How to gain weight if you have diabetes

Diabetes Mellitus is one of the most common and chronic diseases in the world. More than 415 million people are affected by this health condition, out of which 46% are simply not aware that they have it. Diabetes is also the leading cause of coronary heart disease, renal disorders, and adult blindness. There are two major types of diabetes: Type 1 and Type 2.

Type 1 Diabetes

Type 1 diabetes is also called insulin-independent diabetes mellitus (IDDM). This type generally develops in children and young adults and results when the body's immune system attacks its insulin-producing beta cells in the pancreas. Type 1 diabetes accounts for 10%-20%, and people with Type 1 diabetes have to inject insulin daily to survive. While its cause is still unknown, genetic and environmental factors are involved in the disease's development.

Type 2 Diabetes

Type 2 diabetes is also known as noninsulin-dependent diabetes mellitus (NIDDM). The latter typically occurs when the body makes enough insulin but fails to use it effectively. Type 2 diabetes usually occurs in adults over the age of 40. Lifestyle modifications, diet changes, and increased physical activity are critical to the effective management of this disease. However, the 'one size fits all' rule isn't applicable here. And, one should make changes based on individual needs and health conditions.

Other Types of Diabetes

There are other types of diabetes too. These types are neither Type 1 nor Type 2 and stand somewhere between these two types. MODY (Maturity on-set diabetes of the young) is one of those forms that is caused by mutations in genes. LADA (Latent autoimmune diabetes in adults) is a slow-progressing diabetes, which is also known as Type 1.5. One can easily manage LADA with the help of physical activity, insulin, and healthy lifestyle modifications. Gestational diabetes mellitus (GDM) occurs during pregnancy. Generally, this condition is temporary and resolves on its own after birth. However, it also increases the risk of developing Type 2 diabetes later on. Secondary diabetes results after pancreatectomy, pancreatitis, or intake of potent steroids.

Type 1 diabetes is incurable as etiology remains unclear. But research suggests that lifestyle modifications such as diet changes can reduce the risk of developing Type 2 diabetes in high-risk individuals.

Weight reduction is one of the key factors that help reduce the risk of developing Type 2 diabetes. However, it is often challenging for people who have Type 2 diabetes to have a healthy body weight as they grow older, and, indeed, obesity and insulin resistance are two of the main risk factors for type 2 diabetes. Nutritionists and medical experts recommend lifestyle changes to lose weight along with drug prescriptions. On the contrary, those diabetic patients who need to gain weight often fall into the category of type 1 diabetes. For such people, it is also essential to maintain good control of blood sugars. These people should increase the intake of healthy fats and avoid high-sucrose or high-carbohydrate drinks and foods.

Although weight gain is not the most common recommendation to people with type 2 diabetes, weight loss therapy doesn't go well with those elderly patients whose diabetes is accompanied by malnutrition and reduced insulin resistance. It might sound counterintuitive, but many type 2 diabetes patients are malnourished, especially hospitalized elderly patients. Some of these are even severely underweight.

What is Malnutrition?

Malnutrition is dominant among elderly diabetic patients and also contributes to good glycemic control, which makes it more unlikely that malnutrition is perceived as a problem.  It is vital to screen the malnutrition whenever diabetic patients get examined because screening malnutrition would prompt a revision in diet and drug prescription.

Still, malnutrition is dangerous for older adults and has severe consequences.

Malnutrition has adverse effects on the physical and psychological health of a diabetic patient. It weakens the immunity to fight diseases and slows the healing process. Not only it leads to treatment complications, but it is also costly for the healthcare system with extended hospital stays. But everyone seems to have turned a blind eye to this. Experts recommend a routine screening method with quick, simple, valid, and evidence‐based tools within the healthcare plan. The screening will improve the detection of malnutrition among patients, and treatment would be more tailored to the patient's needs. Malnourished patients need to follow a diet that consists of enough nutrients and protein.

Malnutrition is a common problem in many developing countries. However, malnutrition is a common clinical and public health problem in developed countries as well. Critically ill individuals and people undergoing complicated surgeries, dialysis, transplantations, or burn treatments are usually in a high-risk bracket. Also, people with gastrointestinal, respiratory, or renal disease are at higher risk.

