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Diagnosis of diabetes T2 - sudden weight loss

LittleGreyCat

Well-Known Member
Retired Moderator
Messages
4,392
Location
Suffolk, UK
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
Sudden weight loss is an indicator of Type 1... no insulin production...hyperglycemia

Note: new thread to avoid derailing original thread any further.

I have always thought (and read in some places) that unexpected weight loss is also a possible symptom of T2.

http://www.diabetes.co.uk/symptoms/unexplained-weight-loss.html says
Unexpected weight loss is often noticed in people prior to a diagnosis of type 1 diabetes but it may also affect people with type 2 diabetes.

I know that I was diagnosed soon after the classic symptoms of thirst, tiredness, frequent urination, and the sudden loss of half a stone.

I think that both are due to the same basic cause; the body is not getting enough glucose so switches to burning fats.

In some cases this may be due to lack of insulin, and in others may be due to insulin resistance preventing the insulin from acting.
 
Note: new thread to avoid derailing original thread any further.

I have always thought (and read in some places) that unexpected weight loss is also a possible symptom of T2.

http://www.diabetes.co.uk/symptoms/unexplained-weight-loss.html says


I know that I was diagnosed soon after the classic symptoms of thirst, tiredness, frequent urination, and the sudden loss of half a stone.

I think that both are due to the same basic cause; the body is not getting enough glucose so switches to burning fats.

In some cases this may be due to lack of insulin, and in others may be due to insulin resistance preventing the insulin from acting.
Welcome to the forum. I have been through these horrible symptoms and know well the lack of sleep and irritable days spent trying drag myself to work. Don't let this happen to you.
 
Welcome to the forum. I have been through these horrible symptoms and know well the lack of sleep and irritable days spent trying drag myself to work. Don't let this happen to you.
:)
Thank you for your kind welcome.
I assume that it wasn't ironic (or any other form of humour).
I have, in fact, been here for a while.
:D:cool:
 
I hadn't lost weight upon diagnosis and my HbA1c was around 53. I had been tired and lethargic for years but never had the frequent urination or extreme thirst. A friend did lose weight before diagnosis but his BGs were very high and he had gone into DKA. So maybe only those with very high BGs react like a lot of T1s and lose weight prior to diagnosis?

(Jeez I do hope me mentioning T1 isn't thread derailing ...:nailbiting:)
 
I have wondered about this @LittleGreyCat and wondered if the weight loss was linked to blood sugar levels?

I have noticed from reading this forum that although type 2 diagnosis was a shock, many people knew something was not quite right with themselves and had made some lifestyle changes.

Although there is also the pattern of people giving up smoking, gaining weight and then being diagnosed with type 2.
 
I have always thought (and read in some places) that unexpected weight loss is also a possible symptom of T2.
My reason for questioning that thought was that if someone diagnosed as Type 2 mentions unexpected weight loss then loads of people usually say "are you sure you're not Type 1" and recommend further tests.
 
My reason for questioning that thought was that if someone diagnosed as Type 2 mentions unexpected weight loss then loads of people usually say "are you sure you're not Type 1" and recommend further tests.

Nearly 10 years in, and I'm pretty sure that I am not T1 as I managed a non-diabetic HbA1c last test using only diet and exercise and Metformin.:)
 
No sudden weight loss it took me 12 months of no holds barred Low carb and about 600 calories a day diet to get rid of over eight stones.

long time on preds then put on loads of weight mainly midriff and upper back and got the moon face and bruising on arms then diabetic blood sugar levels and complications.
 
From what I have read, weight gain due to insulin resistance is a sign that the body is producing plenty of insulin - which also ramps up the insulin resistance. Which ramps up the hunger, and the blood glucose levels, but the glucose isn't reaching the muscles or the organs which are insulin resistant - but fat cells don't get as insulin resistant, so the glucose is carried into fat cells by the abundant insulin. Jason Fung's blog Intensive Dietary Management is a great source for this info, and on how insulin works.

By contrast, sudden weight loss is (may be) due to insufficient insulin, uncontrolled high blood glucose, glucose being peed out via the kidneys, and the body effectively consuming itself to try and feed the cells which are not getting the glucose due to insufficient insulin.

The first situation is common in T2s, while the second situation is common in untreated T1s.

However, if T2s are untreated for so long that their beta cells die off (because beta cells die in the presence of too high glucose, and dead beta cells can't produce insulin) then the person can lose the ability to generate insulin, their insulin levels fall, their insulin resistance falls too, and they start to experience insufficient insulin (and weight loss).

