Anorexia and pre-diabetes

Elenas

Active Member
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38
Type of diabetes
Prediabetes
Treatment type
Diet only
You can have lots of green veg with butter or olive oil on. I am unsure about you saying about 50g of carbs a meal - bread has only 18g of carbs a slice. Lots of cheese is good and higher in calories.

When you say you can reach 250mg/dl after 20g of carbs, what was your pre-meal figure? It may be that you are running high in the background, so the meal isnt spiking you much. Have they tested you for type 1?

Thank you for the suggestion, yes i can try to check with a slice of bread as it will still be under the 20 g. Before I’m always at about 110 .

Not tested for T1 as my pancreas is producing too much insulin , so it’s rather the opposite problem of t1 diabetes.
 

Elenas

Active Member
Messages
38
Type of diabetes
Prediabetes
Treatment type
Diet only
Unfortunately, the harsh truth is that with a BMI of 16, then consuming 800 calories a day, you are not on a healthy path. You need to find a way to consume more. I'm not necessarily saying you need to eat more carbs. As someone who lives a low carb lifestyle, that would rather go against me, but more nutritious foods.

You mention not caring for meat; does this mean you are vegetarian, you just don't care for it too much or you are uncomfortable due to the calorie dense nature of some meats? Do you eat fish? Fish can be excellent, and oily fish is nutrient dense.

If eating more nutritious food pushes your blood sugars up too much then it could be you need some pharmaceutical support to cope. If your numbers go very high, as your doctor ruled that you could be a slow onset Type 1?

Whatever is going on, it is important you find a way to stabilise your weight. Ending up with malnutrition - or worse, will not enhance your life, no matter what your blood sugars are.

I agree with you and yes… I need adjustment.

For meat is really the fact that the meat industry is in my eyes absolutely horrendous. It’s really an ethical positioning I have.
Same for fish , I don’t eat it.

I wish for some other options than metformin , so far it’s the only they have offered me. Is there any medication I can ask to have that will allow me more room to eat heavier carbs ?

I’ve indeed read about LADA T1 and my problem is opposite, I have too much insulin in my body . My pancreas over produced it and I have insulin resistance in results. So if Im not mistaken it’s rather the type 2 kind.
 

Antje77

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19,284
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LADA
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At 800 calories over a longer period of time you are on an extreme starvation diet, I can understand your doctor being worried.
Do you eat cheese? I love eggs fried in butter with a generous amount of melted cheese and perhaps some tomato, lots of calories too.
Mayonnaise can be useful as well if you're looking to up the calories: eggs mayo, slices of tomato and cucumber with mayo.
 

Geordie_P

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Messages
849
Type of diabetes
Type 2
Agree with Antje above- eggs, butter, cheese and mayonnaise are excellent sources of calories. Tree nuts are good for raising your calories too: hazelnuts, walnuts- that sort of thing.
 
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EllieM

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800 calories is indeed a starvation diet and with a BMI of 16 it's going to kill you pretty fast. No doubt your ED (eating disorder) team have already read you the riot act about starvation and organ damage, so I won't go there.

If you've been eating that little for a while then it's quite possible that your appetite has reduced accordingly, so though you don't want to be underweight, your appetite may not currently be trustworthy as to telling you when you are hungry.

So: breakfast, morning tea, lunch, afternoon tea, supper, bedtime snack....
(My experience with a family member who got as thin as you after going on an elimination diet for headaches).

My guess (but I am not a doctor) is that you'll need to be aiming at more than doubling (trebling, quadrupling?) your current calorie intake.
Cheese, full fat unsweetened Greek yoghurt (add vanilla or berries?), lots of eggs (cheese omelets?).....

I don't suppose there's any chance of getting your endocrinologist to talk to your ED team?

If you were my daughter, at this point in time I'd be encouraging you to prioritise the ED over the T2, because it's more dangerous.

Lots of virtual hugs.
 
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NicoleC1971

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Yes exactly, my own insulin level, my pancreas produce it too much, and it’s not well absorbed by my cell ( insulin resistance)

Well I actually use my home glucose monitor, and every single fork of carbs spike me.
If I eat 20g of carbs I reach 250 mg/dl 2h after, so yes I admit I’m kind of dead scared to eat carbs.
My body tolerate some veggies with low glycemic index , but that’s it.
After carbs I feel thirsty and at night I have disconfort in my leg .

