Pizza night!

[Dinet]

I am type 2 and was diagnosed at 55 and also not twice as heavy as I should be! Found that quite insulting as it makes it sound as if all type 2s are overweight. Like you lots of type 2 s in the family and by no means are most of them over weight. I ate pizza with a side salad. The Glucose goddess as she is known says if you are going to eat a meal heavy in carbs eat a salad started first as there is evidence that can stop a big spike, also taking a tablespoon of vinegar in water 10 minutes before a meal. If you had a balsamic vinegar and oil dressing on the salad that could be your vinegar. I would email the restaurant and ask if they do side salads

I m overweight, Type-2, I m not insulted. Being older and overweight is the most "common" presentation for this condition

 

[Junius]

Early 30s and underweight? Red flag for something other than a type 2 scenario there. Ordinary type 2s are usually about twice as old as you and twice as heavy as they ought to be so it could be a signal for further examination and awareness that there are other possibilities which should be checked for.
I'd be in some difficulty finding anything to eat if the options were pasta or pizza - I'd eat before going and request a pot of coffee and could they do something like a bit of salad with cheese.

I agree. Early 30's and underweight is not diabetes type 2 territory! Get to like pasta and order a big pasta salad and pint of water. And make an appointment with a 2nd opinion doctor if you're not feeling well.

 

[Angela64]

This weekend I'm invited to an Italian restaurant. They only serve pizzas and pastas. I'm not a fan of pasta so I might as well get a pizza. I very rarely eat at restaurants and maybe once a month I would get something like pizza or fast food.

A bit of background: Recently been diagnosed as prediabetic, I'm in my early 30s and underweight.

What would be an expected spike after eating a medium pizza?

Maybe a calzone? I had one couple of weeks ago, it was ultra thin and had tomato, olives, chorizo and a cheese.
This was for lunch and we walked afterwards. I don’t remember my GL but wasn’t massive. Better eating earlier. The Glucosegoddess on instagram uses combining, eating food in order, May work.

 

[tiredgirl91]

Your over thinking it, yes you will spike but a treat once in a while is not going to make a huge difference. You need a treat every so often or what's the point. Eat and exercise the rest of the time and enjoy yourself

I agree I was overthinking it a bit. I ended up eating my favorite pizza anyway and enjoying the night. Maybe not the ideal choice but it is not an everyday occurence

 

[tiredgirl91]

I agree. Early 30's and underweight is not diabetes type 2 territory! Get to like pasta and order a big pasta salad and pint of water. And make an appointment with a 2nd opinion doctor if you're not feeling well.

Not as common but certainly not impossible though

 

[Guilty]

Here is the update.

I had a small salad with cucumber, tomato, onion and olive oil. Then I shared a medium 4-cheese pizza with my friend. So I had about 3 slices, standard crust and I did have a bit of tomato sauce because it's my weakness. I also had a glass of dry white wine.

So I forgot to test before the meal, but 1 hour after it spiked to 10.2 and 2 hours after 9 mmol/l.

It doesn't look good but at least I had a good time. It is what it is... I don't eat food like this on a daily basis though

I think that's good numbers for an occasional meal out!

 

[tiredgirl91]

I think that's good numbers for an occasional meal out!

I don't really know about the numbers, but the occassion on itself (and the food of course) was a really enjoyable experience! Especially because this was my first "junk food" meal since my diagnosis.

 

[AloeSvea]

Yes - in your position, @tiredgirl91, I would see the prediabetes as a reason to cut down on carbs - not an all-out very low-carb radical move. And eat and meter to keep an eye on it - especially that revealing fasting blood glucose. That would indeed, give you room for social carby food eating as you say, on occasion.

It should not take enormous effort to get you into the healthy blood glucose (and insulin) range? If you haven't already? Cutting down on the obvious excess carbs. And yes - get those tests to make sure you are dealing with (vulnerability to) common garden variety type two, and not those auto-immune kinds - very different treatment for, for sure.

And I agree on the dry wine! The alcohol issue is one shared by all human beings - how to imbibe and enjoy, and keep it at a level that doesn't hurt or hinder health. If I had a bottle of wine for every time I have patiently explained to folks that it is not alcohol itself that type twos have to cut down or out for blood glucose health - but the carbs in any alcoholic beverage. And that non-sugared alcohol does not raise our blood glucose, but in fact, can lower it (as the liver is dealing with the alcohol, and not putting out extra glucose into our systems). As you know already - well done you! If meds taken have a bad reaction to/with alcohol - that is another thing.

