Q: Help! I make bad food choices all the time because I am constantly hungry. I'm hungry, I eat and then I'm instantly hungry again. Does this happen to other women? I have Type 2 diabetes for which I take Metformin and Welchol.
A: Dear Desperate,
What you are experiencing is very common. There are several issues that can cause extreme hunger in Type 2 diabetes. First, you may have high levels of circulating insulin that can be made worse by eating too many carbohydrates or foods with a high glycemic index (foods that convert to sugar quickly). It is important to meet with a dietitian that specializes in diabetes to help you deal with these issues.
Secondly there is another physical issue that can make you hungry. Persons with Type 2 diabetes often lack enough of a type of hormone called incretin. Incretin is responsible primarily for controlling after meal blood sugars. It does this by reducing the flow of sugar from the liver after eating, increasing the natural production of insulin when you eat carbohydrate, and slowing digestion. It’s this last function that is of interest. When digestion is slowed, less sugar is absorbed into the bloodstream from the intestines. Slowing digestion also means that more food stays in the stomach for a longer period of time. (Can you see where this is going?) If you lack incretin, food empties from the stomach faster meaning that you can be hungry shortly after finishing a meal! Incretin can be replaced with certain injectable medications called incretin mimetics. In the US there are currently two, Byetta and Victoza. Weight loss is often a side effect of these diabetes medications. Only your doctor can decide if these might be appropriate for you.
Isn’t is nice to know that you are not alone and that there might be an answer to this problem?! Hope this works for you!