Once a person is admitted to a hospital, her nutritional status will tend to decline unless the medical staff takes sufficient measures to prevent malnutrition. Unfortunately, the latter is often unrecognized and goes untreated for a long time, so that between 30 and 90% of adults and children lose weight while being in the hospital. There is a lack of measurement and documentation of nutritional information, including body mass index (BMI), recent weight loss, and food intake in hospital charts. This lack of information happens due to the absence of formal screening programs that can play an essential role in the detection of malnutrition and its treatment.

Commonly, disease‐related malnutrition occurs in association with insufficient nutritional intakes. The increased dietary requirements or a reduced ability to absorb nutrients could also be a factor. But inadequate dietary intake seems to be the top reason for developing malnutrition.

Different studies have concluded that diagnostic patients lack energy, protein, and micronutrient intakes that are insufficient to meet nutritional requirements. Some studies have also shown that institutionalized patients don't consume the right amount of nutrients because the food services don't meet the dietary needs of that particular group of patients. 

Consequences of Malnutrition

Malnutrition has plenty of adverse effects on the human body. The harmful consequences on body structure include deteriorating physical and psychological health, slow recovery after disease, injury, and surgery. Malnutrition often results in loss of body structure too. With weight loss, a person loses fat and lean tissue, and organ mass. As for children, malnutrition hits them differently as it will harm their developing systems, which will ultimately lead to slow growth.

One thing is for sure; malnutrition is more than just a reduction in nutritional status. With impaired immune systems, it is hard to fight infections and viruses with a slow recovery, and the wounds are at risk of pressure ulcers. The muscle weakness can also add to a lack of strength, and difficulty in the respiratory system. 

Respiratory function: Weak respiratory muscles make it difficult to cough and expectorate effectively while increasing the risk of chest infection. The situation gets even harder for patients who breathe through artificial ventilation.

Cardiac function: The heart and the veins play a crucial role in the human body; once the malnutrition hits, it becomes impaired and reduces the optimum performance. These events can lead to heart failure. A mobility weakness of skeletal muscles delays the activity, and this increases the risk of thromboembolism and pressure ulcers.

Gastrointestinal Structure: The digestive structure and functions are also affected by malnutrition. A patient can have problems in digestion like absorption of multi-nutrients, acidity, altered gut barrier, and constipation.

Psychological effects: Lethargic behavior and depression are common among malnourished patients. It is the root cause of low morale and reduced will to recover. The weakness and continuous illness affect appetite and physical ability and ultimately leads to worse condition. There have been adverse effects observed in the behavior of children as well. Malnutrition also raises concerns for potential long‐term deficits in cognition and reduced libido.

The physical and psychological consequences of malnutrition increase the risk of getting sick from viral infections that lead to complicated and costly healthcare problems. Such patients will also suffer complications before and after hospitalization, including hefty medical bills for those who do not live in a country where a universal healthcare system is available.

Common signs of potential malnourishment among individuals:

Although malnourished people are not necessarily underweight, weight loss is an essential symptom of undernourishment, which is a type of malnutrition. Therefore, a BMI of less than 18.5 kg/m2 is an important sign of a suboptimal nutritional status.

A rapid unintentional weight loss is another meaningful sign of possible malnourishment, particularly if this is greater than 10% of the initial weight and occurs in less than six months without intentionally increasing physical activity or reducing dietary intakes.

How to gain weight if you have diabetes

Underweight type 1 diabetic subjects struggling to gain a few pounds should eat foods high in healthy fat and calories, such as generous portions of extra virgin olive oil, nuts, avocado, or fatty fish, such as salmon, or mackerel, among other. Talk to the team of doctors who handles your diabetes. They will review your medications, and hopefully, the doctor and nutritionist will steer you in the right direction to stay healthy while gaining weight.     

It's vital to see your GP if you have lost weight recently without the intention of it. If you notice anything unusual with your health or body, regardless of its shape and size, it is best to get checked out by a healthcare professional.

Do you have diabetes and you want to put on weight?

