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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest ways to lose weight for a diabetic

Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Mon, 11 Jun 2018 in Diabetes
Question: I am a overweight (+30 lbs) diabetic with excessive fat in the abdomen. I have not been able to lose the weight with a vegan diet and exercise. Should I go on a ketosis diet, or a very low calorie diet or take weight loss drugs like phentermine? Or is there some herbs or vitamins that might help? I am desperate to lose the weight to reduce my cardiovascular risk of stroke, since I have had multiple strokes already.
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Answered by Dr. Shehzad Topiwala 30 minutes later
Brief Answer:
Weight loss

Detailed Answer:
Sorry to learn about your bothersome weight challenges.

Ketosis diets are unsafe medically. VLCD (Very Low Calorie Diets) while effective in the short term, are difficult to maintain for long as they are tough to adhere to. So typically weight regain ensues.

Many fad diets popularized by media and prominent individuals, have been found to be no better than a balanced healthful calorie-restricted approach.

Weight loss drugs are an option. But you must seek formal consultation preferably with an endocrinologist to see whether phentermine or another type of pill is suitable for you.

Additionally, other means to lower your cardiovascular risk must be followed such as good control of your diabetes and blood pressure.

When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala 42 minutes later
Dr. Topiwala, Thank you for your answer. I will make an appointment with an endocrinologist and take the list of tests with me. I will forgo the ketogenic or VLCD diets, on your advice.
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Answered by Dr. Shehzad Topiwala 5 hours later
Brief Answer:
Best wishes

Detailed Answer:
for good health always
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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