thin fit prediabetic - is there hope?

OK I just got a call about my latest blood test and apparently I am now diabetic. This is really upsetting to me because I too am thin and active: 56 years old, BMI 20.9 and I'm a cyclist on a racing team, even (though not competitive in any sense of the word). Like most here I read that I need to lose weight, exercise and stop smoking. Done. So now what? I suppose I can adjust diet. I eat pasta all the time, and rice - though I try to limit the latter to post ride meals when supposedly your cells are all clamoring for sugar.

I really appreciate that this page exists, and I hope this group doesn't mind me venting a little. And in the interest of full disclosure, am a Yankee - though I'm at this very moment listening to the Clash. At high volume.

Sorry about your news, but you can get back to normal with a suitable diet and a blood glucose meter. The pasta will have to go I'm afraid though.
What else do you eat? Can we help at all?

I eat vegetables, though typically only one with each meal - two counting pasta sauce. I make a yogurt-frozen-berry-and-whey protein shake for breakfast and have a mostly oatmeal dry cereal with coffee. I eat fish a couple times in a week, and various bean or lentil dishes. I think I need to rely more on the beans and that type of thing, everything I read says fiber is good... And beer. I just read that alcohol LOWERS blood sugar, so that's confusing. Seems like a "high carb with beer" diet may be beneficial...

No no no no. Sadly, not beer! The better news is red wine, dry white, or most spirits (with sugar free mixers) are absolutely fine! Beer is liquid sugar I'm afraid, although some of the beer drinkers on here may suggest an odd brand that is better than others. Alcohol does lower BS but any that are sugar filled such as beer will spike you right up before it drops you down. Dry wine and spirits don't have much (just a trace) of sugars. You can check all this out for yourself if you get a meter.

Sounds like I'll have a meter soon. I've got appointments lined up, so I'll know more in a week or so. And I was being facetiously hopeful with the carbs and beer diet idea. Though mostly hopeful...

Mr. Bluetit follows a carb and beer diet. He can. His last blood glucose test a few weeks ago came back at 4.5. Sad, isn't it.

Hello to you all. I have not posted for a while, having received wonderful advice on this site and wonderful support.
I am inspired to write because I am also slim/thin 5ft 4 and 7st 12. I was told I was prediabetic last august. No diabetes in the family and I had a very good diet. Told by surgery to reduce the large amounts of fruit I was eating and to concentrate on low GI diet and come back in six months for another blood test. Fortunately I found this website, bought a meter, started a low carb diet and began testing what I could safely eat. I have not lost any weight fortunately ( it would not look good ). This week I asked GP for a HbA1c test and it has come back 36. This feels like a great reward for all that self denial though I have never gone hungry.
I like to cook so have been experimenting with alternatives to carbs. You would not believe the things I can do with a cauliflower.

dendify said:

I am thin (BMI 21), exercise regularly and eat a healthy diet. Recently tested with fasting BG 6.4, 2 hour GTT 10.1 despite this. I'd like to hear from any other people who are in a similar situation on whether watching following the standard advice here (viewtopic.php?f=39&t=26870) has had any long term impact. Most of the information I can find is about people who can benefit from weight loss and starting to exercise. If my impaired glucose tolerance is just due to my unlucky genetics, should I just resign myself to an inevitable progression to full type 2?

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Same here man. On 28th birthday doc said my tests were pre diabetic. I am 6 foot 4 195 pounds. Normal weight if not thin. Excerise my whole life. I eat to live, I don't live to eat. But it runs in my family so half of me wants to accept it but the other half says test again in a month. Thin folks blood tests tens to be inconsistent. Keep that in mind.

collectingrocks said:

I have heard that statins increase the risk of diabetes, muscle degeneration and joint pain. There seems to be a lot of empirical evidence out there

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I've taken Soya Lecithin /granules from the local Wholefood shop for some years instead of statins, on which I had some joint pain and find that my cholesterol, though a little high at 6.1, is mainly so because of 'good' cholesterol.

dendify said:

I am thin (BMI 21), exercise regularly and eat a healthy diet. Recently tested with fasting BG 6.4, 2 hour GTT 10.1 despite this. I'd like to hear from any other people who are in a similar situation on whether watching following the standard advice here (viewtopic.php?f=39&t=26870) has had any long term impact. Most of the information I can find is about people who can benefit from weight loss and starting to exercise. If my impaired glucose tolerance is just due to my unlucky genetics, should I just resign myself to an inevitable progression to full type 2?

