How Weight Can Influence Diabetes

Diabetes is a disease or condition which can affect every organ system in your body. People having type 2 diabetes are at least twice as likely to have experienced high blood pressure, heart disease and/or stroke as people who don't have diabetes. My brother, Ralph, was diagnosed with type 2 diabetes more than 20 years ago. His overall health was really bad; his blood pressure was high, his heart was enlarged, and he was diagnosed with a fatty liver; he suffered with swelling in his entire body, including his extremities. Diabetes type 2 is a preventable. I interviewed Ralph to paint a word picture of what his journey to wellness has been like.

What was it like when you discovered you were a diabetic? "I was diagnosed with diabetes in 1992. I weighed about 290 pounds back then. I went on a diet in 1994 through to 1995 and was able to get off some of the meds. My weight got down to about 235 pounds, but the diet got boring. By 1996 my weight went up to 300 pounds. I retired in 1998 and my weight increased to 330 pounds. I had to go on stronger meds."

Did you have to take insulin? "It became necessary to take insulin in 1999; the oral meds could no longer do the job. I was taking two types of insulin at the time. I took 108 units of Lantus at night before bed. This is slow-acting insulin to keep the blood sugar down overnight. I also took 20 to 25 units of Humalog; this is fast acting insulin to knock high blood sugars down to normal quickly. I took the Humalog with each meal because my meals would my sugar spike if I didn't.

For 6 years I took insulin shots and Glucophage pills. My weight stayed at a constant 340 pounds during those years. I resigned myself to the fact that this is how my life would always be. Then one day I became sick. I don't mean that I was nauseous, but I was very cold and couldn't get warm. I was on my way to a summer pool match; it was a hot day but I was very cold. I couldn't stand the air conditioning in the car and it was very hot. Once I got to the pool hall, I couldn't go in because I was just too cold. One of the pool players was an EMT and he came out to check on me. My blood sugar had been out of control for a few days and I had developed a full body infection. The EMT helped me inside and gave me some ice water to drink and made me bathe my face and arms with cold water. I went to see my doctor the next day and my doctor said I was lucky that someone was there to help me, because what was happening to me was life threatening."

How has your weight affected your diabetes? "After the scare with the huge infection, I tried losing some weight. When I had that terrible infection in 2005, I got ulcers on my lower shins. For years, I had been retaining water in my legs and feet. My feet began to look like stuffed sausages. All my life I wore size 10 shoes, but with the swelling and weight gain I went into a size 13 W. I needed the larger shoes because my feet were fat, not because they got longer. I lost 65 pounds in 8 months. When my weight was down my leg ulcers would go away and when I gained weight and needed more insulin, my ulcers would return. My doctor would order antibiotics, patch me up and give me hell for destroying my health.

I lost down to about 285 pounds at that time. I felt better. I was able to lower the 108 units of Lantus to about 20. I no longer needed as much Humalog either. However, by 2007 I was back up to 350 pounds and using huge does of insulin. The swelling in my feet was alarming. I needed more and more insulin. In 2009 I was up to 150 units of Lantus and 35 units of Humalog with each meal. My doctor's scales maxed out at 350, so he could no longer weigh me.

In December of 2009 my doc had some new scales in that could weigh me. I was up to 366. My lower leg ulcers returned. My blood glucose level was out of control. Even with massive doses of insulin and 2500 mg of Glucophage/Metformin a day, wasn't doing anything to control my blood sugar. I was becoming insulin resistant. My doctor said he couldn't give me any more insulin, that it would do no good. He said I had to lose weight."

How has diabetes affected your internal organs? "My doctor sent me for tests; my kidney function was suffering, and so was my liver function. I had to come off the water pills because they were stressing my kidneys too much. Without the water pills I had more trouble with blisters erupting on my lower legs. It was a vicious cycle, and I was getting sick of going to so many doctor appointments and staying sick. I had to see specialists for my liver and kidneys. I also had gout and my doctor didn't know how to treat it because the medications I was taking aggravated my gout. Life was absolutely miserable; it revolved around medicine and 5 or 6 shots a day.

