struggles with obesity, with a BMI of 38. His HbA1c is 8.5 %, and his fasting blood sugar averages around 190 mg/dL. He follows a basal-bolus insulin regimen but finds it challenging to control his blood sugar levels alongside his weight.

Could his weight be contributing to insulin resistance? Are there safe weight-loss medications or dietary strategies for someone with type 1 diabetes, or should we consider alternative approaches like structured exercise or bariatric surgery?

Kindly guide.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Type 1 diabetes occurs when there is an insulin deficiency. Obesity can worsen blood sugar control. Given his BMI (basal metabolic index) of 38, the best options for weight control would be the use of medications or bariatric surgery. Available medications include GLP-1 (glucagon-like peptide-1) agonists.

I suggest you follow the below-mentioned dietary controls:

Reducing portion sizes.
Using the healthy plate method (1/4 protein, 1/4 carbohydrates, and 1/2 vegetables).
Consuming fleshy fruits daily.
Avoiding frying, boiling is a better option.
Avoiding alcohol and smoking.
Engaging in structured exercise.
Regarding insulin, basal insulin alone might not be sufficient to control his blood sugar. I suggest you consider premixed insulin.

Please kindly discuss this with your endocrinologist.

I hope this has helped you.

Kindly follow up if you have more doubts.

Thank you.