I don’t feel I’m anorexic in the sence that I’m okay with the fact to gain weight and will happily gain some , just I don’t suceed because i don’t know what to eat to make me gain weight without spike my BS.
I get that you have done what we all suggest i.e. eat and test but I would suggest testing after 4 hours and experimenting with different combinations of fat and carbs (more fat will slow down absorption of carbs). Your goal is to get into range after 4 hours and if you are doing this then your hba1c should reflect that you spend most of your time in the right range. It is normal to have a spike after a meal ; it is continuous snacking, overeating of carbs and the consequent insulin spikes that cause problems in those of us that have a diabetic tendency (75% of the population according to the work done by Joseph Kraft).
You may have a genetic tendency to being insulin resistant or is it possible you have a reduced amount of insulin (LADA) ? I know you've posted before but I can't remember if you had your c peptide test done to establish if your insulin production is normal? If it isn't then even eating zero carbs won't keep your bgs down.
Is it possible that although you are not trying to lose weight you are nonetheless getting very controlling with your food/testing regime to he detriment of your wellbeing. I do think that fear of carbs should be addressed because it could become entrenched an then it gets harder to get back to happier ways of eating . Can you remember being relaxed around food for example?
I am a type 1 so carb counting has had to be a thing for me but I have a relaxed day weekly just to give me a mental break ! I find that this has helped me and it hasn't led to bingeing though inevitably I do get rockier blood sugars. If that seems like a horrific idea to you then I'd say you do have a problem.
 
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lucylocket61

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6,435
Type of diabetes
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Thank you for the suggestion, yes i can try to check with a slice of bread as it will still be under the 20 g. Before I’m always at about 110 .

Not tested for T1 as my pancreas is producing too much insulin , so it’s rather the opposite problem of t1 diabetes.
what tests have been done to show your pancreas is producing too much insulin?
 
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lucylocket61

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6,435
Type of diabetes
Type 2
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With a BMI of 16, your pre-diabetes is the least of your worries. Get your weight back up, then focus on your blood sugar levels. It is possible that your liver is pumping out lots of glucose because you are starving, and a better diet and weight will resove some of this. Pre-diabetes is not life threatening, your ED is.
 
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Jo123

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717
So you think I should snack more?
I m currently not taking breakfast or snack because I’ve seen it’s bad for insulin, that it spike it and so increases the insulin resistance.
Will it be okay for me to add snack?

I would definitely add have a breakfast and snacks at this stage is not healthy to have that low a bmi and eat even if you're not hungry to get that weight on.
 
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lucylocket61

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Have you ever had an eating disorder diagnosed before?

I see from your posting history that you have RH and cant eat dairy.
 
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Resurgam

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I eat at 12 hour intervals as that was what my meter showed was the best for me. It stopped my BG levels rising up and up all morning.
If you are definitely a type two then eating a low carb diet, plus whatever protein and fat you approve of is probably going to sort out most problems.
I eat a lot of eggs, and at one time kept quail to supply them - they are very quiet and easy to look after, and of course, I was sure that they lived happily - deliriously happily when allowed to go out into the garden to eat things.
 
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Elenas

Active Member
Messages
38
Type of diabetes
Prediabetes
Treatment type
Diet only
At 800 calories over a longer period of time you are on an extreme starvation diet, I can understand your doctor being worried.
Do you eat cheese? I love eggs fried in butter with a generous amount of melted cheese and perhaps some tomato, lots of calories too.
Mayonnaise can be useful as well if you're looking to up the calories: eggs mayo, slices of tomato and cucumber with mayo.

Thank you for the suggestion , I like cheese yes, especially the mozarella and feta cheese.
 
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Elenas

Active Member
Messages
38
Type of diabetes
Prediabetes
Treatment type
Diet only
800 calories is indeed a starvation diet and with a BMI of 16 it's going to kill you pretty fast. No doubt your ED (eating disorder) team have already read you the riot act about starvation and organ damage, so I won't go there.

If you've been eating that little for a while then it's quite possible that your appetite has reduced accordingly, so though you don't want to be underweight, your appetite may not currently be trustworthy as to telling you when you are hungry.

So: breakfast, morning tea, lunch, afternoon tea, supper, bedtime snack....
(My experience with a family member who got as thin as you after going on an elimination diet for headaches).

My guess (but I am not a doctor) is that you'll need to be aiming at more than doubling (trebling, quadrupling?) your current calorie intake.
Cheese, full fat unsweetened Greek yoghurt (add vanilla or berries?), lots of eggs (cheese omelets?).....

I don't suppose there's any chance of getting your endocrinologist to talk to your ED team?

If you were my daughter, at this point in time I'd be encouraging you to prioritise the ED over the T2, because it's more dangerous.

Lots of virtual hugs.

Thank you so much, yes I actually eat everything you have listed but I guess my problem is the quantity.
I will try to snack more.
 

