BMI 20, age 30, type 2 diabetic

[AloeSvea]

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)

I'm sitting next to my old ma while reading the above 'Killing Me Softly' research report, and, kind of pleased she isn't reading "fetal insult" - it's bad enough for her when I tell her off for the ribena in my baby bottle! Ah dear.

Interesting study though - all part of the big picture when looking at metabolic health ...

 

[ert]

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.

Researchers are classifying thin people with type 2 diabetes as type 4. It appears to be a more aggressive form of diabetes if you are thin.

https://www.healthline.com/health/diabetes/type-4-diabetes

 

[thhpe]

C-peptide test should be done after food with a blood glucose of about 7 mmol/l.

Many years ago I had a C-peptide test done together with all the fasting blood test (lipids, glucose, etc.) I almost screwed the consultant for wasting my money on the C-peptide test. He explained that due to my fasting BG of 5 mmol/l the C-peptide test has no meaning as the beta cells are not challenged (5mmol) hence very little insulin was produced hence very low C-peptide detected.

 

[SarahPlum]

How do. I’ve had all the tests for LADA, I was diagnosed at 32 with hba1c of 106. My bmi is 27 and I have an active lifestyle. Nothings working for me so I imagine insulin soon. Pants isn’t it

But you’re not alone. It is indeed really unfair.

 

[AloeSvea]

Hi @ert

• Type 4 diabetes. Type 4 diabetes is the proposed term for diabetes caused by insulin resistance in older people who don’t have overweight or obesity. A 2015 study with miceTrusted Source suggested this type of diabetes might be widely underdiagnosed. This is because it occurs in people who aren’t overweight or obese, but are older in age.

 

[AloeSvea]

C-peptide test should be done after food with a blood glucose of about 7 mmol/l.

Many years ago I had a C-peptide test done together with all the fasting blood test (lipids, glucose, etc.) I almost screwed the consultant for wasting my money on the C-peptide test. He explained that due to my fasting BG of 5 mmol/l the C-peptide test has no meaning as the beta cells are not challenged (5mmol) hence very little insulin was produced hence very low C-peptide detected.

I get c-peptide tests done from time to time, and always fasting, along with other blood lipid and HBA1c tests. Not a problem.

 

[ert]

Hi @ert

• Type 4 diabetes. Type 4 diabetes is the proposed term for diabetes caused by insulin resistance in older people who don’t have overweight or obesity. A 2015 study with miceTrusted Source suggested this type of diabetes might be widely underdiagnosed. This is because it occurs in people who aren’t overweight or obese, but are older in age.

They don't define older. I assumed in the given context it meant not young children.

 

[lovinglife]

They don't define older. I assumed in the given context it meant not young children.

This definition is more clear on the age referring to it as “elderly”
https://www.salk.edu/news/salk-news/faq-on-type-4-diabetes/

 

[jonathan183]

Type 2 diabetes is an insulin resistant condition - obesity can come along for the ride but is not essential for the condition.
Type 1 diabetes can develop at any time - antibodies tests may indicate type 1 but cannot rule it out.
C-peptide can confirm the body is producing very little or no insulin - which would require starting on insulin straight away. Whether you started off as type 1 or type 2 is irrelevant if your body is not producing insulin you need to start taking it ... it's about time c-peptide was done as part of the diagnosis.
A c-peptide test can be done a couple of different ways with varying inconvenience and accuracy. A blood glucose of around 7mmol/l and a very low c-peptide would be clear cut ...

 

[Fenn]

A blood glucose of around 7mmol/l and a very low c-peptide

My consultant used this to rediagnosed me, 8mmol with my cpep 0.05, but I’ve heard cpep can be very inaccurate, this leaves me forever uncertain. Sorry to derail op.

If GAD and Cpep can be inaccurate, it’s kind of understandable there are so many wrongly diagnosed.

 

[Marie 2]

@Fenn While there can always be some inaccuracy in blood work. And especially at the beginning, some type 1's still produce some insulin. I would expect the discrepancy would not be big enough to be registering a too low to a too high reading of a difference. I would think any inaccuracy would be more of a low versus a low normal thing. Or high and even higher? But I doubt there would be a huge enough inaccuracy that would change the signs of being a type 1 versus a type 2.

 

[AloeSvea]

They don't define older. I assumed in the given context it meant not young children.

" A 2015 study with miceTrusted Source indicates that diabetes might be underdiagnosed in older adults who don’t have overweight or obesity. While not an official classification of diabetes, researchers are calling this type 4 diabetes.

Type 4 diabetes isn’t an autoimmune condition like type 1 diabetes, and it’s not linked to weight like type 2 diabetes. Instead, this potential type of diabetes may be linked to the aging process. Research into this condition is ongoing, but scientists have already uncovered some connections."

But I like your take on what "older" is!

 

[ert]

" A 2015 study with miceTrusted Source indicates that diabetes might be underdiagnosed in older adults who don’t have overweight or obesity. While not an official classification of diabetes, researchers are calling this type 4 diabetes.

Type 4 diabetes isn’t an autoimmune condition like type 1 diabetes, and it’s not linked to weight like type 2 diabetes. Instead, this potential type of diabetes may be linked to the aging process. Research into this condition is ongoing, but scientists have already uncovered some connections."

But I like your take on what "older" is!

They need another classification type for the 20% of type 2's who are low or normal BMI and find themselves with a more aggressive form of diabetes. Dr Jason Fung writes about it in his books. Here is a personal experience of someone following Dr Jason Fung's intermittent fasting.
https://www.dietdoctor.com/thin-diabetic-reversed-type-2-diabetes

 

[AloeSvea]

They need another classification type for the 20% of type 2's who are low or normal BMI and find themselves with a more aggressive form of diabetes. Dr Jason Fung writes about it in his books. Here is a personal experience of someone following Dr Jason Fung's intermittent fasting.
https://www.dietdoctor.com/thin-diabetic-reversed-type-2-diabetes

I don't need to read anyone else's personal experience of that - lol! I call myself having "weight loss resistant type two". And, the Swede's have already done a great re-classification system. Hasn't caught on though.

 

[thhpe]

AloeSvea states:
I get c-peptide tests done from time to time, and always fasting, along with other blood lipid and HBA1c tests. Not a problem.

Perhaps I should elaborate more : C-peptide is part of the proinsulin molecule, the C shape peptide that is being cleave off to produce the insulin molecule. So for every insulin molecule produced a C-peptide molecule is also produced.

If a person blood glucose level is low e.g. 4.4mmol/l, he/she would not be producing any insulin and C-peptide as doing so will get that person into hypo. That is the reason to diagnose whether any person is still producing insulin, the C-peptide test is only meaningful when the blood glucose shall be around 7mmol/l or higher. As that person if still able to produce insulin will reflect that capability in the C-peptide test.

Of course to do a C-peptide test on fasting is not a problem to the testing lab. The question is, is it meaningful without knowing whether any insulin is produced hence a meaningful measurement of C-peptide. In my case it is a waste of money doing on fasting at < 5mmol/l blood glucose.