How to shed the pounds with a type 2 diabetes diagnosis
Type 2 diabetes is preventable. It can be reversed with careful weight management. Our clinical pharmacist, Amie Anand, outlines the link between obesity and type 2 diabetes, the importance of weight in managing symptoms, and safe approaches to losing weight for people with diabetes.
Reviewed by: Amie Anand
Published: December 2024
Next review: December 2027
Type 2 diabetes accounts for 90% of all diabetes cases worldwide.1
You are 80 times more likely to get type 2 diabetes if you are obese (with a BMI over 30) compared to those with a healthy weight.1
This is because of the buildup of visceral fat around your stomach and organs. Visceral fat releases several inflammatory chemicals called cytokines that can affect your blood sugar levels, appetite and ability to control your weight.
They also interfere with how insulin works making it more difficult for you to achieve normal blood sugar levels.
Your pancreas then produces more insulin to make up for this. If this continues, over time, your pancreas will stop working properly and you’ll develop insulin resistance. This is a condition that makes it difficult for your body to respond to insulin and control your blood sugar levels. This is known as insulin resistance. Over time, insulin resistance can lead to type 2 diabetes.2,3
There are many complications linked to unmanaged type 2 diabetes. Diabetic foot, heart disease and eye problems are only some of the conditions you could develop if you don’t or are unable to improve your health.
Losing weight will reduce the risk of these complications developing.4
Acting early is the best approach to reversing your symptoms. If you’ve just been diagnosed, talk to your doctor or pharmacist about the best strategies for losing weight. They’ll be able to give you personalised advice and support.
As you lose weight, you may find that you need to take less medicine to manage your type 2 diabetes symptoms. But you should discuss your medication use with a healthcare professional before making a change.
Calorie deficit
To lose weight, you need to make sure you are consuming fewer calories than you use each day. This will put you in a calorie deficit. Talk to your doctor or dietician about how many calories you should eat in a day – the NHS recommends 2000 kcals for women and 2500 kcals for men. But on average, reducing your daily intake by 600 kcal will help you see changes.5
When you start losing weight, your metabolism will steadily improve in efficiency, meaning it will burn through excess fat faster than before. A more effective metabolism makes it easier for your cells to process glucose – reducing your body’s insulin resistance over time.6
Resistance training
You should try and integrate resistance training into your exercise routine to help improve insulin resistance. This type of exercise focuses on building your strength. Your muscles are responsible for approximately 75–95% of your body’s glucose uptake. So as your muscles get stronger they are more able to process glucose – reducing your insulin resistance.7
Cardio workouts
In addition to resistance training, you should try to add aerobic (cardio) exercise into your routine. Cardio exercise burns excess fat and increases your heart rate. You should start with 20 minutes of moderate-intensity exercise 4 to 5 days a week. You should then try to increase this to 30 to 60 minutes 5 to 7 days of the week. This can help regulate your insulin resistance and improve other aspects of your health, like reducing your risk of heart disease.7
A combination of both resistance and cardio exercise optimises your ability to manage blood glucose levels. You can integrate both types of exercise through circuit training. Circuit training is where you do different types of exercise in a session to target different areas of your body. You should aim to build up your routine so you are doing 150 minutes of moderate intensity exercise per week.7,8
If you live with type 2 diabetes and are trying to lose weight, there are two main things you should keep track of:
- Your blood sugar levels
- Your weight loss
Some people may need to use a glucose monitor to help monitor how well they are controlling your blood sugars. With a simple finger prick, you can test the amount of glucose in your blood before and after meals and exercise. If you don’t have one, speak to your doctor or diabetes care team about it. They should be able to prescribe one for you.
You’ll also need to track your weight loss. You can do this using apps, taking progress pictures or using a scale. There are lots of ways you can do it.
What is important to stay motivated, set achievable goals and discuss any concerns you have with the healthcare professionals who are supporting you.
- Risk factors | Background information | Diabetes - type 2 | CKS | NICE. Accessed March 18, 2024. https://cks.nice.org.uk/topics/diabetes-type-2/background-information/risk-factors/
- Watts M. The UK is the fattest country in Europe. The number of obese adults is forecast to rise by 73% over the next 20 years from to 26 million people, resulting in more than a million extra cases of type 2 diabetes, heart disease and cancer. Diabetes. September 8, 2022. Accessed October 22, 2024. https://www.diabetes.co.uk/diabetes-and-obesity.html
- Dhokte S, Czaja K. Visceral Adipose Tissue: The Hidden Culprit for Type 2 Diabetes. Nutrients. 2024;16(7):1015. doi:10.3390/nu16071015
- Adult obesity and type 2 diabetes. https://assets.publishing.service.gov.uk/media/5a7f069140f0b6230268d059/Adult_obesity_and_type_2_diabetes_.pdf
- Calorie counting - Better Health. nhs.uk. December 13, 2022. Accessed March 7, 2024. https://www.nhs.uk/better-health/lose-weight/calorie-counting/
- Farhana A, Rehman A. Metabolic Consequences of Weight Reduction. In: StatPearls. StatPearls Publishing; 2024. Accessed October 29, 2024. http://www.ncbi.nlm.nih.gov/books/NBK572145/
- Bollinger L, LaFontaine T. Exercise Programming for Insulin Resistance. Strength & Conditioning Journal. 2011;33(5):44. doi:10.1519/SSC.0b013e31822599fb
- Exercise. nhs.uk. April 26, 2018. Accessed March 1, 2021. https://www.nhs.uk/live-well/exercise/