Elenas

Active Member
Messages
38
Type of diabetes
Prediabetes
Treatment type
Diet only
I get that you have done what we all suggest i.e. eat and test but I would suggest testing after 4 hours and experimenting with different combinations of fat and carbs (more fat will slow down absorption of carbs). Your goal is to get into range after 4 hours and if you are doing this then your hba1c should reflect that you spend most of your time in the right range. It is normal to have a spike after a meal ; it is continuous snacking, overeating of carbs and the consequent insulin spikes that cause problems in those of us that have a diabetic tendency (75% of the population according to the work done by Joseph Kraft).
You may have a genetic tendency to being insulin resistant or is it possible you have a reduced amount of insulin (LADA) ? I know you've posted before but I can't remember if you had your c peptide test done to establish if your insulin production is normal? If it isn't then even eating zero carbs won't keep your bgs down.
Is it possible that although you are not trying to lose weight you are nonetheless getting very controlling with your food/testing regime to he detriment of your wellbeing. I do think that fear of carbs should be addressed because it could become entrenched an then it gets harder to get back to happier ways of eating . Can you remember being relaxed around food for example?
I am a type 1 so carb counting has had to be a thing for me but I have a relaxed day weekly just to give me a mental break ! I find that this has helped me and it hasn't led to bingeing though inevitably I do get rockier blood sugars. If that seems like a horrific idea to you then I'd say you do have a problem.

Thank you for the fedback , I can try to take my BS after 4h and see how it goes.
I have too much insulin going while they tested me 2 times with a fasting insulin test.
It was 17 and 19 pmol/L and it should be between 2 to 5 to be considered normal.
My HOMA ratio was elevated
I don’t know if they have done c peptide.

And I’m pretty relax when eating as I eat the same kind of meal everydays.
 

Elenas

Active Member
Messages
38
Type of diabetes
Prediabetes
Treatment type
Diet only
Have you ever had an eating disorder diagnosed before?

I see from your posting history that you have RH and cant eat dairy.

Well I have a moderate intolerance to lactose it give me eczema but I keep eating it otherwise I would be even more skinny I guess so. No meat, no dairy, few carbs … what is left ?

And since I went low carb my RH isn’t coming at all anymore. I only experienced this rather violently when they test me with the glucose tolerance test ( OMG I almost die )

And yes I had anorexia nervosa as a teenager , it was 10 years ago. And I fully recovered from it and eat whatever I wanted during the last 10 years of my life until my pre diabetes diagnosis .
 

andromache

Well-Known Member
Messages
168
I’ve just received a diagnosis of “anorexia nervosa” it’s something I have difficulty to accept as I feel I don’t fit into the diagnosis.

Everything is so confusing I’ve been diagnosed with pre diabetes ( insulin resistance) last year , and yes I did everything I could to control my insulin and BS so it won’t spike . Everyone adviced me to do a low carb diet ; so I eventually start to control my carbs intake like everone with diabetes is doing.
I’ve lost weight it’s true that I’ve lost a lot … and I wasn’t overweight , so I end up with this low weight. Which my endocrinologist first thought that will improved my numbers… it didn’t.

I have tried to gain back kg with healthy fat, I even ask for help here many time about how I can I safely gain weight .
I did my best , olive oil, avocado , nuts , eggs everydays ….
Well unfortunatelyt I keep losing, I think that what clearly can make me gain weight is high carbs such as rice, pasta, bread and juices…
But without insulin ( Im a type 2) and without metformin ( I don’t tolerate it) I just can’t take the risk to eat this ? Will it heavily spike my BS… can I?

Now they are asking my to gain weight ( my bmi is 16) but just how can I efficiently manage my pre diabetes and weight gain at the same time… I don’t know , they are asking me to eat meat and I’m a vegetarian since my 13 years old so it’s a no way for me.

Everything I read about diabetes type 2 is about dieting, exercising, losing weight… I feel like an alien with the opposite problem.
Now I’m about to start a therapy for my “anorexia “, but will it fit my pre diabetes problems? They are more like “intuitive eating” , “lot of small snack” … while I thought I needed intermittent fasting for reduced my insulin.
I’m so confused .
Is there anyone here that share such kind of problems with an ED, how do you mange your botth condition?
Any restrictive eating regime can lead to disordered eating in the susceptible. I have a history of teenage AN. That was many decades ago now, but old habits die hard, and it is something I was mindful of when starting to eat low carb. I turned veggie at 13 as well, by the way - it was all part of the same downward-spiral process for me. I'm not saying you'r the same, just that it's a common pattern.

This is what works well for me: eating real, whole foods and lots of them, and highest quality I can afford. Meat, fish, dairy, eggs, vegetables except starchiest ones, olive oil, nuts. This way, I stay a healthy weight and feel strong and my metabolic health is improving. Three good meals a day. BUT, also carrots, parsnips, lentils, berries, yoghurt and whole milk - see next para....

