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Correlation of Weight Loss and Hba1C

I think that for a number of us there is a correlation between weight loss and HbA1c. From diagnosis I lost 35lbs and my HbA1c went from 95 to 33, reduction 62 in the first 6 months. One difference for me was that I was not considered really overweight to begin with as my BMI was 24.9/25. Having got my BMI down to 19.6 and showing some signs of being malnourished I was told to put on weight and having put on about 7 lbs my HbA1c has only gone up 2 points.
 
CherryAA said:
I think that the liver dump increases the closer I get to eating enough calories to maintain weight and probably even more so if I eat enough to actually put weight on.
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I wish that were true in my case. I think I can quite categorically say that the Metabolic Rate I calculate using the Harris Benedict formula doesn't bare any resemblance to what I can eat without gaining weight. Even if I have a "blow out" day and eat everything I want when I want my calorie intake is still only 1900 against of a RMR of 2400 (Harris Benedict says I should multiply that by 1.2 if I get out of bed, which I do every day). I usually eat about 1200 calories and don't feel hungry on that or deprived of fibre. The fridge is practically empty all the time to prevent picking and I weigh everything to enter stuff into my "weight by date" software. My GP can only say that my metabolism is broken but has no suggestion for encouraging it to work, except the eat more idea that was obviously wrong. I was recovering from a knee replacement so I was even exercising regularly to get the knee working again.

CherryAA said:
none of this changes my view that LCHF diet
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100% behind that, I've been referred to the diabetic team at the local hospital and so long as I don't have to see the endocrinologist I saw 20 years ago (he is still there somehow) I'll be fine, unless they start preaching the eatwell plate thing and you need your carbs for energy etc etc.

I will find the answer one day, might even write a book about my search. LOL
 
DavidGrahamJones said:
I wish that were true in my case. I think I can quite categorically say that the Metabolic Rate I calculate using the Harris Benedict formula doesn't bare any resemblance to what I can eat without gaining weight. Even if I have a "blow out" day and eat everything I want when I want my calorie intake is still only 1900 against of a RMR of 2400 (Harris Benedict says I should multiply that by 1.2 if I get out of bed, which I do every day). I usually eat about 1200 calories and don't feel hungry on that or deprived of fibre. The fridge is practically empty all the time to prevent picking and I weigh everything to enter stuff into my "weight by date" software. My GP can only say that my metabolism is broken but has no suggestion for encouraging it to work, except the eat more idea that was obviously wrong. I was recovering from a knee replacement so I was even exercising regularly to get the knee working again.



100% behind that, I've been referred to the diabetic team at the local hospital and so long as I don't have to see the endocrinologist I saw 20 years ago (he is still there somehow) I'll be fine, unless they start preaching the eatwell plate thing and you need your carbs for energy etc etc.

I will find the answer one day, might even write a book about my search. LOL
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@DavidGrahamJones

I too find that in order to actively "lose" weight I need to be eating about 1250 calories a day. My weight maintenance over the last two months has come from a diet with 1600 calories per day in it, so clearly I cannot eat anything like the formula numbers either. I use cronometer and I weigh everything and record it, even the spinach, Yesterday I ate for a dessert one large strawberry 38 g dipped in double cream 6g - and both went into the calculations, thus I know that my calories counts and carb counts are fairly accurate . Overall it sounds like our metabolisms are pretty similar .

My comment about the liver dump increasing related to that change from 1250 to 1600 , whee the 1600 average includes a small number of days where I "overate" to about 2000 calories and paid for that with much higher overnight fasting numbers and much higher ensuing liver dumps.

I only get into ketosis at around 1250 calories , and it is only when I in ketosis that proper weight loss ensues and my liver dumps get smaller. Do you monitor ketosis? How has your Hba1C changed with weight loss ?

I have a libre freestyle and from that I can see very clearly that the liver dump is connected to the previous day's food and the timing of that food. I can now pretty much predict where my fasting blood sugar will be and how bad it will get or my worst period (8.00am-12.00) based on my knowledge of the previous day's eating pattern . I haven't found a form of eating that stops the liver dump, food, no food, carbs, no carb, proteins, liquid - before bed, during bed, on rising, - nothing stops the numbers going up by about 2-4 mol compared to fasting - and where that ends up is a function of how many calories I ate the previous day and how deeply I am in ketosis.
 
