Sudden Weight Loss: Is It Related To Diabetes?

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what causes weight loss in diabetes

The major health challenges prevalent in our society today include diabetes, obesity, and hypertension. It often happens that those with one of these conditions also have one or both of the others. Because diabetes is a disruption in the metabolism of sugar and fat, these people are often overweight or even obese. Although CBD for weight loss might be helpful, their obesity is a challenge to their cardiovascular system resulting in related complications such as high blood pressure, coronary artery disease, and COPD (chronic obstructive pulmonary disease).

CDC reports reflect the following statistics:

  • Diabetes:[1] Among the US population overall, crude estimates for the latest CDC report for 2018 were 34.2 million people of all ages or 10.5% of the US population.
  • Obesity[2]: The US obesity prevalence was 42.4% in 2017 – 2018.
  • Hypertension[3]: 47% or 116 million people in the US have hypertension.

Leading causes of death[4] in the US from recent CDC statistics include heart disease and diabetes.

Although a majority of diabetics are overweight, some lose weight rather than gain it. In fact, if you have not been diagnosed with diabetes, sudden weight loss can be an early indication of the onset of diabetes. Why does this happen?

What Causes Weight Loss In Diabetes?

If you experience unexplained weight loss, you should see a doctor. It is possible you may have what is termed prediabetes. This means that your pancreas and insulin production are already becoming compromised resulting in increased fat-burning because your glucose is not being properly metabolized to give your body the energy it needs to function. This increased burning of fat causes weight loss which needs to be evaluated by a doctor to determine the cause.

According to the CDC, 88 million US adults or more than 1 in 3 have prediabetes[5]. More than 84% do not know they have it. With prediabetes, blood sugar levels are higher than normal, but not high enough yet to be diagnosed as Type 2 diabetes. Prediabetes raises your risk for Type 2 diabetes, heart disease, and stroke. The good news is if you are diagnosed early enough, you may avoid full-blown diabetes and its long-term effects on other systems in your body.

Several studies have proven that, although there is no cure for Type 2 diabetes, early diagnosis can actually reverse it for some people. Through diet changes and weight loss, you may be able to reach and maintain normal blood sugar levels without medication.

For example, Dr. Mike Lean, professor of nutrition at the University of Glasgow in Scotland, is an author of a 2016 study[6] that followed 306 people who had been diabetic, some for up to 10 years, who were put on a weight loss program.  At 12 months, almost half of the participants achieved remission to a non-diabetic state and off antidiabetic drugs when they lost about 33 pounds. 

“A person’s likelihood of remission from diabetes is greatest in the first five years after being diagnosed. Unfortunately, many people don’t attempt to lose weight and many doctors don’t know this either so they don’t give patients the proper guidance and encouragement.”

Dr. Lean reported

Unexplained weight loss in diabetes is typically accompanied by other signs and symptoms[7] including:

  • Excessive thirst or hunger
  • Excessive urination
  • Itchy skin
  • Dark skin around the neck and armpits
  • Slow healing of cuts and bruises
  • Yeast infections
  • Unusual fatigue
  • Mood changes, including irritability
  • Vision changes

What is Diabetes?

Diabetes is a common metabolic condition that affects the way your body uses sugar from the foods you eat.  Insulin, produced by the pancreas is insufficient or not working properly preventing the body from metabolizing glucose from the blood and transporting it into the body’s cells to use as energy. When this occurs, the body starts burning fat and muscle for energy, causing a reduction in overall body weight.

Three Types of Diabetes

Doctors have known for some time that there are three types of diabetes:

  • Type 1 diabetes often develops quickly. Instead of being able to use insulin, your body stops producing it altogether. Because it usually appears in children and young adults, unusual weight loss is often first noticed by parents. If you have Type 1 diabetes, you will need to take insulin every day for the rest of your life to survive. Currently, no one knows how to prevent Type 1 diabetes.
  • With Type 2 diabetes, referred to as T2DM for diabetes mellitus, your body does not use insulin well and cannot keep blood sugar at normal levels. T2DM can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy food, and being active.
  • Gestational diabetes develops in pregnant women and usually goes away after the baby is born. This type of diabetes can increase your risk for Type 2 diabetes later in life.

