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Medical Conditions > Endocrine and Immune System Conditions

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A balanced diet and an active lifestyle are important for all kids, so that they can maintain a healthy weight. But for kids with diabetes, those things are even more crucial. That's because weight can influence diabetes, and diabetes can influence a person's weight.

Weight issues can affect kids and teens who have type 1 or type 2 diabetes.

Weight and Type 1 Diabetes

If it's undiagnosed or untreated, type 1 diabetes can make people lose weight. In type 1 diabetes, the body stops producing the hormone insulin , which is needed to use glucose , the main type of sugar in the blood. Glucose comes from the foods we eat and is the major source of energy needed to fuel the body's functions. Because the body can't use glucose properly, it flushes the glucose (and the calories) out of the body in urine. As a result, a child who develops type 1 diabetes can lose weight, despite having a normal or increased appetite. Once a kid or teen with type 1 diabetes is diagnosed and treated, his or her weight usually returns to normal.

Excess body weight can occasionally be a problem for people with type 1 diabetes as well. Some children with type 1 diabetes are overweight before they develop the disease. And some kids with type 1 diabetes may become overweight after diagnosis if they don't maintain healthy eating and exercise habits. Developing type 1 diabetes isn't related to being overweight, but because lots of body fat can make it harder for a child's body to use insulin properly, overweight children with type 1 diabetes can also have trouble controlling their blood sugar levels .

Weight and Type 2 Diabetes

Most people are overweight when they're diagnosed with type 2 diabetes . Being overweight or obese increases a person's risk for developing type 2 diabetes. If a person who already has type 2 diabetes gains weight, then it will be even harder for him or her to control his or her blood sugar level.

People with type 2 diabetes have a condition called insulin resistance . People with insulin resistance are able to make insulin, but the body can't use it properly to move glucose into the cells. As a result, the amount of glucose in the blood rises. The pancreas then makes more insulin to try to overcome the problem. Eventually, the pancreas can wear out from working overtime and may no longer be able to produce enough insulin to keep blood glucose levels within a normal range.

People with insulin resistance are often overweight and don't exercise very much. But weight loss, eating healthier foods and portion sizes, and getting exercise can actually reverse insulin resistance. For people with type 2 diabetes, reversing insulin resistance makes it easier to reach target blood sugar levels, and, in some cases, the body's ability to control blood sugar may even return to normal.

People who don't have diabetes can have insulin resistance, but they are at a higher risk for developing the disease. For overweight people without type 2 diabetes, losing weight and exercising can cut their risk of developing the disease.

Helping Your Child Get to a Healthy Weight

Being at a healthy weight is good for everyone - parents included! When kids with diabetes reach and maintain a healthy weight, they feel better and have more energy. Their diabetes symptoms may diminish, their blood sugar levels may be easier to control, and they may be less likely to develop complications from diabetes, like heart disease.

A doctor can judge whether a person's weight is healthy by using the body mass index (BMI). Your child's doctor may recommend that your child lose weight to control diabetes, in which case a weight management plan may be prescribed. Even if your child's BMI is in the healthy range, the doctor can help you create a meal and exercise plan for your child.

Your emotional support can be an important part of helping your child get to a healthy weight. Overweight kids can have low self-esteem or feel guilty about having diabetes. Try to stay positive. Don't talk about feeling "fat" or "thin" - talk about being "healthy." Help your child understand that all healthy people need to actively manage their weight - even you. And remember that your child picks up your attitudes about weight and eating - after all, you buy the food and cook the meals. By buying healthy foods and cooking healthy meals for your child, you can provide the tools that your child needs to get to a healthy weight.

Being a good role model for your child is also important. If you are overweight, talk to your own doctor about beginning a weight management program so you can set a good example for your child.

Your child's diabetes meal plan already helps guide what your child eats, so reaching a healthy weight may simply mean adding more physical activity to your child's well-balanced diet. Getting more exercise will make your child feel better and help with diabetes and weight control, so be sure to encourage your child to get moving every day.

Weight Control Challenges

Reaching and maintaining a healthy weight can be a challenge for some kids and teens, just as it can be for adults. Here are some common problems to watch for and discuss with your child's doctor:

• Oversnacking. Some kids with diabetes eat too many snacks because they or their parents are very fearful of hypoglycemia , or low blood sugar. If you have any questions about the types of snacks your child should be eating and when, talk to your child's doctor or registered dietitian. Also, discuss the importance of following the diabetes meal plan the doctor has provided with your child. To keep tabs on oversnacking, be aware of the snacks in your home and how quickly they're being eaten.
• Sneaking snacks. Kids or teens may sneak the candy or sweets that they're supposed to eat in moderation. This can result in elevated blood sugar levels. Parents may not know about the sneaked snacks and may then respond to the child's elevated blood sugar by giving the child higher doses of insulin. This cycle can lead to excessive weight gain. Be sure your child understands why it's important to follow the meal plan, and ask questions if your child's blood sugar levels seem unexplainably high.
• Extreme dieting. Some kids with diabetes - especially teens - may try to lose weight with fad diets, starvation diets, or other extreme measures. These methods aren't good for anyone, but they're especially unhealthy for people with diabetes because they throw blood sugar levels off track.
• Skipping insulin. Teen girls, in particular, sometimes skip insulin injections to lose weight. Talk to your child about why this is a dangerous tactic - it can lead to very high blood sugar levels and even diabetic ketoacidosis . Teens who do this may need counseling from a mental health professional to address an eating disorder or other body image or emotional problem.

If you and your child follow the doctor's advice about food and exercise, your child will be able to reach and maintain a healthy weight. Kids who reach a healthy weight feel better and find that diabetes management is easier. They feel like they're more in control of their diabetes, their bodies, and their health. If either of you needs help along the way, just ask - your diabetes health care team can offer tips and advice on coping with weight control challenges.

Reviewed by: Steven Dowshen, MD
Date reviewed: April 2007