If you can lose weight then you can lose some of the insulin resistance that is causing the high bg levels, If you can lose enough weight to lose the visceral fat that is the cause of your insulin resistance then you will see non diabetic bg levels, not everyone will be able to achieve this though as some will have damaged beta cells and not be producing enough insulin of there own so will still need to eat LC or use insulin or or other drugs that can stimulate the pancreas to work harder.

Lose weight lose insulin resistance and your bg levels should come down as many members here have seen happen.
 
Sid Bonkers said:
Lose weight lose insulin resistance and your bg levels should come down as many members here have seen happen.
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So, I presently have a calorie deficit of 1000 calories or more and I should be losing weight but I'm not. I do exercise, and I still don't lose weight,

What next?
 
CherryAA said:
Do you monitor ketosis? How has your Hba1C changed with weight loss ?
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If I think back to when I cut the carbs which also cut my calorie intake by about 700 calories (I can see from "Weight by Date software exactly how much carbs I was eating, in calories as well as grams of carb) my HbA1c dropped dramatically within months (taking into account previous HbA1c and first HbA1c which was about 4 months after carb reduction) and before I lost a substantial amount of weight. In fact I went on to lose about 4 1/2 stone although my HbA1c stayed about the same. Which is why for me there did not seem to be any direct correlation between weight and insulin resistance. In January 2017 my c-pep came back as 1.7 which is the low end of normal range and my insulin resistance is 2.5 against a normal of < 1. Obviously insulin resistance is major problem although I guess I could do with a more productive pancreas, maybe?

I'm also lucky enough to have a FreeStyle Libre and the information has been invaluable, it impressed my GP enough to stop her from just prescribing more drugs which with my paranoia about weight gain wouldn't make me happy.
 
DavidGrahamJones said:
So, I presently have a calorie deficit of 1000 calories or more and I should be losing weight but I'm not. I do exercise, and I still don't lose weight,

What next?
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I can only say what I experienced, it didnt happen overnight or after a week or a month and it wasnt easy, I didnt have a single drink for over 4 or 5 months and I was very strict in my diet for about a year, I was on insulin at the time so had to count carbs and was eating around 60g a day, no, its wasnt easy but I lost 4 stone in the first year and then relaxed my diet slightly and lost a further stone the following year, if you can lose weight it will help.

Even now 7 years later I still probably eat less than a third of the amount of food I used to eat before I was diagnosed, I think over time I just got used to eating less just as I got used to not smoking after giving that up just over 10 years.

I never thought I could do either and neither was easy but fear helped me a lot with both first suffering respiratory failure and then two yeas later being diagnosed T2.
 
Today I have eaten the highest amount of calories than I have had on any day in the last 12 months 950 (normally have about 600 to 700 calories a day) and have had less than 50 g of carbs my basal rate according to my health monitor is about 1500 calories a day a punishing 12 months but I have lost the weight I felt I had to, some times being serious isn't enough some times it requires obsession.
 
I have not lost any weight since diagnosis. Have largely maintain between 74-76 kg all thru the past 18 months.But I have experience waist loss of 2 inches.

HbA1c had reduced from 11%(97mmol) to and also maintain around 5.5%(37mmol). This is similar to the observations for those who went thru bariatric surgery.

http://care.diabetesjournals.org/content/36/4/1047
Reversal of type 2 diabetes to normal metabolic control by either bariatric surgery or hypocaloric diet allows for the time sequence of underlying pathophysiologic mechanisms to be observed. In reverse order, the same mechanisms are likely to determine the events leading to the onset of hyperglycemia and permit insight into the etiology of type 2 diabetes. Within 7 days of instituting a substantial negative calorie balance by either dietary intervention or bariatric surgery, fasting plasma glucose levels can normalize. This rapid change relates to a substantial fall in liver fat content and return of normal hepatic insulin sensitivity.
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Hence I remain focused on fasting glucose and by proxy insulin control instead of weight loss.
 
Interesting with regard to myself I will never know if my reading is from weight loss or metformin.
Hba1c before metformin 6.7./ 6 months later 6.8.on metformin

25 /30 kg lighter 5.4 / 5.5.
10 years later.Doc said insulin in 10 years so I'm ok still on metformin only Changing my diet was one of the hardest things but I can't tell how each contributed to a change in the hba1c reading

There is a saying that goes you can never be too thin or too wealthy....?????????
 
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DavidGrahamJones said:
Ha Ha, I have a serious obsession then. LOL
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Good because that's what you need if your going to lose the weight you have to be able to ignore every one who says no you can't do that and to overcome every obstacle in your path remember it's a matter of life and death. No joke.
 