Obesity and Diabetes

Does obesity promote T2DM or does T2DM cause obesity? This has been a difficult question to answer due to the metabolic complexity of this disease.

Reports indicate[8] that severe obesity in childhood and adolescence increases the risk of T2DM in youth and young adults. T2DM, which is commonly asymptomatic, frequently is not recognized until random blood glucose is measured.

Scientists believe that insulin resistance is the cause of the excessive fat accumulation associated with T2DM. Moreover, this resistance is the etiology of hyperlipidemia and excess fat accumulation characteristic of T2DM. It can be found in lean people before they are even diagnosed with diabetes and thus is a precursor to T2DM. So far it is not known what causes insulin resistance.

Hormones and Diabetes

There is also a complex relationship between insulin, glucose, and the appetite-regulating hormones leptin and ghrelin[9]. In diabetes, this relationship is out of balance affecting the metabolism of fat in the body. Thus, a diabetic may lose weight rapidly or gain weight.

Leptin, the hormone produced in the pancreas that indicates your stomach is full, is partially controlled by insulin. Since leptin decreases appetite and increases fat-burning metabolism it can cause weight loss.

Ghrelin, the hormone that indicates you are hungry, is inhibited by insulin and glucose. This may explain the low ghrelin levels found in patients with T2DM.

Also, it is worth noting that insulin sensitivity[10], rather than insulin itself, may play a more important role in the regulation of ghrelin.

Ghrelin and the other hormones associated with appetite have a vast range of physiological functions which influence eating patterns and weight management. Current knowledge of these hormones, particularly ghrelin and leptin, is far from satisfactory.  Further studies still need to be done to understand their complexity and biological roles in the body, particularly in the case of T2DM.

Weight Management in Diabetes

Controlled weight loss is the best goal in the management and possible reversal of T2DM. This can be done, especially if you notice a sudden weight loss, through eating a balanced low-calorie diet with attention to carbohydrates and sugar intake. Coupled with routine exercise, diabetics have managed to control their diabetes and some even reverse it. Beware of OTC diet pills and prescriptions for weight loss. These can be dangerous to a diabetic with your complex metabolism.

A riskier weight control procedure is bariatric surgery, used with obese people who have had unsuccessful weight loss. The American Diabetes Association reported that a resolution of T2DM has been an additional benefit of bariatric surgery[11]. It was observed that prompt reversibility of T2DM was due to the normalizing of peripheral insulin sensitivity and by enhancing pancreatic β-cell sensitivity to glucose. These changes occurred very early after the operation. The proportion of individuals achieving normal blood glucose levels was based primarily on the extent of weight loss.

High Blood Pressure and Diabetes

As reported by John Hopkins Medicine, high blood pressure[12] is twice as likely to strike a person with diabetes than a person without diabetes. Left untreated, high blood pressure can lead to heart disease and stroke. A person with diabetes and high blood pressure is four times as likely to develop heart disease than someone who does not have either of the conditions. About two-thirds of adults with diabetes have blood pressure greater than 130/80 mm Hg or use prescription medications for hypertension.

Conclusion

Sudden weight loss in diabetic and pre-diabetic people is not healthy and can lead to nutritional depletion and other conditions. Better to begin a controlled weight loss program that aims to normalize weight loss and eventually balance diet and exercise with the monitoring of glucose levels. Studies support this approach with the possible reversal of diabetes so that symptoms disappear. This is not a cure, but a positive maintenance regimen to keep glucose metabolism balanced and fat storage/fat burning within normal limits.