As someone who had lots of body fat on me when I was diagnosed, and the usual problem area of belly fat - I am not offended by anyone referring to that fat stored on my body as a sign of being vulnerable to type two.

Tiregirl - what actually is your HBA1c, and your BMI? If you don't mind me asking. Also, your height waist ratio - which is more interesting for you re your vulnerability to type two. I have found here in the forum, that what mahy be thought of as thin/underweight nowadays, was just slender in times past, and clinincally speaking. Anyone being clinically underweight is vulnerable to ill-health (but yes - not usually blood glucose regulation problems!). Health problems for the clinically underweight (BMIs 18 and under i believe) can be very vulnerable to.... death from malnourishment! And heart issues, due to being under-fueled, basically. Obviously very serious.

 

[Robbity]

I think I'd go with @TriciaWs and others choices of pizza topping without (or less of) the carby base. But to me being T2 means I'm "carbohydrate intolerant" so I don't feel obliged to accommodate other people by eating something that may do me no good. I don't believe that anyone who's gluten. lactose, peanut intolerant, etc, is expected to consume anything that can cause them harm, so the same should apply to carbs.

Here's an example of a "biphasic response" from a Libre graph a few years back when I ate a rather large amount of both fats and carbs - not actually pizza though (vertical dividers mark hourly intervals) :

And something else to consider too when checking for spikes, as I understand it our livers treat alcohol as a "poison" and therefore processing it is given priority over any carbs that might be consumed at the same time...

 

[tiredgirl91]

Yes - in your position, @tiredgirl91, I would see the prediabetes as a reason to cut down on carbs - not an all-out very low-carb radical move. And eat and meter to keep an eye on it - especially that revealing fasting blood glucose. That would indeed, give you room for social carby food eating as you say, on occasion.

It should not take enormous effort to get you into the healthy blood glucose (and insulin) range? If you haven't already? Cutting down on the obvious excess carbs. And yes - get those tests to make sure you are dealing with (vulnerability to) common garden variety type two, and not those auto-immune kinds - very different treatment for, for sure.

And I agree on the dry wine! The alcohol issue is one shared by all human beings - how to imbibe and enjoy, and keep it at a level that doesn't hurt or hinder health. If I had a bottle of wine for every time I have patiently explained to folks that it is not alcohol itself that type twos have to cut down or out for blood glucose health - but the carbs in any alcoholic beverage. And that non-sugared alcohol does not raise our blood glucose, but in fact, can lower it (as the liver is dealing with the alcohol, and not putting out extra glucose into our systems). As you know already - well done you! If meds taken have a bad reaction to/with alcohol - that is another thing.

As someone who had lots of body fat on me when I was diagnosed, and the usual problem area of belly fat - I am not offended by anyone referring to that fat stored on my body as a sign of being vulnerable to type two.

Tiregirl - what actually is your HBA1c, and your BMI? If you don't mind me asking. Also, your height waist ratio - which is more interesting for you re your vulnerability to type two. I have found here in the forum, that what mahy be thought of as thin/underweight nowadays, was just slender in times past, and clinincally speaking. Anyone being clinically underweight is vulnerable to ill-health (but yes - not usually blood glucose regulation problems!). Health problems for the clinically underweight (BMIs 18 and under i believe) can be very vulnerable to.... death from malnourishment! And heart issues, due to being under-fueled, basically. Obviously very serious.

Hi and thank you for your detailed reply.
My HBA1c is 5.9, and soon I will have a follow-up on that so I'll see how things are going.

My BMI right now is around 16. Too low, I know
I have been skinny my whole life, not worrying about calories and food at all. You know, a real "intuitive eater". Luckily I was never really into fast food (except for a couple of years during high school but I'm pretty sure all teens go through similar patterns) And I never really gained weight even eating "unhealthy". My highest BMI point was 18.

Now I'm worried because I lose weight without trying.

 

[AloeSvea]

Ah! Ok @tiredgirl91 - you are thin indeed. A BMI of 16 - wow!

And with an HBA1c of 41/5.9%, you have just snuck into the lowest diagnosable level of blood glucose for a prediabetes diagnosis in my country - but in your homeland it's 39/5.7%?

Whatever - obviously your body can take decent levels of healthy fat and protein - the idea that all of us can, in the LCHF literature at any rate. But you, in particular can go wild with nuts and cream low carb substitutes of anything you fancy. I personally never worry about the cheese and cream, much to high carb low fat friends and family's puzzlement and confusion. What you absolutely should not be doing is low-calorie ways of eating or intermittent fasting - that seems clear.