If you have diabetes and you wish to gain weight, it would be ideal for getting tips from an expert nutritionist. Since you have to make changes with your lifestyle, you must consult with your diabetic team as well. They can help you understand why you might be losing weight or have difficulties in putting up even a few pounds. Below are some tips that I suggest to gain weight in a healthy way 

·      Eating smaller meals and snacks throughout the day will increase your appetite and help you gain weight

·      Adding full-fat dairy products such as milk, vegetable cream, cheese, and yogurt in your pasta, vegetables, or soups is a healthier option for gaining weight. Probiotics are very healthy for your gut as well

·      Add unsaturated fats to your diet like extra virgin and cold-pressed olive or grapeseed oil as they can make you gain weight in a healthier way

·      Avocados, nuts, and seeds also contain healthy fats

·      Eat vegetables with chicken spread or grated cheese

·      Try to have nourishing milk smoothies and coffee

·      Eat wholegrain cereals to have improved stomach functions

·      Nutritional supplements that are available in the market are also a good source of multivitamins and minerals. These drinks or food are ideal for those who have a poor appetite and struggle to gain weight

Ironically, trying to put on some weight is harder than losing weight, especially when you are malnourished, and you have lost appetite. I have gathered some ideas that can be helpful for people with diabetes who would like to put on some weight.

Here are some general recommendations from my online course on Udemy for people with diabetes who want to put on healthy weight.

·      Eat more often: People with low BMI get fuller easily, even with less food and snacks. To gain weight, you need to add smaller meals and snacks in between the proper ones instead of larger meals

·      Choose nutrient-rich foods: If you want to gain weight, adding protein-rich foods such as milk, cheese, yogurt, meat, fish, eggs, or nuts would be ideal. But make sure you choose full-fat milk and whole Greek yogurt instead of skimmed or semi-skimmed milk

·      Boost your energy intake: To gain weight, you need to stimulate the process by adding food or snacks that help with a faster metabolism. Add oil, avocado, cream, cheese, dressings, sauces, or honey to your meals and snacks and see the weight gain in a few months.

·      Drink milk: Milk is considered a whole food. To encounter malnutrition effects, use enriched fresh milk and yogurt with cereals, or use it during baking and cooking.

·      Choose nourishing drinks: Milk-based drinks can help you gain weight easily. Try milky coffee, hot chocolate, milk and fruit smoothies, and cream-infused soups. Replace your fruit and kale slushes with milk or cream-based smoothies when you are trying to gain weight.

·      Eat snacks as small meals: In this Udemy course, I suggest people turn their snacks into mini-meals. Let's suppose you are going to eat an apple, so slice it and dip in some yogurt and sprinkle some almonds and nuts with granola topping. If it is banana time, mash it up on a whole grain bread slice, top it with some peanut butter and eat it as a quick snack. Try carrots and crackers dipped in hummus and cheese, respectively as well.

Generally, diabetic people should avoid eating foods that are high in sugar or high in refined carbohydrates. Therefore, I do not recommend to try to gain weight by eating high amounts of refined grains or high-sugar dessert.

Instead of eating a lot of carbs, try eating healthy fats that will keep your glucose levels in check. Eating healthy fats will help you gain weight while preventing cardiovascular diseases. Technically speaking, fats provide more energy compared to both carbs and even alcohol. People with malnourishment suffer from lack of appetite, and this is why they eat less food than healthy people. Hence, it is ideal that you eat smaller meals throughout the day because it will help you get more calories in total.

I have made a list of meals for diabetic patients who wants to gain weight by increasing their calorie intake. You will find it here below. I have divided these meals into two groups. One has meals with 300 kcal, and others have meals with 400 kcal.

Meals that help diabetic people to gain weight

Underweight people often have low appetite. The following meals are designed to pack the maximum amount of energy in the minimum possible quantity. The following ideas can be used as high-energy snacks or as meals to eat every 2-3 hours. On average, a woman should eat at least 1800-2000 kcal to keep her body weight stable, whereas a man needs 2000-2300 kcal per day.

As I wrote before, diabetic people should be extra-careful about not consuming too many carbohydrates from refined cereals. Always choose unrefined grains (wholegrain rice, pasta, etc.) and avoid eating two carb-rich options among the list below during the same day.

300 kcal dishes for diabetic people who need to gain weight

Fruit porridge

Boil 30 g of rolled oats in 180 ml of water for 3 minutes. Oats should absorb all the water without having to be drained. Season with the following ingredients: 2 tablespoons of honey or agave syrup, 1 tablespoon of flaxseed oil, 1 tablespoon of cocoa, 50 g of diced fruit.

Greek yogurt with honey

80 g of whole Greek yogurt, 3 tablespoons of honey, 1 tablespoon of cocoa powder, 1 tablespoon of flaxseed oil.

Milk and rusks

100 g of whole milk-soaked with 3 wholemeal rusks and 25 g of almond or peanut cream.

