Diabetes Self-Management Articles

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Why Can’t I Lose Weight?
Finding Your Trouble Spots

by Jacquie Craig, MS, RD, LD, CDE

If you are having frequent hypoglycemia, work with your health-care provider to adjust your diabetes treatment regimen. The potential consequences of frequent hypoglycemia include not just weight gain but also falls, accidents, and, in some people, hypoglycemia unawareness (the loss of early signs and symptoms of hypoglycemia). It’s important to work with your diabetes care team to find the reasons for frequent hypoglycemia and to fix them.

Not enough sleep
Getting less sleep than your body needs can contribute to weight gain and make weight loss difficult. In a study of 68,000 middle-aged women called the Nurses’ Health Study, it was found that women who slept 5 hours per night were 32% more likely to experience major weight gain (defined in the study as about 33 pounds) and 15% more likely to become obese over the course of the 16-year study than those who slept 7 hours per night. Women who slept 6 hours per night were 12% percent more likely to have major weight gain and 6% more likely to become obese. (No significant difference in weight gain was found among the women who reported sleeping 7, 8, or 9 hours or more.) There were no differences between the groups with relation to physical activity and calorie consumption.

Similar results have been found in studies that include both adult men and women, and those studies have also implicated sleeping too much. In one study, people who got only 5–6 hours of sleep a night were 35% more likely to gain 11 pounds over a 6-year period than people who slept 7–8 hours a night. Those who slept 9–10 hours a night were 25% more likely to gain 11 pounds over this period.

There are many reasons people don’t get enough sleep. Having a busy life with many activities and obligations can lead to habitually going to bed late or getting up early. Consuming too much caffeine during the day or too close to bedtime can contribute to poor sleep. In the Nurses’ Health Study, the nurses who slept fewer hours were more likely to have worked overnight shifts.

Sleep apnea, in which breathing repeatedly stops for several seconds at a time during sleep, can contribute to inadequate sleep. Signs and symptoms of sleep apnea include loud snoring during sleep and daytime sleepiness. Because sleep apnea is so common in people with Type 2 diabetes, and because it is associated with so many health problems, some medical professionals now believe that all people with Type 2 diabetes should be screened for it.

Drinking too much alcohol can disrupt sleep. Although many people believe that alcohol makes it easier to fall asleep, in fact, alcohol is a stimulant and can cause you to wake up more frequently during the night.

There are also many ways to increase the amount of sleep you get. One is to adopt a pattern of going to bed and waking up at the same time every day. Another is to make your bedroom as dark and quiet as possible. Reducing caffeine intake, especially late in the day, can help, as can reducing alcohol consumption. Practicing a relaxation technique during the day or just before bedtime can also help. It can be a formal technique, such as meditation, or an informal practice, such as listening to soft music or reading before bed. Getting sleep apnea treated, if you have it, can make a big difference.

Getting regular physical activity can help with sleep quality. Usually, people with insomnia are advised against working out too close to bedtime, because exercise has an arousing effect and can make it harder to fall asleep. However, in a small study reported in 2008 at the annual meeting of the Associated Professional Sleep Societies, study participants with insomnia who performed a session of moderate aerobic activity a few hours before bedtime had increased sleep time and a reduction in the time it took to fall asleep once the lights were out. The study found that moderate aerobic activity, such as brisk walking or biking, worked better than heavy aerobic or strength-training exercises at improving sleep.

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