JohnEGreen said:
Good because that's what you need if your going to lose the weight
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I've been at this weight losing game for well over 8 years, more like 10 years. The frustrating thing is that I know from my "Weight by Date" software that I have been on a calorie reduced diet for all of that time. Processed foods went out the window 10 years ago and just about everything I eat is prepared from scratch (except tinned ratatouille). Initially I was on 500 calories less than BMR, then 1000 calories less than BMR, the only time I successfully lost weight was when I stopped taking Rosiglitazone, the reason behind a lot of my problems in the first place, who do I sue? That weight loss stopped the moment I started taking Gliclazide and in fact I gained weight, no change in diet or exercise, just gained weight. Even when I increased my exercise substantially for 6 months, nothing happened except I ached a lot.

The next time I lost weight was when I went low carb but even that ground to a halt after a while. I stupidly took my GPs advice (she and the dieting profession all say the same), "you don't eat enough", big mistake, I gained 11 kgs. Not slowly, more like big jumps and difficulty was that it was tricky to spot because my weight was changing because of fluid retention, by up to 5 kgs a week, up and down for months on end and one month it didn't go. I weigh every day to get a handle on this fluid retention thing, blooming nightmare!

So the dieting lark has taught me a few things, the Harris Benedict formula isn't accurate for everyone because it doesn't take into account metabolic rate, even dieticians recognise that we will burn fuel at different rates. Hence the comments like "Your metabolism has slowed down, you don't eat enough, eat more to speed up your metabolism". I wasn't a pig in the first place and it's impossible to see where I overate. Even while I was traveling for work a lot, I must be the only person to go to Pizza Hut and only eat from the salad bar, NO PIZZA. I probably deserve a certificate for showing the chef in the hotel I stayed at in Dundalk, Ireland, how to make a Spanish omlette and how to poach eggs properly (white wine vinegar!?)

One last thing, sorry to bore everyone, I was actually seen by a psychiatrist and a dietician together. They decided I didn't have am eating problem, I have a weight problem, could have told them that. The only thing they could say about my food diary was "you eat a lot of fish". LOL LOL Not in batter though LOL LOL
 
I think it is quite a coincidence... I have done almost the same loosing a lot , and my HbA1c has also lowered but much faster in the beginning and then remained down low..(was on 1000 calories for 6 month ) untill this last month when I got more extreme in excercising and that forced me to eat much more... now my HbA1c is creeping upwards ... ( now about 2200 calories a day and 6000 calories burned at fitness a week )

Then lately I have also eaten much more carbs .. it is as if the intence excercise demands me to eat carbs... today however I´ll try to be lower in carbs like about 100 grams in total even though I will excercise a lot...
 
Did anyone see the program on Channel 4 last night about 'Super Slimmers'? It is probably on catch up. It said that most people who lose weight will put it back on again, and probably more, as our bodies will adapt and try to get our weight back to what it was.
 
Prem51 said:
Did anyone see the program on Channel 4 last night about 'Super Slimmers'? It is probably on catch up. It said that most people who lose weight will put it back on again, and probably more, as our bodies will adapt and try to get our weight back to what it was.
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Didn't see it, but have been very familiar with that experience for a loooong time. All my adult life.
This link explains it perfectly.
https://intensivedietarymanagement.com/biggest-loser-diet-explained/
The sad thing is that it is common sense, yet most people (medical professional and dieters) just pretend it doesn't happen. An elephant in the room.

I think T2s are in a particularly difficult situation; they may be highly motivated to lose the weight, and willing to go to extreme measures to achieve it, but face an even more difficult challenge to keep the weight off - due to insulin resistance. Add in the metabolic flexibility that diets create, and it becomes even more challenging.

The answer seems to be lowering the carbs and eating to the meter. For ever. Otherwise it is just YoYo dieting. For ever.
 
DavidGrahamJones said:
I've been at this weight losing game for well over 8 years, more like 10 years. The frustrating thing is that I know from my "Weight by Date" software that I have been on a calorie reduced diet for all of that time. Processed foods went out the window 10 years ago and just about everything I eat is prepared from scratch (except tinned ratatouille). Initially I was on 500 calories less than BMR, then 1000 calories less than BMR, the only time I successfully lost weight was when I stopped taking Rosiglitazone, the reason behind a lot of my problems in the first place, who do I sue? That weight loss stopped the moment I started taking Gliclazide and in fact I gained weight, no change in diet or exercise, just gained weight. Even when I increased my exercise substantially for 6 months, nothing happened except I ached a lot.