+ 12 sources

Health Canal avoids using tertiary references. We have strict sourcing guidelines and rely on peer-reviewed studies, academic researches from medical associations and institutions. To ensure the accuracy of articles in Health Canal, you can read more about the editorial process here

  1. Centers for Disease Control and Prevention (2020). National Diabetes Statistics Report, 2017 Estimates of Diabetes and Its Burden in the United States Background. [online] Available at: https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf.
  2. ‌CDC (2021). Adult Obesity Facts. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/obesity/data/adult.html#:~:text=The%20US%20obesity%20prevalence%20was,from%204.7%25%20to%209.2%25. [Accessed 6 Oct. 2021].
  3. ‌CDC (2021). Facts About Hypertension. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/bloodpressure/facts.htm [Accessed 6 Oct. 2021].
  4. ‌Anon, (2021). FastStats – Leading Causes of Death. [online] Available at: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm [Accessed 6 Oct. 2021].
  5. ‌CDC (2020). Prediabetes – Your Chance to Prevent Type 2 Diabetes. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/diabetes/basics/prediabetes.html [Accessed 6 Oct. 2021].
  6. ‌Lean, M.E., Leslie, W.S., Barnes, A.C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K.G., Rodrigues, A.M., Rehackova, L., Adamson, A.J., Sniehotta, F.F., Mathers, J.C., Ross, H.M., McIlvenna, Y., Stefanetti, R., Trenell, M. and Welsh, P. (2018). Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The Lancet, [online] 391(10120), pp.541–551. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext [Accessed 6 Oct. 2021].
  7. ‌Chronic Conditions Team (2021). Unexplained Weight Loss? Why You Need to See a Doctor. [online] Cleveland Clinic. Available at: https://health.clevelandclinic.org/what-you-should-know-about-unexplained-weight-loss-and-diabetes/ [Accessed 6 Oct. 2021].
  8. ‌Malone, J.I. and Hansen, B.C. (2018). Does obesity cause type 2 diabetes mellitus (T2DM)? Or is it the opposite? Pediatric Diabetes, [online] 20(1), pp.5–9. Available at: https://pubmed.ncbi.nlm.nih.gov/30311716/ [Accessed 6 Oct. 2021].
  9. ‌Erdmann, J., Lippl, F., Wagenpfeil, S. and Schusdziarra, V. (2005). Differential Association of Basal and Postprandial Plasma Ghrelin With Leptin, Insulin, and Type 2 Diabetes. Diabetes, [online] 54(5), pp.1371–1378. Available at: https://pubmed.ncbi.nlm.nih.gov/15855322/ [Accessed 6 Oct. 2021].
  10. ‌Kempa, A., Krzyzanowska-Świniarska, B., Miazgowski, T. and Pilarska, K. (2007). Not insulin but insulin sensivity, leptin, and Cortisol are major factors regulating serum acylated ghrelin level in healthy women. Journal of Endocrinological Investigation, [online] 30(8), pp.659–665. Available at: https://pubmed.ncbi.nlm.nih.gov/17923797/ [Accessed 6 Oct. 2021].
  11. ‌Guidone, C., Manco, M., Valera-Mora, E., Iaconelli, A., Gniuli, D., Mari, A., Nanni, G., Castagneto, M., Calvani, M. and Mingrone, G. (2006). Mechanisms of Recovery From Type 2 Diabetes After Malabsorptive Bariatric Surgery. Diabetes, [online] 55(7), pp.2025–2031. Available at: https://diabetes.diabetesjournals.org/content/55/7/2025 [Accessed 6 Oct. 2021].
  12. Anon, (2021). Diabetes and High Blood Pressure. [online] Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetes-and-high-blood-pressure [Accessed 6 Oct. 2021].

Medically reviewed by:

Sandra Cesca is a freelance healthcare writer with many year’s experiences working in the health industry. She covers allopathic, naturopathic, holistic, and complementary medicine. Sandra is also a cultural photographer and tour guide living her dream in tropical Puerto Vallarta, Mexico.

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