 Today we are going to talk about how to lose weight when you have diabetes. I see a lot of diabetic patients and I get this question every day. How am I going to lose weight? Because of diabetes, am I stuck with this weight gain? No, tune in. I'm gonna give you all the secrets. Okay, so number one question. Why do you gain weight when you have diabetes? Well, that is Very very common. Number one when you're insulin resistant if you have type 2 diabetes and you're insulin resistant It is so freaking easy to gain weight. So I don't I never blame my patients Look, it is not you it is sometimes the body you came in the genetics a lot of environmental factors contribute to your weight gain so first of all, let's take the blame part away now of Of course, we have to make sure that we concentrate on your diet and exercise and that's not easy and the medications play a huge role as well But we'll talk about which medications that causes weight gain that you didn't know about and then which medications that can actually cause Tremendous weight loss that you have never heard of. So let's go step by step So the lifestyle changes. We always preach patients. Okay, go lose weight eat better blah blah blah, right? How many people change their behavior very little? I mean it is hard Okay, especially when you're 40 50 year old you have lived your life and now somebody comes and tells you Oh, you got to change everything. First of all, that's not the realistic We have to make sure that we set realist realistic Expectations and then that depends on every individual patient and guess what even if I tell you right now You feel super pumped up. You feel like super ready to go lose weight You're gonna in a day or two You're gonna go into a party somebody's gonna invite you somewhere somebody's gonna put a plate in front of you Bam, everything is gone. So it is very important to feel accountable. So how do you feel accountable? You have to be monitored. Okay, so if a police is monitoring you everywhere, okay? How careful would you be with your behavior? I'm not saying that you're a criminal But even when you're going, you know on a on a road, which is 30 miles an hour most people go 35 But if you know that the police is behind you, would you go 35? You're probably stick with 30, right? So being monitored is extremely important. So That's why at trigger MDs, we monitor you we monitor your blood sugars Every time you enter it automatically comes to us everything you eat if you want to log that in it comes to us So as long as you feel accountable that is the key. So at sugarmds.com We help you with that now Let's move on what medications can actually Help you lose weight. But before that, let's touch base. What are you on right now? Look at your medication list. If you're on a glupazide glima paride gliboride or any sort of insulin You're not in a good position. You will probably Continue to gain weight no matter what you do It is hard and the moment you start going on a diet and you really force yourself You may end up with a very severe low blood sugar and you do not want that when you have a low blood sugar You feel like a truck pass right on top of you. So it's not a good feeling So how do we tease that out in my practice? I always try to get rid of these medications that causes weight gain and All the insulins if I can get rid of insulin I will and I can and there are a lot of ways to do that It's just not easy in a primary care setting. That's why in my specialty practice at sugarmds.com We always strive to get people off of medications that causes weight gain and all the insulins If possible and that that is possible. Most people think that there once they go on an insulin They're insulin-dependent. No, that's and no you never become insulin-dependent unless you're type 1 diabetic. Okay, so Let's go back to the medications you're on So if you're in Glypozide, Glymoboride, we talked about the Glyboride or any insulin it could be Troceba, it could be Togio, Lontus, Levenmere, Novolog, Himalog, Novolin, Himalon You name it. So how do we get rid of these medications? Number one, of course, we're gonna work on your lifestyle changes and exercise as that has a dramatic effect Every time you make a change in your diet and every time you make a change in an exercise that is like equal to one medication. Now Set that aside. What can we do for your current medications? Number one, there are a lot of Medications in the market that can actually that you that we can replace with as a result You suddenly stop gaining weight and immediately going to weight loss mode. So how does that happen? Now there are two classes of agents in the market. Number one is a GLP-1 agonist and the number two is SGLT-2 inhibitors. Now, not everybody is a great candidate for it So after listening to this video, don't just go to your doctor and say oh, give me this, give me that First of all doctors don't like that and number two your doctor may not be comfortable with it The best medication in the market right now Best medications, I would say because I'm not siding with any medications or any company or brand Osempic is number one in weight loss and then Trilosity is there as well and then you have Victorza you have Bidurian all these agents help tremendously and we'll talk about how do they help and these are called GLP-1 class They are intestinal hormone agonist So why intestinal hormones are so important? We'll touch base in a second and the second part is SGLT-2 inhibitors. These are the medications that Allow your kidney to excrete excessive sugar in your system and these are called in Makana, Jardines, Farciga, Stegalato. Okay, so Again, let's go back to you know, how they work and why they're important Now when you have diabetes your gastrointestinal system unfortunately does not produce enough gastrointestinal hormone So as you know your body Communicates the