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Being underweight

sansevieria

Member
Messages
16
Type of diabetes
Prediabetes
Treatment type
Diet only
Hello,
I've recently been diagnosed with pre-diabetes, with a HbA1C of 48 mmol. I have a BMI of 18, my weight seems to fluctuate by a few kg - right now I'm 47kg but this time last month I was 51kg. Does anyone know if being underweight negatively effects glucose levels, can it falsely increase/decrease a "true" glucose reading?
 
Hi and welcome!

love your name, sansevieria.

I have a beautiful non-variegated specimen of you on the cabinet in the bedroom (ooer!).
Bought the wee thing from eBay. Came as a bare rooted sprout wrapped in newspaper from its tropical home, with jungle clay still clinging to its roots. (I was horrified, because I had expected it to come from the UK, not be wrenched from its tropical home and stuffed in a cardboard tube for 2 weeks in the post!)

Anyway, the little dear survived, and flourished, and is now 7 clumps and 30 inches high.

We are both very happy!

Anyway, to your question:

There are several different bits of info worth bearing in mind.

Firstly, assuming you are a pre - Type 2 diabetic
the HbA1c (your reading of 48) is a measure of your average glucose reading over the last 2-3 months. It is considered the most accurate glimpse of what is going on with you, and is often used for diagnosis. A score of 48 is (as I understand it) right on the borderline of diabetes (pre diabetes is 42-48, and diabetes is 48+).

So that result is effectively a warning shot across the bows that you are very much teetering on the brink of the Big D.

However, a lot depends on diet, lifestyle and exercise. There are many members of this forum who have changed their eating and increased their exercise, and have effectively moved back into prediabetes, and even improved their health so much that they have moved back into the normal range.

What dietary advice (if any) did your doc give you?

Also, the HbA1c can be affected by individual circumstances. Something like anaemia can cause a false result.

Please Note: I am not trying to interpret your result, and give you false reassurance, but I AM trying to give you a better understanding of your result.

Something else to bear in mind is that most type 2 diabetics are overweight (largely due to the excess insulin produced by their bodies) and they can improve their health by losing that excess weight.

Since you already have a lowish BMI, that option isn't as available to you.
However, there is a definite relationship between muscle and fat proportions. so the more muscle to fat that you have, the easier it is to control your blood glucose. The less muscle, and higher fat proportion, the more difficult. That is very simplified, but it goes a long way to explaining why so many type 2s benefit from exercise and gym membership.

So are you a mean, lean muscular BMI 18, or a sedentary, unfit BMI18? It can make quite a difference.

Hope that helps!
 
Hi and welcome. Someone who is underweight at diagnosis is more likely to be a T1 (LADA) than someone who is overweight. This can occur because the insulin supply can dry-up and the body can't use the carbs it has and the weight drops and the body starts using muscle and fat. This can come on quite slowly. There can be other reasons for weight loss but if the GP assumes T2 then do discuss the possibility of Late onset T1 and ask for a c-peptide and possibly GAD test. It's good to have the correct diagnosis early on as the preferred tablets are different. Whether it's T1 or T2, keep the carbs down in the diet and increase proteins and fats
 

I had another HbA1c two weeks ago, I only just found out the result - 50 mmol. My doctor is still insisting that I don't have diabetes. I am confused.
He said that the most common medication can cause IBS-like symptoms and apparently my gastroenterologist has decided I have IBS (without informing me of this, ofc) so he didn't want to prescribe anything. He did outright say "you don't have diabetes so you don't need medication" though), even though everything I've read says exactly what you said - higher than 48 = diabetes.

I haven't had much in the way of dietary advice. "Cut down on refined sugars" was about the only thing, and I don't really eat any as is. I've seen both a diabetes nurse ("you already eat healthy food so no problem there and you don't have diabetes, so you don't really need to see me") and a dietitian ("let me prescribe you this weight-gaining drink that has 30g of sugar per serving") ... not exactly the most helpful bunch of people.

I do have low ferritin levels, but my actual iron stores are normal. This time last year I was "borderline" anaemic and I haven't really responded to oral iron tablets that well (originally I was 3 ug/L but I'm currently at 14 ug/L, normal people are 20+)

I'm not a muscular person by any means. I do a lot of walking (no car and too cheap to use the bus lol) but no actual sports (my joints are hypermobile, my physio says no high impact sports and no stretchy sports which pretty much just leaves like cycling and swimming, sigh).

Do you have any recommendations for a glucose meter? I'd like to be able to track what's going on, and see if there's any foods that my body's particularly struggling with.

(my sansevieria is much less exotic than yours, £1 from Wilkos lol. He's flourished a lot though, I am a proud plant-mother)
 


The cheapest meter that I know of, is the SD Codefree (Amazon, eBay or the manufacturer).
Buy the one that gives readings in mmol/l (those are the units we use in the UK).
Comparing notes with other forum members we tend to agree that it isn't the most accurate meter, but it's cheap, cheerful, and we type 2s don't need absolute precision. We need regular testing so we can spot trends, and adjust our diet accordingly.

If your borderline anaemia is affecting your hba1c result, then getting a monitor is a great way to find out.
The way it works is that the hba1c is an average, and the home meter gives you a snapshot.
So if you test for a few weeks, regularly enough that you can work out your average BG over that time.
If it matches your hba1c, then you know that anaemia isn't affecting the result.
If the result is different, then you can go back to doc and ask for further information/investigation, because the hba1c is clearly not showing the true situation.

Your doc may well be absolutely right about raised BG because of meds. There are many medications out there that affect our blood glucose in various ways (insulin resistance, affecting the liver, etc.) and the effects can be long or short term.

BUT in the meantime, you BG is higher than normal, isn't it? (And you will know this for certain after you've been testing for a few days ) And that ain't good, and can lead to diabetic complications (which are basically the effects of having too high BG for too long), so I wonder if your doc isn't missing the point a bit...

Stick around, this forum is a great info source.
 
Hi @sansevieria

Several years ago I lost a lot of weight (10Kg) was anaemic and not responding to iron supplements. Dr eventually sent me to gastro clinic and they discovered I had coeliac disease. Have they tested you for that?

Also agree with @Daibell that you should ask about slow onset T1 (LADA). An HbA1c of 50 suggests your average BG levels are 8.1mmol/L
 
Welcome! A BMI of 18 is certainly quite low. What kind of foods make up a typical day of eating for you?
 

Yeah, they checked for coeliac disease and hyperthyroidism about this time last year and both came back negative. My gastro just discharged and referred me on to the IBS nurse, who sent me to dietitian - there seems to be a lot of "not my problem" going on I've been re-referred to the IBS nurse so hopefully that'll go somewhere useful but that's probably too optimistic.

I asked my doctor earlier about having different blood tests to figure out what's going on, and he said that those are tests for people who are definitely diabetic and I'm not (or something equally nonsensical). He wants to speak to an endrocrinologist before deciding anything further, it just means a lot of waiting around to hear back I guess (three weeks until I see him again and I want to feel like I'm making progress in the meantime..)

NoCrbs4Me said:
Welcome! A BMI of 18 is certainly quite low. What kind of foods make up a typical day of eating for you?
Click to expand...

I've always been small, and I know I don't eat as much as I should, but I'm definitely eating more than I used to and still losing weight. There's a screenshot from MFP in the spoiler. I don't have much of an appetite (I've always been that way) and I have a lot of nausea so eating is never fun.

 
I get the sense that you are an egg-free, dairy-free vegetarian. The lack of processed food is good. I guess you already know that you are not eating enough and I have no idea what the remedy for that is. Too much carbs is definitely not your problem.
 
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