The next time I lost weight was when I went low carb but even that ground to a halt after a while. I stupidly took my GPs advice (she and the dieting profession all say the same), "you don't eat enough", big mistake, I gained 11 kgs. Not slowly, more like big jumps and difficulty was that it was tricky to spot because my weight was changing because of fluid retention, by up to 5 kgs a week, up and down for months on end and one month it didn't go. I weigh every day to get a handle on this fluid retention thing, blooming nightmare!

So the dieting lark has taught me a few things, the Harris Benedict formula isn't accurate for everyone because it doesn't take into account metabolic rate, even dieticians recognise that we will burn fuel at different rates. Hence the comments like "Your metabolism has slowed down, you don't eat enough, eat more to speed up your metabolism". I wasn't a pig in the first place and it's impossible to see where I overate. Even while I was traveling for work a lot, I must be the only person to go to Pizza Hut and only eat from the salad bar, NO PIZZA. I probably deserve a certificate for showing the chef in the hotel I stayed at in Dundalk, Ireland, how to make a Spanish omlette and how to poach eggs properly (white wine vinegar!?)

One last thing, sorry to bore everyone, I was actually seen by a psychiatrist and a dietician together. They decided I didn't have am eating problem, I have a weight problem, could have told them that. The only thing they could say about my food diary was "you eat a lot of fish". LOL LOL Not in batter though LOL LOL
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I do feel for you, it is very frustrating when you do the " right things" and nothing happens. I have been in the same boat for two months now and so in a bid to kick start things aain , I substantially increased exercise and reduced my food. net effect 0.5 kilo INCREASE . do you still have a lot to lose? I console myself with knowing that from a weight perspective I look a lot better and feel a lot healthier from beore and the primarily goal i the control of blood sugars and that seems to be working.

Are you absolutely sure you need the medications that seem to be contributing to your problem. I know once started its hard to come off them.
 
A few months ago, I set up this thread where I suggested a theory that based on my own data Hba1C is directly correlated to weight loss in a linear fashion. At the time I posited that based on my own experience 1lb of weight loss for me equalled 1 mmol IFCC based on my degree of over-weightness correlated to my own IFCC. A couple of other people posted their numbers and despite some confusion as to the actual measures - once converted to the same metrics , the correlation held true for those figures too.

Researchers have now published the results of a data analysis of 17,204 people where they have found that yes there is a correlation and it is linear in the fashion I described. i.e. the hba1c reduces at a proportionate rate based on your own hba1C at diagnosis and your own degree of obesity.

As noted in an article on the study at Physician’s Briefing, the researchers found that overall, there was a linear relationship between weight loss and HbA1c reduction. Specifically, the average person saw their HbA1c drop by 0.1% for each kilogram (about 2.2 pounds) of body weight lost — regardless of whether it was the first or last kilogram of weight loss over the course of the study. But that’s doesn’t mean this average applied to everyone — in fact, people with a higher starting HbA1c level saw a bigger drop in HbA1c for each kilogram of body weight lost, compared with those who started at a lower HbA1c level.


This study shouldn’t be considered definitive, and its researchers conclude that its results should be used to help design future studies on how weight-loss interventions can help manage Type 2 diabetes. But the results strongly suggest that the higher your HbA1c level, the more you have to gain, so to speak, by losing weight. This means that someone who is overweight, but not obese, and has a very high HbA1c level might benefit more from weight loss — at least in terms of diabetes control — than someone who is obese but has only a slightly elevated HbA1c level.

From my own experience, following my initial reductions in Hba1C , despite the fact that I have been recording excellent blood sugar numbers on my libre freestyle for some time now - with blood sugar readings well in the "normal" range at all times and very very few spikes . Hba1C figures have remained stubbornly at the similar levels for months as has my weight and even small movements in it ( I do it fortnightly) are directly correlated to changes in my weight during that period.

https://www.diabetesselfmanagement.com/blog/hba1c-weight-loss/

http://www.physiciansbriefing.com/Article.asp?AID=721826

Sometimes n=1 observations can simply point to things that hold true for many people, as appears might be the case here.
 
Am I the exception that proved the rule then? My HbA1c dropped from 129 to 70 and I'd lost 6lbs. Another blood test tomorrow and I've maybe lost another kg. BMI was in the normal range to start with..
 
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