What has your weight loss journey been like? A couple of years ago my doctor sent me to weight counseling, but this was useless to me. This skinny counselor told me I didn't eat right and I needed to lose weight. No kidding! I felt like she looked down on me because I was so heavy. I didn't get that heavy by choice, and I needed some real help. I went back to my doctor to tell him the weight counseling didn't work and how I felt about it. I was so depressed over my situation that I told my doctor I was going to leave his office and go to McDonald's and eat myself to death. I was tired of the pain and tired of not being able to walk, talk or even breathe.

My doc suggested I try Weight Watchers. I said it probably wouldn't work, but I would give it a try. He said he would rather see me do this than to give up and kill myself with food. I left my doctor's office and went directly to Weight Watchers to sign up. I knew if I went straight home, I might never have signed up, so I did it before I went home.

Earlier at the doctor's office, I weighed in at 362, which was a 4 pound loss since my 366 the previous December. At the Weight Watcher office I weighed in and it also weighed me at 362. I felt relieved that the scales at my doctor's office were accurate, at least. I went to my first Weight Watcher meeting on March 3 2010. The next one was March 10 and I lost 8 pounds! Yes, it was water weight, but it was weight. In 2 more weeks I had lost another 8 pounds and was less than 350 pounds. I was beginning to get encouraged. I felt that it just might work this time. The weight was coming off. My blood sugars were going down and I was able to start taking less insulin.

Have you been discouraged with Weight Watchers as a way to lose weight? No. If I looked at my goal as needing to lose 170 pounds, I would have become overwhelmed. But that's not how Weight Watchers does it. The day I signed up with Weight Watchers they calculated my 5 percent and my 10 percent goal target. These were goals to shoot for. I achieved them. I have also achieved my 25, 50, 75 and 100 pound weight loss goals. I was so happy to see the 3 disappear from my weight when it got down to 299. That happened last August.

The more weight I lost the better I felt. As recently as last Christmas I still needed an electric cart to shop in stores. I still couldn't walk without back and joint pain. In January of this year (2011) I tried shopping without the electric cart. I was tired, but I made it. I felt like I had achieved another victory. I started doing this more and more."

Are you taking insulin now? "The weight kept going down, and I kept going down on insulin. I have been insulin free for about 2 months now. I still take 2500 mg of Metformin, but that medicine may go away too with more weight loss."

What would you tell people who struggle with weight and diabetes? "If you think of it as a weight loss journey and not a diet, you can be successful. If you set small goals for yourself along the way you can achieve them."

Where has your weight loss journey taken you? "There have been many victories in my journey. One success is that I no longer wear a size 56 pants; I went down from a size 56 to a 54 and then down to a size 52. All of these pants have been donated to the Salvation Army. I am now into a size 42.

My weight has come down from 362 (Weight Watcher's weight) to 243.8. I need to lose 53 more pounds to reach my final goal. I will do this; it may take another year, but I will succeed."

Have your ulcers healed? "Yes, they have healed completely, but they left some huge ugly red scars behind. I guarantee you I will never wear shorts in public again, because of them."

How is your liver and kidney function? "My liver is still fatty, but to a much lesser degree now. My liver function is normal now, according to my doctor. More weight loss will probably improve my fatty liver even more. At least the numbers are normal. My kidney function is also back to normal."

How are your knees? "My knees are much better now. My doctor thought I would never go back to work because the knee didn't respond to surgery as well as he had hoped. He didn't know that I would lose a lot of weight. I could go back to work driving, if I wanted to, but I will stay retired."

How much weight have you lost? "I've lost 118 pounds now. I have 53 pounds to lose to meet my goal."

When did you start noticing a difference in your diabetes? "I started noticing the difference in my diabetes very soon after starting to lose weight. First I noticed the insulin started working more efficiently, and then I noticed I needed to start cutting down the dosages. I was able to stop taking insulin about 12 months after starting losing weight."

I am very proud of my brother's accomplishment in his weight loss journey. I know, without a doubt, if it wasn't for Weight Watchers, my brother would still be in bad shape. He might not even be alive now, if he hadn't made some positive changes in his life.

Weight Watcher's isn't necessarily a program for diabetics, but it is based on healthy eating and diabetics can benefit from it, as my brother did. My brother paid $15 to sign up for Weight Watchers and he pays $13 a week to attend the meetings. He said the cost is well worth it, and if you factor in what he was paying for $60 copays for Humalog and Lantus, and not paying $27 each month for needles and $25 for pen needles each month, he is saving money. There is much more that could be written here, but I will save it for another article. Stay tuned!