BMI 20, age 30, type 2 diabetic

[aseriesofunfortunateevents]

Hello,

I was recently diagnosed as type 2 diabetic. I don't display any of the common risk factors. I'm young, thin and reasonably active.

My antibody test came back negative meaning i'm type 2 diabetic (upon diagnosis my fasting blood glucose was 17 and by hba1c was 95).

While i'm happy that I have type 2 rather than type 1, I can't help feeling that it is a bit unfair considering I don't have any of the lifestyle indicators.

Has anyone else been through something similar?

 

[EllieM]

My antibody test came back negative meaning i'm type 2 diabetic (upon diagnosis my fasting blood glucose was 17 and by hba1c was 95).

Did they do a cpeptide as well?

 

[aseriesofunfortunateevents]

Did they do a cpeptide as well?

I'm not sure. What would this help to indicate?

 

[EllieM]

I'm not sure. What would this help to indicate?

It would tell you how much insulin you were producing. It is my understanding that some T1s don't come up on the GAD testing. New T2s (usually) have high insulin production, because they are insulin resistant, though in the long term that can become lower because of high blood sugars damaging insulin producing cells. T1s will be low.

And there are other types of diabetes eg T3c (damaged pancreas) or MODY (genetic mutation, usually happens in families with lots of diabetic relatives.)

 

[ianf0ster]

Hi @aseriesofunfortunateevents and welcome to the forum.
There are estimated to be around 10% of Type 2 diabetics who were slim when diagnosed and there are even teenagers with Type 2, but it's very unusual to be so slim, so unless both a cpeptide and an antibody test show you as Type2 then there is still a possibility that you are Type 1 since this would be more common for somebody like you.

Thin Type 2s are usually TOFI (Thin Outside, Fat Inside) this means that they carry some visceral fat in and around organs such as the liver and pancreas etc. In fact there is a medical condition called NAFLD (non-alcoholic fatty liver disease) which is caused by eating lots of fruit, grains and other starchy or sugary food.

In my late 60's when diagnosed as Type 2, I was considered reasonably slim (though I had put on over 2 stone since my 20's). So my GP's had not been concerned about my weight or possibility of diabetes. In fact they had been encouraging me to eat lots of fruit and whole grains - just the things to cause NAFLD.

There are thought to be 2 non-medical ways of beating Type 2 either dramatic weight loss or Low Carbohydrate way of eating. Because of not being fat I did it with Low Carb, but discovered that even though I didn't consciously cut calories I still lost weight.

I think that both methods of beating Type 2 are rather intertwined. If you crash diet (800calories per day) then you naturally eat fewer carbs the same as if you consciously eat fewer carbs then you probably eat more fat and protein which makes you satiated quicker and so you lose weight! Personally I prefer to be satiated than feeling I'm starving, but still many others still take the opposite approach.

 

[DEBBIESCOTT]

Yep, bmi 18.5, was young fit & active developed GD with second baby, 25 years later diagnosed with MODY, (apparently that all along) no history of diabetes anywhere in family, weight & bmi still the same & exercise 6 days a week
I totally agree it’s not fair

 

[Marie 2]

I second the getting a C-peptide. There are some type 1's that test negative for the antibodies but don't make insulin and they don't know why. That should give you the more definite answer. Low or low normal is a sign of type 1 because you aren't making enough insulin, high or high normal is a sign of type 2 because you make extra making up for being insulin resistant. Commonly because of costs only a GAD antibody test is done, but there are other antibody tests. My Diabetic Educator is one of those that tested negative for antibodies, but doesn't make insulin. The fact that you are pretty young and slim fits more with being a type 1. While way too many youth are getting type 2 now, I think they are almost all overweight? I'm not saying you are a type 1, but I would at least push for a C-Peptide test.