How is your waist height ratio? That is the last measurement that might give us an insight into your body composition. But whatever - as above - you can be eating fat and protein heartily regardless. This should bring your blood glucose level down to healthy levels, if you are indeed on the carb intolerant continuum.

 

[tiredgirl91]

Ah! Ok @tiredgirl91 - you are thin indeed. A BMI of 16 - wow!

And with an HBA1c of 41/5.9%, you have just snuck into the lowest diagnosable level of blood glucose for a prediabetes diagnosis in my country - but in your homeland it's 39/5.7%?

Whatever - obviously your body can take decent levels of healthy fat and protein - the idea that all of us can, in the LCHF literature at any rate. But you, in particular can go wild with nuts and cream low carb substitutes of anything you fancy. I personally never worry about the cheese and cream, much to high carb low fat friends and family's puzzlement and confusion. What you absolutely should not be doing is low-calorie ways of eating or intermittent fasting - that seems clear.

How is your waist height ratio? That is the last measurement that might give us an insight into your body composition. But whatever - as above - you can be eating fat and protein heartily regardless. This should bring your blood glucose level down to healthy levels, if you are indeed on the carb intolerant continuum.

To be honest, I have no idea of my waist height ratio. I have never measured it. But I'm not tall nor short, kind of standard height (1.68cm) and I have never had belly fat.

 

[AloeSvea]

1.68cm isn't average I don't think - unless you're in the Netherlands or Scandinavia? Parts of Africa? So - Above average height? But yeah - depends on what country or region you live in, and your generation too probably. And ethnicity. Easy for you to Google average heights for your own region, ethnicity - I am assuming gender in there of course.

Anyway - the waist/ height ratio is interesting for those with insulin resistance based type two, or vulnerability to as evidenced by prediabetes, as it's about the visceral body fat that is around your organs that can contribute/cause/make worse problems with blood glucose regulation. But as you say - you don't have any and have never had any. If you want to follow this up - Find a health calculator online of your choice - my fave is health-calc. There is one on this website, if you are UK based and use inches to measure (goodness!). Easy to do - enter your height and your waist measurement, and it works out your ratio in terms of the .50 figure or less, being optimal for health purposes.

But I agree with you - probably no point as you are genuiniely skinny. The first I have met in here I have to say! It being ultra rare for type two indeed. Not so for the various kinds of auto-immune diabetes, so I am not surprised by you being urged to get tested for all those LADAs and MODYs and so on.

So what are you saying @tiredgirl91, regarding upping your healthy fat big time, and filling up on protein? You're talking about decent amounts of really nutritious filling and wonderful tasting food that should help you big time with that fatigue in your username.... This is something you can pursue immediately, and I would be very surprised if it doesn't put you into non prediabetic blood glucose levels immediately, and put some meat on your bones, as they say.

How are you thinking and feeling about that?

 

[tiredgirl91]

@AloeSvea

As for my height, I just notice that most of my peers are taller than me. Well ok, not most but quite a lot of them. That's why I said I'm average. Nevermind
Very soon I'm going to be tested for LADA. But Type 2 is not impossible after all, because no matter my weight and age - I have a couple of relatives with Type 2 and they were super skinny when they were diagnosed as well. But older than me though.
About the food choices, I don't know if I should make any changes until my next A1C and other labs are out. Fatty foods make me nauseous and I can't fit lots of calories that way. And I'm scared of losing anymore weight. My clothes are falling off me.

 

[HSSS]

@AloeSvea

As for my height, I just notice that most of my peers are taller than me. Well ok, not most but quite a lot of them. That's why I said I'm average. Nevermind
Very soon I'm going to be tested for LADA. But Type 2 is not impossible after all, because no matter my weight and age - I have a couple of relatives with Type 2 and they were super skinny when they were diagnosed as well. But older than me though.
About the food choices, I don't know if I should make any changes until my next A1C and other labs are out. Fatty foods make me nauseous and I can't fit lots of calories that way. And I'm scared of losing anymore weight. My clothes are falling off me.

It’s always possible your relatives were misdiagnosed too….. did they progress to insulin? and as well as LADA there are a number of types of genetic diabetes. Good to hear you are exploring all the possibilities though. Whatever the cause the weight loss needs investigating.


I used to feel sick with fats pre diagnosis and low carb/keto. But the more I reduced the carbs the less the fats had that effect. And there’s still proteins.

