Van's late nights and short sleep, often only 3-4 hours per night, led to rapid weight gain. A recent fainting spell revealed critically high blood sugar at nearly 400 mg/dL, significantly above the normal level of below 250 mg/dL. Doctors administered insulin to stabilize her blood sugar and recommended hospitalization for further evaluation, but she chose to return home.

A week later, Van returned for a follow-up, receiving a diagnosis of type 2 diabetes. She also presented with "black spots," an early sign of diabetic retinopathy. During her examination at Tam Anh General Hospital, TP HCM, Van weighed 71 kg and measured 1,53 m, resulting in a BMI of 30, indicating severe obesity. Further diagnoses included grade two fatty liver disease, dyslipidemia, and a peripheral vestibular disorder.

Doctor Hoang consults Van on her weight loss regimen. *Photo: Tam Anh General Hospital*

Doctor Lam Van Hoang, Head of Endocrinology and Diabetes, explained that Van had been living with undiagnosed and untreated diabetes for an extended period, which allowed the disease to progress and cause complications. He noted that prolonged stress can elevate cortisol and adrenaline levels, impacting glucose processing and leading to high blood sugar.

When the body fails to produce sufficient insulin or use it effectively, glucose accumulates in the bloodstream instead of being converted into cellular energy, resulting in persistent fatigue. Additionally, continuous stress prompts the body to produce excess cortisol, which can damage the nervous system and contribute to vestibular dysfunction.

Doctor Hoang devised a treatment plan for Van that simultaneously addresses obesity, controls blood sugar, and resolves the diabetic retinopathy. The plan includes weight loss medication to help manage appetite and promote sustainable weight reduction. Furthermore, Van received guidance on a balanced, nutritious diet and a moderate exercise regimen tailored to her health condition.

After one month, Van lost 4 kg, her "black spots" disappeared, and her blood sugar stabilized. Within three months, her weight decreased to 61 kg.

According to Doctor Hoang, weight management for individuals with diabetes is more intricate than for those with general obesity. This is due to the necessity of balancing weight reduction with the maintenance of stable blood sugar levels.

One primary factor contributing to weight gain is elevated insulin levels in the blood. Excess insulin promotes fat storage, leading to weight gain and obesity. Conversely, when the body accumulates too much excess energy, adipose tissue (fat) can release hormones that contribute to metabolic diseases.

Doctor Hoang emphasized that losing 5-10% of body weight can significantly help manage diabetes and improve insulin resistance. For individuals with type 2 diabetes, weight loss is a crucial component of treatment. Patients should pursue scientific weight reduction under medical supervision to achieve a healthy weight and maintain stable blood sugar levels.

Duc Hanh

*Patient's name has been changed