 Hey guys, this is Dr. Ahmed Ergen. I'm an endocrinologist and I'm going to talk to you today about why diabetics lose weight Well, I'm not saying why diabetics cannot lose weight. I'm saying why diabetics lose weight and I'm going to tell you about Why do you lose weight with or without medication Sometimes you'll lose weight if you're on certain medications, which I will talk about that as well But I'll talk about Why are you losing weight when you have diabetes? That's today's topic. Let's get started Alright, so before we start this video make sure you subscribe make sure you share this video So you can help us grow and we can bring you more videos now Once all the time a patient with type 1 or type 2 diabetic will lose weight because of insulin deficiency now you're gonna say Type 1 diabetics are insulin deficient, aren't they? What about type 2 diabetics? Are the insulin deficient? Yes, they are sometimes now As you can imagine, I'll tell you why not having insulin in your system will cause weight loss Now I'll tell you why type 2 diabetics can also be extremely insulin deficient as well So insulin deficiency happens when your pancreas totally fails Which means that there is almost no insulin coming out of your body or very little so You know it comes from beta cells, right? So beta cells in pancreas make insulin Now in type 1 diabetes that will fail in type 3 diabetics that will fail to a great extent Now insulin is the ultimate Metabolic anabolic hormone so insulin makes things things grow insulin makes you gain weight Knowing that if you do not have any insulin in your body, you know that you will lose weight. How? Now if he instantly if there is no insulin in your body, what happens your blood sugar goes up, correct? Very easy You may have insulin in your body your sugar may still go up if you're insulin resistant But in this case I'm talking about insulin deficiency only now your blood sugar will go up now When your blood sugar goes on what happens your kidney is normally in normal people your kidney will start absorbing Blood sugar any time your blood sugar is about 180 Okay Now in diabetics that's a little bit higher maybe after 220 but after 220 You're pretty much on your own because after 220 your kidneys will be like I don't know what to do man. You're that's way too high and your kidneys will be like I'm out of here and then your blood sugars are gonna be going all the way down to your bladder Because your kidney is not going to be able to absorb what is passing through and then you're gonna end up pink So as a result patients with diabetes who have uncontrolled diabetes that are about 220 blood sugar Chronically or most of the time they will end up having a lot of weight loss and a lot of excessive urination because when you pee the sugar The sugar will attract water. You cannot just pee crystal Crystallized urine I mean crystallized sugar, right? So so so in order to You know be able to urinate sugar your kidneys will let more water go down So you're gonna be constantly thirsty as well for that reason so constant urination constant thirst Will be together with weight loss or will bring the weight loss with it Just because you're losing a lot of sugar now I call this wasting so you're basically wasting so if your body is wasting sugar all the time Your body will start running on fat and protein and of course you're gonna go into ketotic state and it's gonna be like almost Unofficial or unintended ketogenic diet type of situation But your blood sugar will be running high compared to keto diet, which is not the case here Your blood sugars will be running high damaging your organs and damaging your pancreas even more It's a disaster So it's like you're flooding in a neighborhood where you cannot really do anything and things only get worse If rain doesn't stop, right? So that's why people lose weight when they're an insulin deficient now This is common in type 1 diabetes. So why top 2 diabetics become insulin deficient? So here's why normally when you have type 2 diabetes your body Will try to make insulin for a long time It's called insulin resistance will try to you know, your blood sugar will stay normal Okay, that's your blood sugar less. I'm gonna call this a 90 to 100 level But your insulin level in time will keep going up just like this To maintain your blood sugar still in the normal range at some point because of the stress too much stress or working too much or Burning out whatever you call it just like human beings these poor cells will stop making The insulin and it will start going down now The insulin goes up because of the demand It's like if you start spending more and more money if you start buying more and more things if you start getting more and more loans Then you're gonna have a lot of debt, right? This is like a debt going up that you have to pay for this So if your body needs that much insulin because you grew your body so much Then once your insulin levels go down like your income in this case I'm just making an analogy your income goes down. It suddenly will tell yourself. Oh, what did I do? You know like now it is very hard to get out of a million dollar