There is a figure that is often bandied about (I am sorry, I cannot quote a specific source) that says most T2s have lost half their beta cells by the time they are diagnosed. If this is correct, it must mean that the remaining cells are working hard, and are more likely to fail, especially if blood glucose continues uncontrolled. If that were to happen, then the T2 would (presumably) transition from insulin resistant and fat storing to insulin deficient and losing weight. I believe that this process is what leads T2s to start injecting insulin.

Obviously, it is much more complicated than that! But @Mep and @leslie10152 and @Kristin251 may have first hand experience of this.
 
From what I have read, weight gain due to insulin resistance is a sign that the body is producing plenty of insulin - which also ramps up the insulin resistance. Which ramps up the hunger, and the blood glucose levels, but the glucose isn't reaching the muscles or the organs which are insulin resistant - but fat cells don't get as insulin resistant, so the glucose is carried into fat cells by the abundant insulin. Jason Fung's blog Intensive Dietary Management is a great source for this info, and on how insulin works.

By contrast, sudden weight loss is (may be) due to insufficient insulin, uncontrolled high blood glucose, glucose being peed out via the kidneys, and the body effectively consuming itself to try and feed the cells which are not getting the glucose due to insufficient insulin.

The first situation is common in T2s, while the second situation is common in untreated T1s.

However, if T2s are untreated for so long that their beta cells die off (because beta cells die in the presence of too high glucose, and dead beta cells can't produce insulin) then the person can lose the ability to generate insulin, their insulin levels fall, their insulin resistance falls too, and they start to experience insufficient insulin (and weight loss).

There is a figure that is often bandied about (I am sorry, I cannot quote a specific source) that says most T2s have lost half their beta cells by the time they are diagnosed. If this is correct, it must mean that the remaining cells are working hard, and are more likely to fail, especially if blood glucose continues uncontrolled. If that were to happen, then the T2 would (presumably) transition from insulin resistant and fat storing to insulin deficient and losing weight. I believe that this process is what leads T2s to start injecting insulin.

That makes perfect sense to me.
 
@Brunneria it's in the signature of @kokhongw
Prediabetes? Upto 50% beta cells dysfunction.
Diabetes? Up to 80% beta cells dysfunction. Dr DeFronzo.

Still trying to figure out the difference between dysfunction and death of beta cells, the studies were too complex for my little brain. I did learn that dysfunction in cells means poor quality, ineffective insulin being produced and that dysfunction and death of beta cells are different.

Poor quality insulin could result in weight loss @LittleGreyCat
 
@Brunneria

This is the 2009 paper by Dr Ralph A. Defronzo that places the figure of up to 80% beta-cells dysfunction in T2D upon diagnosis. He has several other very good papers that spans 30-40 years...
From the Triumvirate to the Ominous Octet: A New Paradigm for the Treatment of Type 2 Diabetes Mellitus
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661582/

Most disturbingly, subjects in the upper tertile of IGT (2-h PG = 180–199 mg/dl) have lost 80–85% of their β-cell function (see second arrow in Fig. 3). Although not commented upon, similar conclusions can be reached from data in previous publications (2,3,7,15). The therapeutic implications of these findings are readily evident. By the time that the diagnosis of diabetes is made, the patient has lost over 80% of his/her β-cell function, and it is essential that the physician intervene aggressively with therapies known to correct known pathophysiological disturbances in β-cell function.

Also I had experienced significant weight loss (10kg) prior to my T2D diagnosis with HbA1 @11%. Hence I would have gone thru a period of high uncontrolled glucose that resulted in significant beta cells death...
 
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This is the actual 2008 paper that connects Fasting glucose with loss of beta cells function...
The relationship between fasting hyperglycemia and insulin secretion in subjects with normal or impaired glucose tolerance
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043181/
Thus subjects with FPG between 95–100 mg/dl, which is considered to be normal, already have lost ∼60% of their β-cell function compared with subjects with a FPG concentration of ∼70 mg/dl.
 
Still trying to figure out the difference between dysfunction and death of beta cells, the studies were too complex for my little brain.

My understanding is that beta cells loss is less than the functional loss observed. Eg...they measure 50% less beta cells, but functional loss may be 80% due to insulin resistance etc...so when we recover some of the functions, improved glucose tolerance, is it due to increasing beta cells mass or just improved insulin sensitivity or both?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043181/
An interesting question relates to the etiological significance of β-cell dysfunction that is associated with increasing fasting hyperglycemia: is the β-cell function primary or is it acquired? The results of this study do not favor one scenario over the other. Thus insulin resistance could lead to an increase in FPG that secondarily causes a defect in β-cell function. Alternatively, a primary decrease in β-cell function (either due to a functional defector to a loss in β-cell mass) could result in an increase in FPG, and the resultant increase in FPG could feed back to further impair β-cell function.
 
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