 

[tiredgirl91]

It’s always possible your relatives were misdiagnosed too….. did they progress to insulin? and as well as LADA there are a number of types of genetic diabetes. Good to hear you are exploring all the possibilities though. Whatever the cause the weight loss needs investigating.


I used to feel sick with fats pre diagnosis and low carb/keto. But the more I reduced the carbs the less the fats had that effect. And there’s still proteins.

As far as I know they don't/didn't use insulin (one of my relatives passed away a couple of years ago due to diabetes complications, sadly)

I've already talked to my doctor and we scheduled all needed tests. So, very soon I will have an explanation for my condition. Hopefully I'm not as scared and confused as I was at the very beginning, when I heard the prediabetes diagnosis. Now I know that, whatever it is, I can handle it and manage it. If I need medication, it is not the end of the world.

And yes, I love protein-rich food such as red meat, poultry especially chicken and turkey breast, some fish, greek yogurt etc.
But what I've found is that protein spikes me, almost as much as pure carbs and sugar. Is it just me?

 

[HSSS]

As far as I know they don't/didn't use insulin (one of my relatives passed away a couple of years ago due to diabetes complications, sadly)

I've already talked to my doctor and we scheduled all needed tests. So, very soon I will have an explanation for my condition. Hopefully I'm not as scared and confused as I was at the very beginning, when I heard the prediabetes diagnosis. Now I know that, whatever it is, I can handle it and manage it. If I need medication, it is not the end of the world.

And yes, I love protein-rich food such as red meat, poultry especially chicken and turkey breast, some fish, greek yogurt etc.
But what I've found is that protein spikes me, almost as much as pure carbs and sugar. Is it just me?

It certainly seems to have that effect on many type 1’s. I see fewer type 2 reporting that. Personally I don’t seem to have issues with protein. there was an explanation for this and from memory it was around insulin resistance v lack of insulin but I can’t remember the details right now. If it comes back to me I’ll add it to the post.

I’m glad you’re feeling calmer and better able to cope.

 

[tiredgirl91]

It certainly seems to have that effect on many type 1’s. I see fewer type 2 reporting that. Personally I don’t seem to have issues with protein. there was an explanation for this and from memory it was around insulin resistance v lack of insulin but I can’t remember the details right now. If it comes back to me I’ll add it to the post.

I’m glad you’re feeling calmer and better able to cope.

It seems like more and more things point towards me being type 1. Now this fact with the protein as well... But I don't want to draw conclusions just yet. I'll wait until my labs are done, at the moment, the more I think, the more stressed I become and that has an effect on my readings as well.

 

[HSSS]

It seems like more and more things point towards me being type 1. Now this fact with the protein as well... But I don't want to draw conclusions just yet. I'll wait until my labs are done, at the moment, the more I think, the more stressed I become and that has an effect on my readings as well.

I’m not suggesting it can’t happen in type 2. Just that I read about it in type 1 more. You simply have nothing that says type 2 about your circumstances to me and lots that says another type. As you say all you can do is wait and see at this point and be alert to changes.

 

[AloeSvea]

Ah yes, @tiredgirl91 - it will be very interesting, and important for you of course! To find out if you are a LADA/MODY case - having an autoimmune disease rather than a metabolic one at least.

The issue of you possibly having anemia, and that affecting your blood glucose readings has been posed. (And you are just within the very low prediabetes range, for many countries at least.)

The matter of nutrition, and keeping you well fed is much more straight forward! You need a decent amount of protein and healthy dietary fat to survive and thrive. With those two macronutrients, and water, those macros are not 'options on the menu' in the way choosing a way of eating is, and what level of carbs to eat is. If you are skinny, and getting skinnier because fats make you feel sick, and proteins spike you so you are choosing not to eat them? - you have a really big immediate health issue at stake. Malnutrition can kill you, or at least go a long way to causing the organ damage that puts your life in danger. I hope you don't mind me being direct about this.

You need to eat protein, regardless of the spiking involved demonstrated on your blood glucose meter. And some fat. Just to repeat - Eating protein and fats and getting enough water are not optional for us to live and thrive.

You may already be being seen by a nutritionist? What are your loved ones, and your doctor saying about your being nourished properly by food? If you don't mind me asking... I know it's pretty personal. But the deep dive into food and nutrition is pretty par for the course in this Forum, due to the dietary nature of metabolic disease, and the fact that management of the autoimmune diabetes also requires knowledge of food and macros and so on. This means that in depth discussions of diet and exercise sometimes, are a big part of what we share.