Avocado smoothie

Blend the following ingredients: half an avocado, 50 g of apple, 50 g of carrots, 2 tablespoons of almond cream, and peanuts.

Fruit with cream

200 g of fresh fruit sliced, served with 40 g of whipped cream, 1 tablespoon of grated dark chocolate, 10 g of whey protein, and 1 teaspoon of sugar.

Avocado smoothie

Blend the following ingredients: half an avocado, 200 g of fruit, and 10 g of whey protein. If necessary, add 1-2 tablespoons of cow or vegetable milk to dilute.

Crostini with olive tapenade

Prepare a save by blending: 30 g of black olives, a couple of salted anchovies, and 1 tablespoon of extra virgin olive oil. Distribute the cream on toasted bread (50 g).

Quinoa salad

Ingredients for one person: 30 g of quinoa, 30 g of avocado, red onion, 50 g of tomatoes, chopped parsley, a teaspoon of extra virgin olive oil, lemon juice, red wine vinegar, salt, and pepper.

Bring the water to a boil, add the quinoa, mix, and bring back to the boil. Cook over medium heat for 12 minutes. Drain and rinse well with cold water. Transfer the quinoa into a large bowl. Add all the ingredients and mix well. Serve.

Pasta with olive oil and grated cheese

Season 50 g of cooked egg pasta with 1 tablespoon of extra virgin olive oil and 1 tablespoon of grated hard cheese.

Pasta Bolognese

Prepare a meat sauce with 40-50 g of minced meat, tomato sauce, and 1 tablespoon of extra virgin olive oil. Boil 50 g of egg pasta and season with the sauce and 1 tablespoon of grated cheese

Bean risotto

Ingredients for one person: 50 g of rice, 80 g of beans, 50 g of cabbage, 1 teaspoon of extra virgin olive oil, white wine, vegetable broth, onion, salt, and pepper.

Boil the beans after having soaked them for 24 hours. Fry the onion in the olive oil, add the cabbage, and let it dry. Next, pour the rice and toast it. Pour a little white wine and let it evaporate. Add the boiling stock a little at a time and continuously stir, allowing it dry each time. Continue until the rice is almost cooked. At this point, add the beans before serving.

Millet and lentils

Ingredients for one person: 60 grams of decorticated millet, 50 grams of dried lentils, 1 teaspoon of extra virgin olive oil, 1 bay leaf, celery, onion, salt.

Soak the lentils for a few hours and then boil them with a bay leaf. Cook the millet separately in salted water for about half an hour. Once cooked, add it to lentils previously seasoned with a mixture of celery and onion. Heat up for a few minutes and serve.

Omelet

Beat 2 eggs together with 3 teaspoons of Parmesan. Cook the omelet with 1 tablespoon of extra virgin olive oil.

Meat tartare

Serve 80 g of minced veal with 3 teaspoons of olive oil and 2 tablespoons of grated Parmesan.

Chicken with cream of leeks

Ingredients for one person: 100 g of chicken (a part of your choice), 100 g of leeks, 1 tablespoon of extra virgin olive oil, bay leaves, white wine, salt, and pepper.

Wash the leeks and cut them into slices. In the meantime, cut the chicken into pieces and brown it in a pan with the oil, then moisten it with wine. Cover and cook over high heat for a few minutes, turning it over to cook on all sides. Add the finely chopped leeks, the laurel, and sprinkle with salt and pepper. Continue to cook everything until the chicken is ready.

Salmon (or mackerel) with olive tapas

50 g of salmon or mackerel, cooked with a tablespoon of olive oil and served with a cream prepared by blending the following ingredients: 20 g of olives, 1 tablespoon of extra virgin olive oil, and 1 anchovy (the latter if liked).

Salmon (or mackerel) with lemon

Cook 80 g of salmon fillet or mackerel with 2 tablespoons of extra virgin olive oil. Serve with lemon juice and possibly thinly sliced vegetables.

Fish soup

Fry two tablespoons of extra virgin olive oil and onion. Add fish (150 g) cut into small pieces and sauté' 1-2 minutes. Add some hot stock and continue cooking for another 3 minutes. Finally, add chopped parsley and 2 tablespoons of cream. Boil another couple of minutes and serve.

Salmon with mushrooms

Ingredients for one person: 150 g of smoked salmon, 30 g of mushrooms, 1 tablespoon of extra virgin olive oil, lemon juice, salt, and pepper.

