BMI (body mass index) of 22 or less when diagnosed T2?

[brambles]

My GP tells me there has never been a case of anyone with a BMI of 22 or less being diagnosed as Type 2.
Is this true?? Can anyone help as I have never seen this statistic written anywhere.

 

[viviennem]

I don't know exactly about the BMI of 22 figure, Brambles, but not all Type 2s are obese. I think about 20% of us are skinny, and there are several who post on here.

Not all obese people become diabetic, either. It is quite possible that in some Type 2s at least, the insulin resistance (meaning that the insulin we produce can't get the blood glucose into our muscle cells etc for us to use for energy) can in fact cause obesity, because fat cells don't become insulin resistant so the insulin just stuffs the glucose into those instead :shock:

That's a very simplistic explanation of something that is not a simple subject. I think that it will turn out eventually that there are lots of related conditions with the same symptoms, which are now all lumped under "Type 2".

Don't let you doctor's comments worry you (in case they are); some Type 2s are skinny, and even need to gain weight. We're all different!

Viv 8)

 

[Sanober]

Hello, I was BMI 22.7 at diagnosis and now 22, and it's not made a difference to my diagnosis, my test shows I produce insulin normally (not insulin resistant) yet my insulin's not being used properly by my body. Therefore, I'm still T2 for now but with a ?

So Viv's correct in that there are slim T2s out there, however some folk who are initially diagnosed as slim T2 go on to show later that they are actually T1 (but a slow onset version of it sometimes called T1.5 or LADA). But there's also research that Viv has also highlighted on another post that showed a TV documentary and research in India about folk who are 'thin fat' i.e low BMI but high internal fat around the organs that results in insulin resistence i.e T2.

Also, not all overweight people become diabetic either (think the statisic is 10% develop T2).

So no longer does there appear to be a clear cut T1/T2 scenario now - there are variations inbetween with more and more research going on out there.

 

[carty]

Hi brambles
I was under7 stone when I was dx as type 2 I dont know what BMI that is but it is very skinny :!:
CAROL

 

[lovinglife]

My Dad was very skinny when he was daignosed years ago with T2 - not sure of his BMI but when his 34inch waist trousers on his suit he was putting on to go to a christmas do fell down around his ankles when he fastened them he decided it was time for a trip to the docs - he is 6ft 4 so he was very skinny!

 

[MarkE]

Well, I had a BMI of 18.3 on my diagnosis a year ago, so they are clearly talking rubbish. Not happy when so called professionals make such idiotic statements!

 

[Unbeliever]

I was seven stone oo. Wasn't very interested in what my BMI was so can' remeber even if I was old. They were more concerned with warning me not to lose any weight. As if these hings are so easy.

I think the BMI is no taken too seriously by dietitians etc now bu in the absence of anything else it is used to decide who may be prescribed certain reatments.
I think that certain doctors like o try o impress paients wih these eneralisations ..Perhaps there is a medical version of The Readers Digest .

 

[Mark122]

This is a subject that interests me. BMI is of course not a precise guide to body fat. I have a BMI of 24 which is considered "normal" but I still have some fat around the middle (and possibly some fat around my organs that would need an MRI to see!). BMI is of course a good rough guide to who is likely to get ill from their weight and who is not. If your BMI is 40, it is unlikely you will have no health problems at all and serious problems are likely to develop.

I would like to know if there are any published journal articles where researchers have measured newly diagnosed diabetics for BMI and also checked their body fat percentage and or MRI'd them for visceral fat. Can anyone help?

Thanks

Mark

 

[brambles]

Thank you to everyone who replied.
I asked the question as I had a BMI of 24.7 (within range) when diagnosed last June, through a lack of help and advise I tried to stop eating sugar but my food was high in fat instead, this resulted in a BMI of 26.6(overweight).

I am happy to say that my BMI is currently 23.3 as I have lost a good bit of weigh-aiming for 22.6.
I came off my glimepiride when I has a BMI of 24.04 due to hypos.HBA1 c also reduced from 7.4-6.4
in the 3 month period of my weight loss. Tests again next week and I await with interest on A1 results

My GP told me that my reduction in medication was purely down to weight loss, and this is when I was told about the BMI of 22 figure.

Thanks again

 

[Unbeliever]

Glimepiride can cause massive weight gain.