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I am thin, exercise regularly and do not have a sweet tooth, but glucose tolerance has for decades not been my strong suit, and I do have a non-pretty family history for T2D as well as a history of dodgy markers and also a different chronic progressive neurological disorder of my own to deal with. My year or so of L(ish)CHF has improved most of my metabolic markers substantially and I feel much better in myself too. Warning: you might (like me) really need to eat a LOT to keep your weight up. But that's really no hardship, as the food is so delicious. The only trouble is that your half-starved calorie-counting friends might hate you. So yes, my own experience is that there are real benefits to be had from LCHF, even for those of us of normal weight with a good exercise routine already. After all, there's no harm in feeling stronger, healthier and better, is there?

JeanCL said:

I've taken Soya Lecithin /granules from the local Wholefood shop for some years instead of statins, on which I had some joint pain and find that my cholesterol, though a little high at 6.1, is mainly so because of 'good' cholesterol.

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Have you been copying and pasting my cholesterol results again, JeanCL? Seriously though - I'm just the same. It doesn't bother me a bit. As I understand it, the total cholesterol/HDL ratio - and yours will no doubt be neat and tidy for the same reasons as mine - is the really powerful marker for cardiac risk. In comparison, the total cholesterol number itself is basically meaningless and predictive of damned all. I think we're doing pretty well!

Hi, thin fit prediabetic. Both my parents were pre diabetic and they did f.a. about it, cake icecream, they never got it. My sis is plump shes not got it. They said i had pre diabetes a few years ago then said it was a blip. To be honest im annoyed i dont know what to eat, i am cutting down carbs and sugar. Im celiac, 5ft 7, 8st 7lbs. Dont want to lose more than a few lbs or i will be underweight.

Hi Twigs, I'm also prediabetic with an A1C of 6.6 the last time I did bloodwork. I am so fed up, I do low carb, which meant I gave up all the good grains and bread, and fruit which I loved. All my life, food was what I looked forward to each day with my family. Now I'm depressed since I can't freely eat those foods. I'm so sad. I'm afraid of putting food in me and wondering what the sugars will be like. I don't check anymore with the meter. Done with that. I fast 20 hours and sugars are still high, so what's the point. Basically starving on OMAD, since intermittent fasting is supposed to help with blood sugars, insulin resistance, etc....sometimes I just give in, and go for that Indian takeaway, and have butter chicken, sag aloo, chickpeas, naan bread, etc...life is too short, you can't take it with you, right? Live the moment, who knows what tomorrow brings. Sorry to be such a downer. This is just me and my life right now.

Twigs said:

Hi, thin fit prediabetic. Both my parents were pre diabetic and they did f.a. about it, cake icecream, they never got it. My sis is plump shes not got it. They said i had pre diabetes a few years ago then said it was a blip. To be honest im annoyed i dont know what to eat, i am cutting down carbs and sugar. Im celiac, 5ft 7, 8st 7lbs. Dont want to lose more than a few lbs or i will be underweight.

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Hi Twigs,

There is a lot of advice on this site about Low Carb diets (e.g. How to Follow a Healthy Low Carb Diet (diabetes.co.uk), the Low Carb forum etc) You're going the right way cutting down carbs and sugars - it's then a question of how many carbs a day you are eating. Everyone is different, so only by trying can you work out what works for you (especially since thin diabetics/ prediabetics are in the minority).

I was normal weight and fit when diagnosed "prediabetic", and ignored the diagnosis for a several years, then was diagnosed diabetic. For the last 6 months I've followed a moderate low carb diet (around 50 to 70g carbs a day) and brought my blood sugars down to normal levels ( if looking at HbA1c) or prediabetic (Fasting Bloods). I have only lost a few pounds in weight, and certainly don't want to lose any more weight.