different organs communicate through hormones. That's the only communication system So when you eat normally your stomach and your intestinal system is supposed to make an intestinal hormone to alert your pancreas Which is the insulin producing organ to make enough insulin now in diabetes That's not really happening efficiently So as a result we give these medications and suddenly your body makes the insulin within you and as a result You do not have to take insulin so insulin is only given only as much as you need Right and that takes care of the the blood sugar that comes with with the food Now, how do you really lose weight if your body is making insulin? I just told you that insulin causes a weight gain, right? So here is the difference when your body makes only enough insulin to take care of what you eat Then that's not a big problem on the other hand If you are taking insulin from outside you are eating to compensate for the insulin that you have already taken so you have to eat enough to avoid a low blood sugar because you are giving a Predetermined amount of insulin and you're almost forced to eat on the other hand a human body We don't always eat a big meal. We sometimes have a small lunch sometimes a big lunch And you know most of the time small dinner, but sometimes big dinner, whatever and our body normally adjust that insulin and Unfortunately, when you're an insulin you're given a fixed amount of insulin You know unless you're counting carbs, which most of the time it's hard to do Yet you end up getting too much insulin in your system, which causes weight gain now The second good thing about these medications they cut your appetites So we have a lot of intestinal hormone receptors in our body and some of them are in the hypothalamus Which is where a very appetite center is so when you take these medications You know or even before in the normal people when we eat that these hormones go to your brain says there's food Okay, stop eating simple as that now when when that's not really working. We are replacing this intestinal hormone So your body actually realized that there is food. So when I typically start these medications people basically, you know They just feel full by Half the plate or half the hamburger or whatever everything goes in half and they feel full Another good thing about this medications That's the third good thing about this medications is that it slows down your intestinal system So normally you eat things and then it goes through right away now But if it's if it's if it stays in your system if it stays in your stomach instead of two hours It stays in your stomach for six hours That means that for six hours you have a full stomach and that means that you are not gonna feel Hungry so those are all the good things that causes weight loss again These medications are ozampic, tru-lucid-e, Victoza, Bydrian Bayada was there, but this is too cumbersome. It's too old to use But if you have to use Bayada, we can use Bayada as well But again the most popular ones nowadays are ozampic and tru-lucid-e and they're once a week and they do the wonders Okay, so the next class of agents are SGLT twin inhibitors and and as we discussed these are Jardians Steglatro in moccana and farciga Now these agents basically They they allow your kidney to excrete blood sugar. So normally your kidneys do not want to let the sugars go Okay, so normally our body tried to save everything. So if you're in a very food deprived area, you don't want to lose anything, right? So our body is designed to save everything So your kidney will not let sugar go unless you're 220 or 215 blood sugars, which is too high to begin with So that's why you will lose weight if your blood sugars are running 300 400 all the time You may lose weight just because your blood sugars are running so high and kidney will start spilling it out after 250 So just because you're losing weight without medications and you have diabetes, that's not a good thing We call that a wasting because you know, your body is losing so much sugar. You end up, you know Destroying all your protein and fat as well However, with this medications in a controllable fashion when your blood sugars are going about 100 In normal circumstances, you wouldn't urinate that that blood sugar However, on these medications, you know, let's say I brought your blood sugar down to 200 But then you need a little bit more effort to bring the blood sugars down Now we can put insulin on and bring your blood sugar down But then the insulin packs the glucose into fat cells and causes weight gain on the other hand We can actually give you these medications And then what happens mechanically is that these blood sugar is filtered to the kidneys and are not reabsorbed as a result you pass all this sugar into the Toilet so you can lose 300 calories almost every day. So that's a lot of calories So a lot of people for example underest overestimate actually there how much exercise they do they go to that They go to the gym and they they walk like half an hour for an hour They just walk it's not like a running or sprinting and they think that they have lost 500 calories. That's not true They're probably losing a hundred hundred fifty calories And if they're losing 300 calories an hour, they're doing pretty good now Think about this is medications are making you lose 300 calories just by going to the restroom Now, of course, you need to be drinking more water because the sugar is is going to absorb your water as well So you're going to be going to the restroom more often So you need to stay hydrated. These agents has been shown to reduce the heart failure and heart attacks as well They also have been shown to reduce the progression of diabetic kidney disease Okay, so these are the ways to again to lose weight Diet and exercise is very important being accountable is very important. Have a wonderful day