Arrange the salmon slices on a plate and surround it with thinly sliced mushrooms (raw or lightly scalded). Season with olive oil, lemon, salt, and pepper and leave to marinate.

400 kcal dishes for diabetic people who need to gain weight

Avocado smoothie

Blend the following ingredients: half an avocado, 200 g of fruit, 2 tablespoons of almond or 100% peanut cream, 3 tablespoons of whole milk.

Bread and Gorgonzola cheese

70 g of gorgonzola spread on 50 g of bread.

Polenta and Gorgonzola cheese

80 g of roasted polenta with 70 g of gorgonzola

Broad bean cream with bread and oil

Blend the following ingredients in a mixer: 40 g of broad beans (fresh and drained weight), 2 tablespoons of extra virgin olive oil, 1 tablespoon of grated pecorino (or Parmesan).

Hummus with bread and oil

Blend the following ingredients in a mixer: 50 g of chickpeas (or other legumes, fresh or drained weight), 1 tablespoon of tahini (sesame seed cream), 2 tablespoons of olive oil, lemon juice to taste.

Pasta Bolognese

Prepare a meat sauce with 40-50 g of minced meat, tomato sauce, and 1 tablespoon of extra virgin olive oil. Boil 50 g of egg pasta and season with the sauce and serve with 2 tablespoons of grated cheese.

Mascarpone pasta

Boil 50 g of pasta in salted water. Meanwhile, work 40 g of mascarpone with a tablespoon of Grana Padano cheese. Drain the pasta and mix it with the cheeses.

Pasta with cream and saffron

Boil 50 g of whole wheat pasta. Season it with a sauce prepared with 2 tablespoons of cream (check that it contains at least 30% fat), 2 tablespoons of olive oil, and saffron to taste.

Rice and tuna

Boil 50 g of brown rice. Season 30 g of tuna with salt and pepper and cook in 1 tablespoon olive oil. Serve with vegetables as the side.

Vegetable quinoa

Boil 50-55 g quinoa and season with 2 tablespoons of extra virgin olive oil, lemon juice, and mixed vegetables cut into small pieces. It is possible to use the oil to sauté the vegetables, then pour the quinoa directly into the pan with the vegetables to collect all the oil.

Meat burger

Prepare a burger with 100 g of minced meat. Cook it with 2 tablespoons of olive or avocado oil and serve with 2 tablespoons of cooking cream (making sure it contains at least 30% fat).

Baked eggs with avocado

Cut an avocado in half and remove the seed. Place it on a baking sheet, break an egg over the avocado and sprinkle with a tablespoon of parmesan cheese. Bake at 225 ° C for 15 minutes.

Chicken With Olives

Ingredients for one person: 150 g of a whole chicken (weight without bones), 150 g of ripe tomatoes, 1 tablespoon of sliced olives, 1 tablespoon of extra virgin olive oil, onion, broth, white wine, oregano, salt, and pepper.

Brown the onion until brown, add the chicken and brown it on all sides. Add the white wine and add the olives, salt, and pepper. Cook covered until the chicken is tender. Serve with a sprinkling of oregano.

Beef salad

Ingredients for one person: 150 g of boiled beef, a touch of mustard sauce (optional), 150 g of potatoes, 150 g of a mix of carrots, courgettes, and leeks.

Cut the meat into strips or cubes and season with the other vegetables after washing and slicing them. Season with a little mustard sauce, if desired.

Mackerel with olives

Ingredients for one person: 150 g of filleted mackerel, 1 tablespoon of sliced olives, onion, 150 g of ripe tomatoes, oregano, bay leaves, parsley, 1 tablespoon of extra virgin olive oil, salt, and pepper.

Brown the onion in the hot oil, add the olives and tomatoes. Cook for about 30 minutes, stirring occasionally. Meanwhile, pre-heat the oven at 200°C (390°F), and put the fish in the oven together with the sauce prepared separately and with a sprinkling of oregano and chopped bay leaves. Cook for about half an hour in a baking sheet covered with aluminum foil.

In conclusion

So you see, gaining weight while managing diabetes isn't impossible. All it takes is an extra dose of patience and some diligent planning skills. There are several ways as well as foods that can help you gain weight. But, it is important to keep an eye on your sugar levels.

I hope this comprehensive guide with some of my tried and tested recipes will help you gain a healthy weight. Feel free to drop your queries and feedback below as I would love to hear back.