I only found out the effect of diet (and exercise) on my blood sugars by getting a Blood Glucose Monitor for testing, and then getting a Freestyle Libre 2.

Best wishes

(I don't want derail this thread, but Prediabetic and Diabetics are labels; I think of them as points on a spectrum.
I was diagnosed 8 years ago as "Prediabetic" according to an HBA1c test whereas according to an OGTT I taken then I was in the Diabetic range).

This has been wonderful to read ...I have been getting desperate and depressed.
I am 5' 6" and weighed just 7stone 4-5 for years ..felt fine. Do some walking but not loads and don't eat much of anything....I did like a croissant occasionally and a biscuit with my coffee and ice cream with my fruit I always have for dessert in the evening...but since being diagnosed as pre diabetic HbA1c 6.1 ....I cut out the croissant and ate more nuts and less pasta and potatoes ..result.....in 4 weeks I was down to 6stone 11 ...how low do I go before the weight loss is more damaging to me than the pre
diabetes?? I'm 70 and was also DX with high cholesterol.....but come on there must be more medical information about us too thin but prediabetic people ... finding it difficult to cope with TBH and I'm a very positive person usually!

SpanishJan said:

This has been wonderful to read ...I have been getting desperate and depressed.
I am 5' 6" and weighed just 7stone 4-5 for years ..felt fine. Do some walking but not loads and don't eat much of anything....I did like a croissant occasionally and a biscuit with my coffee and ice cream with my fruit I always have for dessert in the evening...but since being diagnosed as pre diabetic HbA1c 6.1 ....I cut out the croissant and ate more nuts and less pasta and potatoes ..result.....in 4 weeks I was down to 6stone 11 ...how low do I go before the weight loss is more damaging to me than the pre
diabetes?? I'm 70 and was also DX with high cholesterol.....but come on there must be more medical information about us too thin but prediabetic people ... finding it difficult to cope with TBH and I'm a very positive person usually!

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You made some nice changes and didn’t get much of a reward. Are you doing any muscle building? Muscles burn sugar and weigh more. Just asking.

SpanishJan said:

and don't eat much of anything...

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You most likely need to increase protein and healthy fats (these from meat and dairy). Sounds like you are eating too little, which is an easy mistake as we cut out carbs. Your body needs nourishment and sustenance

As it is not obesity/too many and too overloaded fat cells behind your blood glucose dysregulation, @SpanishJan, you can focus on the other possible inputs to your metabolic health situation, and nip it in the bud before it develops into T2D - which is the big fear isn't it.

How to see what could have lead you to prediabetes? (other than abdominal fat storage, which has not been your situation.) - like stress, sleep deprivation, too many high sugar drinks - throwing some biggies out there. Also - major vitamin and mineral deficiencies can have a big effect - like vitamin D/safe sun, chromium, magnesium, zinc - to name a few. I would suggest journaling, and get a blood glucose meter, and start testing how different food and drinks, and different things that could be affecting you, are in fact affecting your blood glucose regulation. Once you have gotten to the bottom of it - then you can change it. This could be a good productive way to channel your anxiety - it helps me in that way in any case. And can make eating way less stressful for you, as you find out what works for you and what doesn't.

In many ways you are at an advantage over those who have the 'lose weight' spectre hanging over them, as that can be very hard for many. As you will have read and heard all over this cite by now? Upping your healthy fats, and if you are dairy tolerant - eating and drinking those lower-carb varieties are a classic way to ensure you are nourished and not overloading on carbs. You would indeed need to step over a fear of dietary fat that you may have. To relieve your anxiety, I recommend you read up on it, watch youtubes, and read more of this forum? A really good book, imho is Nina Teicholz's book The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet.

AlanWatson1958 said:

Hi,

I am also thin and fit with a good diet (male aged 54, non-smoker, very moderate drinker, with no family history of diabetes). About a year ago my cardiologist told me that my fasting glucose had risen to 5.6 mmol/l and that I should take more exercise and cut down on carbohydrates. (I already ate muesli, fresh fruit, salads, fish, chicken, wholemeal bread and fresh vegetables, rather than processed food and sugary drinks.) I did as he said and my blood sugar fell slightly, but not enough. I redoubled my efforts, started taking at least one serious period of exercise every day and at least 15 minutes of good aerobic workout after every meal, and cutting out anything that might have too high a glycemic load. After all that hard work, I now find that my fasting glucose has risen to 6.3 mmol/l.

