Managing Hunger and Diabetes: Blood Sugar Control and Weight Loss

Q: Managing Hunger and Diabetes: Blood Sugar Control and Weight Loss

Hello： 1. <br>Your blood sugar is under control, but this does not mean that diabetes has been cured. <br>2. <br>Regarding hunger, it is initially recommended to consume foods that are filling yet low in calories. <br>For detailed advice, it is suggested that you consult a nutrit

Annoying hunger pangs

Hello Doctor, in November 2014, during my health check-up, the doctor diagnosed me with diabetes (fasting blood sugar of 136 after 8 hours, HbA1c of 6.9).
The doctor did not prescribe any medication but advised me to buy a blood glucose monitor for self-monitoring and to return for regular check-ups.
I made significant changes to my diet and started exercising regularly.
Throughout 2015, I had my fasting blood sugar tested three times, which remained between 112 and 117, but my HbA1c dropped to between 5.8 and 6.0.
I have heard that diabetes is irreversible and can only be delayed, with no possibility of a cure.
May I ask: 1.
Even if my HbA1c has dropped to between 5.8 and 6.0, does this only indicate that my condition is controlled and not cured, correct? After meals, I exercise for 20 minutes, and between meals (at 10 AM and 3 PM), I eat a little fruit or snacks.
However, I have been experiencing persistent hunger, especially about two hours after meals and before bedtime, even though my blood sugar levels are not low (around 110 to 120).
May I ask: 2.
What could be the issue if I frequently feel hungry but my blood sugar levels are not low? What tests or adjustments in exercise or diet can I make to improve this? Before being diagnosed with diabetes in November 2014, my weight was 54 kg (158 cm tall).
After changing my diet and exercising regularly, although my HbA1c has dropped to between 5.8 and 6.0, my weight has sharply decreased to 49 kg in January 2015 and now to 46 kg.
After reducing sugar, oil, and salt, my triglycerides have dropped to 39, but my total cholesterol is still 233 and low-density lipoprotein (LDL) is 174 and has not decreased.
May I ask: 3.
Why has my cholesterol not decreased even though my HbA1c and triglycerides have dropped? 4.
I eat the same amount as my husband, but my weight loss is concerning.
If I eat more, my blood sugar levels rise.
What can I do to stabilize my weight without affecting my blood sugar? Thank you for your patience and guidance.
Thank you!!

Sang Sang, 50~59 year old female. Ask Date: 2016/01/11

Dr. Li Zhiyao reply Internal Medicine

Hello: 1.
Your blood sugar is under control, but this does not mean that diabetes has been cured.
2.
Regarding hunger, it is initially recommended to consume foods that are filling yet low in calories.
For detailed advice, it is suggested that you consult a nutritionist at a hospital with a nutrition education clinic.
3.
The relationship between cholesterol levels and individual metabolism is greater than that of diet; therefore, there is no direct correlation with glycosylated hemoglobin and triglycerides.
Your low-density lipoprotein cholesterol is 174, which requires attention and medical consultation.
4.
Regarding weight loss issues, in addition to dietary control and exercise, other causes cannot be ruled out, such as thyroid disorders or malignancies.
It is advisable to consult an endocrinologist to determine if further examination is necessary.

Reply Date: 2016/01/11

More Info

Managing diabetes effectively involves a multifaceted approach that includes monitoring blood sugar levels, maintaining a balanced diet, and engaging in regular physical activity. Your journey of lifestyle changes after being diagnosed with diabetes is commendable, and it’s important to understand the nuances of diabetes management, especially regarding hunger, weight loss, and blood sugar control.

1. Understanding Blood Sugar Control: You are correct in stating that a hemoglobin A1c (HbA1c) level of 5.8% to 6.0% indicates good control of your blood sugar levels. However, it is important to clarify that while you have achieved good control, this does not equate to a cure for diabetes. Diabetes is often considered a chronic condition that can be managed effectively but not cured. The goal is to maintain blood sugar levels within a target range to prevent complications associated with diabetes.

2. Hunger Despite Normal Blood Sugar Levels: Experiencing persistent hunger, even with blood sugar levels in the range of 110 to 120 mg/dL, can be attributed to several factors. One possibility is that your meals may not be providing sufficient satiety. Foods high in fiber, protein, and healthy fats can help you feel fuller for longer. Incorporating more whole grains, legumes, lean proteins, and healthy fats (like avocados and nuts) into your diet can help manage hunger. Additionally, the timing and composition of your meals matter. Eating smaller, more frequent meals can help stabilize blood sugar levels and reduce hunger pangs.

3. Cholesterol Levels and Weight Loss: The relationship between weight loss, triglycerides, and cholesterol can be complex. While weight loss often leads to improvements in triglyceride levels, it does not always correlate with reductions in total cholesterol or low-density lipoprotein (LDL) cholesterol. Factors such as genetics, diet composition, and metabolic health play significant roles in cholesterol levels. It may be beneficial to focus on dietary sources of healthy fats (like omega-3 fatty acids found in fish) and to limit saturated and trans fats, which can negatively impact cholesterol levels.

4. Weight Management Strategies: Maintaining a healthy weight while managing diabetes can be challenging, especially when you are experiencing weight loss. It’s crucial to ensure that you are consuming enough calories to support your energy needs without causing spikes in blood sugar. Consider working with a registered dietitian who can help you develop a personalized meal plan that balances your caloric intake with your activity level. This plan should focus on nutrient-dense foods that provide essential vitamins and minerals while keeping your blood sugar stable.

In summary, managing diabetes involves a careful balance of diet, exercise, and monitoring. It’s essential to focus on whole, unprocessed foods that promote satiety and support overall health. Regular physical activity is also crucial, as it helps improve insulin sensitivity and can aid in weight management. If you continue to experience challenges with hunger, weight loss, or cholesterol levels, consider consulting with healthcare professionals, including a registered dietitian and an endocrinologist, who can provide tailored advice and support.

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