...because here's the thing: in my experience, those of us who are naturally lean absolutely NEED some carbs in order to keep weight on, never mind gain it, as you urgently need to do. You need lots of protein and fat, sure. But if you're like me, you will not be able to keep weight on, let alone gain, if you eat less than 100g of whole food carbs a day.

You are badly underweight, and that is bad for your health now and in the future. And the kind of eating that has got you there needs adjusting, primarily with the goal of getting your BMI to 20 at least, and for that you need to eat a lot more than you're eating now. I think a big part of that will be dealing with a fear of carbs. While your advisors get you up to a healthy weight, they might want you to do more of that than you feel comfortable with. Never mind: getting well is the first priority. Fear of eating is one of the nastiest parts of AN, and eating lots of good food with pleasure and gusto, becoming stronger and healthier in the process is one of the real joys of life. You will recover that joy. But you will need to eat a lot more than you're eating to get there. It will be worth the effort.
 

Antje77

Oracle
Retired Moderator
Messages
19,284
Type of diabetes
LADA
Treatment type
Insulin
It’s a normal size plate I’ m making so I don’t see what I can eat more to have more calories
A normal size plate filled with salad and some protein, plus some added olive oil has a lot less calories than the same plate filled with cooked vegetables, potatoes or pasta, and a fried piece of meat/meat replacer. Salad simply doesn't have many calories for the volume it takes.
So the normal sized plate system doesn't work for tracking portions if the food on the plate is not standard. Same goes for the other way around: if someone eats mostly calorie-dense foods, like lots of fatty meats, double cream in their coffee, generous amounts of butter on their veggies, they'll need to eat smaller amounts than a 'normal sized plate'.
 
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Elenas

Active Member
Messages
38
Type of diabetes
Prediabetes
Treatment type
Diet only
Any restrictive eating regime can lead to disordered eating in the susceptible. I have a history of teenage AN. That was many decades ago now, but old habits die hard, and it is something I was mindful of when starting to eat low carb. I turned veggie at 13 as well, by the way - it was all part of the same downward-spiral process for me. I'm not saying you'r the same, just that it's a common pattern.

This is what works well for me: eating real, whole foods and lots of them, and highest quality I can afford. Meat, fish, dairy, eggs, vegetables except starchiest ones, olive oil, nuts. This way, I stay a healthy weight and feel strong and my metabolic health is improving. Three good meals a day. BUT, also carrots, parsnips, lentils, berries, yoghurt and whole milk - see next para....

...because here's the thing: in my experience, those of us who are naturally lean absolutely NEED some carbs in order to keep weight on, never mind gain it, as you urgently need to do. You need lots of protein and fat, sure. But if you're like me, you will not be able to keep weight on, let alone gain, if you eat less than 100g of whole food carbs a day.

You are badly underweight, and that is bad for your health now and in the future. And the kind of eating that has got you there needs adjusting, primarily with the goal of getting your BMI to 20 at least, and for that you need to eat a lot more than you're eating now. I think a big part of that will be dealing with a fear of carbs. While your advisors get you up to a healthy weight, they might want you to do more of that than you feel comfortable with. Never mind: getting well is the first priority. Fear of eating is one of the nastiest parts of AN, and eating lots of good food with pleasure and gusto, becoming stronger and healthier in the process is one of the real joys of life. You will recover that joy. But you will need to eat a lot more than you're eating to get there. It will be worth the effort.

Thank you for your feedback, indeed I see lot of similarities between what you experienced and what is happening to me.
I have an history of anorexia at teen age as well. Same for vegetarian, I have stopped to eat meat since my 13 years old.
So I guess we have the same way to deal with food.
I also feel that carbs is what will make me gain back the weigh, rather than fatty food that when I eat too much of it I have diarrhea.

My normal natural bmi is around 21 /22 so yes definitively something is going wrong I know.
I will cooperate with my ED provider to see what we can do.
 

NicoleC1971

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3,451
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Type 1
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Thank you for your feedback, indeed I see lot of similarities between what you experienced and what is happening to me.
I have an history of anorexia at teen age as well. Same for vegetarian, I have stopped to eat meat since my 13 years old.
So I guess we have the same way to deal with food.
I also feel that carbs is what will make me gain back the weigh, rather than fatty food that when I eat too much of it I have diarrhea.

My normal natural bmi is around 21 /22 so yes definitively something is going wrong I know.
I will cooperate with my ED provider to see what we can do.
Good luck Elena!
My last thought is that if you do have reactive hyperglycemia then surely this would confuse those tests for Insulin Resistance? If it is condition where you over produce insulin in response to carbs this doesn't imply that you have resistance just high insulin in occasional spurts?
My own ED does echo down the ages even though it was a long time ago. 10 years out I still had occasional ED behaviours at times of stress. I hope you can find a non virtual person to discuss this with face to face.
 
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