With my dietary changes and exercise I am losing weight, down to a BMI of 19.8 this morning. I am full after every meal and never hungry. I already add extra large helpings of olive oil to my salads and fresh fruit and nuts to my muesli to try and increase my calorific intake without adding to my glycemic load.

I really want to avoid getting diabetes; I have a thing called cardiac syndrome x (chest pain and abnormal ECG, but clear arteries). I also have very high homocysteine (a risk factor for everything you can think of except diabetes) and high LDL cholesterol (partly lowered with statins). I have just discovered that have lost 3cm in height, have arthritis and very bad osteopenia, and I am waiting for the results of a follow up test after having some protein in my urine.

Diabetes would make all of these problems worse. I am not resigned to getting it and would like to know what I can do to avoid it, but all the advice on diet, exercise and weight loss seems totally irrelevant to my circumstances.

You ask 'is there hope?' I would like to think so, but I don't know. My next steps are to get myself checked for type 1.5 diabetes and fatty liver disease, find out my HbA1c and buy a monitor to see how my blood sugar varies before and after meals, with or without exercise. I can only hope to find some clues from this information as to what else I can do.

Any advice from forum members would be greatly appreciated.


Alan

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Hi I know this is an old post but I’m just searching through if I can get some answers. Have you managed to lower your blood sugars being slim and already eating healthy? I’m really struggling even eating very low carb I just lose more weight but don’t get very good blood sugar readings would love to know how you are getting on?????? I’m in the same boat where I feel I will just progress to type 2 I’m prediabetic now

Hi, new here, also in the 'slim/fit' category. With apologies for the metric units for any US people reading:

I'm 46 years old and when I turned 40 I had the NHS screening check and it came back with HbA1c of 44, plus moderately high cholesterol (ratio about 7). I changed my diet quite a lot (5:2, plus reducing carbs in general) and did more cycling and got it down to 40/41 (and fixed the cholesterol) and maintained there for a couple of years. Pandemic intervened, no testing and I lost focus, and now it's 2 years later and I'm back at 43 again (measured 1 month ago). But anyhow I haven't progressed to some manifest destiny of T2 in the last 6 years, so that might be of some comfort to some of the people reading this.

Thing is, I've never had weight problems. I am 177cm tall. When I was 40 years old I was probably 70kg, but doing plenty of exercise. I got the weight down to 65kg at one point doing 10,000km/year on the bike, but still HbA1c was 40 (eating a lot of carbs when riding may have caused this?). I have seen in the low carb website people going from 100+ to ~30, but not sure how I'd ever get to 30. I'm guessing the reason is because my idea of 'low carb' isn't actually that at all and I'm actually doing 'low-ish'. I'm guessing that may be the case for many people who are prediabetic since somehow 'pre-' doesn't sound bad enough to go crazy with carb counting.

I do wonder though if there is some genetic reason why my (and others') variation is small? Up until say 10 years ago I never put any weight on, even if I ate loads. Also if I'm training I can never move my VO2max very much at all, perhaps by 10-15%, unlike some people who can train it by 50% or more. I heard there was a genetic reason for this, but I don't have any more info.

I love data so last week I got myself a couple of freestyle libre patches, it's super interesting watching what is going on. I'm currently 67kg. I've had a careful week food-wise (averaging 6.1 mmol/l) during which the biggest spikes are actually getting out on the bike at 06:30 for 50-60 mins, these go higher than actual meals. I have read about the adrenaline response before but I was surprised by this. I will go and do a proper long ride at the weekend, 6 hours or something, and see what the graph looks like over that time, including taking gels/food when in theory the muscles should be hoovering up all the sugar. I also plan to just sit around and do some bad things (eat a whole 200g bag of wine gums, double helpings of pasta or white rice) and see what the spikes look like then.