 

[brambles]

Really? I didn't know that-maybe it wasn't the fat then!
Thanks for the info

 

[witan]

The problem is that your Doctor has been brain washed by all the media portrayal of T2 as being obese - I'm not sure why they've done this (ignorance! slur on people without their idealised body shape!) or what they might gain from it (shares in weight/diet clubs?).

I was 9.5 stone and 5 foot 9 when diagnosed (not sure what BMI they said) but have never been overweight let alone obese.

It would be great if all the slim T2s on the forum could post so we can get an idea of just how wrong your doctor is - you should ask him to explain and challenge his stupidity!

I have said many times that DIABETES is NOT a DISEASE it is the description of a SYMPTOM that has many many underlying causes - some known, others yet to be revealed.

In truth a good proportion of obese T2s are suffering from metabolic syndrome and insulin resistance. It probably is time that the old T1, T2 categories were dropped, science has moved on a long way since they were first implemented. and new names/acronyms could be introduced that better describe the underlying condition. Try...
BCF Diabetes -Beta-Cell Failure Diabetic
RBCO Diabetes - Reduced Beta Cell Output Diabetic - may eventually be BCF
IR Diabetes - Insulin resitant Diabetic
Ges Diabetes - Gestational Diabetes
PTI Diabetes - Pancreatic Trauma Induced Diabetic

Did I miss any?
This may encourage the medical profession to diagnose our conditions properly and focus research on bespoke treatment for the different versions. And hopefully educate the media and the population about the truth of diabetes.

 

[Unbeliever]

Really? I didn't know that-maybe it wasn't the fat then!
Thanks for the info

I have never beeen overweight and couldn't believe how the weight was steadily piling on when I was taking 6x mg of glimeoiride. I asked my Gp at the time who assured me it was "weight neutral". I am sure he believed this himself , he kept requesting thyroid tests etc.
As soon as I started to take Januvia I started to hypo so I came off the glimepiride.
The weight I had gained all disappeared in one month.
When I looked up glimepiride on the internet I found that the Americans seem to accept this
side effect far more easily than we do in the UK.
My DSN comented about my weight loss recently and i told her what had happened . Her comment was
"Yes that can happen " When I thik she wanted me to take all tthat glimepiride ANDinsulin.
The weight gain and hypos would have been all my fault ,of course.

I think those of us within the normal BMI ranges do sufffer different side effecs.
I have often wondered if metformin causes worse side effects in this group because the
desirable side effect of weight loss does not apply.

 

[phoenix]

Did I miss any?

lots, :!:
There are many others, trouble is that is that they are officially called 'Other Specific Types of Diabetes., pancreatic diabetes is one of those as is MODY
The definition and classification that is supposed to be used internationally is only 12 years old . They actually make the point that type 2 is a bit of a catchall and includes groups that maybe should be separately classified

It has been argued that a lean phenotype of Type 2 diabetes mellitus in adults found in the Indian sub-continent may be very distinct from the more characteristic form of Type 2 found in Caucasians. Not enough information is available, however, to characterize such subjects separately.

it is likely that the number of people in this category will decrease in the future as identification of specific pathogenetic processes and genetic defects permits better differentiation and a more definitive classification with movement into "Other types".

http://www.staff.ncl.ac.uk/philip.home/who_dmc.htm

Personally I think that a lot of thin Type 2s may have genetic forms of diabetes like MODY , have a slowly progressing autoimmune form like LADA (T1a) or have another form of slowly developing (non autoimmune) of T1b. It's clear from reading that many thinner type 2s need to go onto insulin relatively soon, pointing to insulin deficiency rather than insulin resistance.
But then again I could 'name' some thinner type 2s who have controlled their diabetes for many years on diet and exercise.

As to the BMI 22, many papers use this as a 'cut off point' so for example in the Nurses health study women women with a BMI of more than 35 were almost 100 times as likely to get diabetes as those with a BMI of 22. However the rates of those diagnosed with NIDDM(T11 then) at BMI 22 was not nil , just very few, and those with a bigger waist/height ratio were (at every BMI) more likely to have/develop NIDDM .

 

[daisy3174]

Hi there just seen this thread, I have a BMI of 22.I have just been diagnosed with Type 2, I have never been overweight in my life and have been a runner since the age of 15, as well as other exercise and being very active and also eating very healthily.I was very shocked with my dagnosis I have to say as I am 37. I think doctors just put things into brackets, but it is not so x