• C-Peptide
  While most tests check for antibodies, this test measures how much C-peptide is in a person’s blood. Peptide levels typically mirror insulin levels in the body. Low levels of C-peptide and insulin can point to T1D.
• Insulin Autoantibodies (IAA)
  This tests looks for the antibodies targeting insulin.
• Insulinoma-Associated-2 Autoantibodies (IA-2A)
  This test looks for antibodies mounted against a specific enzyme in beta cells. Both the IA-2A and GADA tests are common T1D antibody tests.
• Zinc Transporter 8 (ZnT8Ab)
  This test looks at antibodies targeting an enzyme that is specific to beta cells.
• Islet Cell Cytoplasmic Autoantibodies (ICA)
  Islet cells are clusters of cells in the pancreas that produce hormones, including insulin. This test identifies a type of islet cell antibodies present in up to 80 percent of people with T1D.
• Glutamic Acid Decarboxylase Autoantibodies (GADA or Anti-GAD)
  This test looks for antibodies built against a specific enzyme in the insulin-producing pancreatic beta cells.

 

[ert]

You need to ask for a c-peptide test to see how much insulin you are producing to help with your diagnosis.

 

[Fenn]

I tested negative for GAD (or on the top edge but the numbers for a positive test I’ve seen are huge) but I am being considered type one by my consultant and everyone else, I’m still not convinced

 

[OB87]

Is your diet carb heavy normally? I was diagnosed with type 2 age 32 I was active but bmi was 30. During my pregnancy before I was diagnosed I was slimmer and I had gestional diabetes and my bmi then was in the normal range but I did eat a lot of carbs

 

[jonathan183]

As others indicated push for a c-peptide test, if you are type 1 you are better off finding out now rather than becoming very ill before they figure things out
If you are type 2 then look at sugars you are consuming, fructose can cause problems and BMI may not indicate a problem - fruit juice and other sugar drinks being much worse than eating fruit.

 

[boggle]

Mody calculator:

https://www.diabetesgenes.org/exeter-diabetes-app/ModyCalculator

 

[gemlou84]

Hi there, same here - bmi 23 and very active, no family history - yet still have type 2. I’ve started to research something called lean diabetes. I haven’t been tested for type 1 - it’s just assumed I have type 2.

 

[lovinglife]

Any type of diabetes for anyone is unfair, there are many, many reasons why people develop diabetes and no one deserves it

 

[lucylocket61]

Any type of diabetes for anyone is unfair, there are many, many reasons why people develop diabetes and no one deserves it

Thank you for saying this. It's unfair for all of us.

 

[zand]

For those who don't know (and there seem to be some on this thread) T2 is a metabolic disorder whereby you become insulin resistant. Insulin resistance makes you gain weight, so having T2 makes you fat. I was gaining weight for 25 years before my pancreas got tired and i was diagnosed with T2. How I wish I had been diagnosed whilst still slim! That really is unfair.

 

[Fenn]

Unfair? I’ve been married twenty five long years, don’t talk to me about unfair!

 

[stuffedolive]

I too am a thin T2, always active and never put much weight on. A few years ago whilst studying diabetes online with an Australian university I came across the Barker Hypothesis which offers an explanation for the foetal origins of metabolic diseases such as diabetes.
I was a low birthweight baby and have never been able to build much muscle however hard I tried. Killing Me Softly: The Fetal Origins Hypothesis - PMC (nih.gov)

 

[Daibell]

Hi. Do ask for the C-Peptide test. The GAD test is not conclusive and many GPs don't understand that; I even had to argue that with my consultant and he now agrees. It's not just antibodies that can cause beta cell damage. Some viruses can cause it which is why you can acquire T1 at any age not just as child.

 

[Ronancastled]

I've read the preliminary results from Prof Taylor ReTune study here he looked at normal BMI T2s.
MRI scans showed the same thing as Direct study, excess fat on the liver/pancreas.

It would appear that TOFI T2 dysfunction is that the liver deposits fat on the organs first before using the subcutaneous stores like the rest of us. People speak of genetic reasons & this would appear to be the route.