house. It is very hard to Sell your car is all depreciated and now you're pretty much in a bed shape. Okay That and at that point when your insulin starts going down then your sugar starts going up Now what happens here is your insulin is going down your sugar is going up At that point you need to really intervene. That is a breaking point right here Right here your insulin starts going down your sugar starts going up If you don't do anything something very aggressive here with lifestyle changes or a medication or both You will be in trouble very quickly Then what's gonna end up happening is just like how the debt end up accumulating very quickly and then the interest and then you're Sound like you're like you're drawing same thing for your body Eventually you will Your sugar will be so high that this high blood sugars high blood sugars will actually Kill your pancreas your beta cells More and more So if you have 20% of your beta cells left If you let your blood sugars remain high Eventually you will have no beta cells left from high blood sugars and That can happen very quickly if you're not really measuring your blood sugar. You may go from 6% of you on C To 16% of you on C within three months. I See that all the time people come to me. They say my A1 C was 6% couple months ago. What happened to me? 16% because you got into what we call a crisis. It's called glucotoxicity Glucotoxicity means that your glucose start going up and becomes toxic to your pancreas will totally Paralyze your pancreas your beta cells your beta cells will become unresponsive. They may not be totally dead, but they will be paralyzed Unless you bring your blood sugars down very quickly those beta cells are not going to do anything Even if you start eating well for a while these beta cells will Stay paralyzed and then that causes insulin deficiency and then suddenly those top two diabetic patients start losing weight Stop being excessively thirsty excessively your nation. They go to the doctor. They get diagnosed with diabetes They if they change your lifestyle and they start on the medication, they may quickly recover and then their beta cells Okay, the beta cells will start recovering now that misconception is and I get this question a lot And these people actually asked that question recently My A1 C was high. Now this is almost normal back to normal. Am I cured? No, you're not cured Unfortunately, because you're too late by the time you get diabetes diagnosis You only have like 20% of your beta cells left 20 30% max now When your A1 C is really high as I said your beta cells were paralyzed now those 20% you regained the 20% of the beta cells Okay, the 20% of the beta cells that were drowning Are back, but you only got back 20% of these beta cells Now remember as we get older everything in our body gets older So if you're prone to diabetes And you only have had 20% of your beta cells left That means that yes, you're in remission for now, but you have to really watch out For another episode coming in so because if you ignore it again Your blood sugar may start creeping up and the next thing you know, your beta cells aren't a failure again It's like an economical crisis just because you got out of an economical crisis That doesn't mean that you're good for forever You still have to watch your economy to make sure that you don't go into another crisis or bankrupt Right. That is the main reason why people with diabetes lose weight. Other than that Some medications will cause weight loss as well So and if the doctor didn't tell you you will not know why you're losing so much weight So metformin can cause around, you know, two to three percent weight loss So you should know that another common class is g lp1 G lp1s can cause a lot of weight loss I have seen people losing up to 80 pounds of weight loss and sometimes blows my mind I mean, how did you lose 80 pounds? Sometimes I actually had a patient with a hundred pounds But it's an exception. Most people will lose at least five to ten pounds on this g lp1 drugs and these are Rubellis, Eurozempic, Trullicity Biodary and etc. Biodary is not that strong But I believe I think the most the strongest one for weight loss in my practice in my experience is ozempic Studies also show that as well and then the Rubellis and then Trullicity and so forth. Now The SglT class Which is your Jardins, your Farsiga in Rocana, etc. They also cause significant weight loss Not as much as g lp1, but they also they all people can also lose a lot of weight, but there's a limit with those I'm not seeing really people losing more than 15-20 pounds on these but still they can cause weight loss So if you started these and you know that they can cause weight loss now, you know, all right, I Think that's pretty much it. So if you guys Want to share your experience want to comment? Please be sensitive. Please be open You can share your experience. You can ask questions We cannot directly treat you but I can briefly answer you if I can and I don't want to mislead you because sometimes short answer Is not the best answer But make sure you share this video make sure to subscribe and we'll see in the next video