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Thin Type 2 Diabetics

I have said this before, if I had had the very common symptom of obesity then I would have been diagnosed much, much sooner. As it was, I was diagnosed almost by accident at a routine check up that I now believe was to check cholesterol levels rather than anything else. (Blummin' C word). My HbA1c went unchecked because I did not have that symptom or any other at the time of diagnosis hence my horrible numbers. Perhaps more stringent measures to diagnose should be considered, however, I had declined offers of tests in the previous years so it was a case of leading the horse to water....
 
At my surgery everyone over 40 is invited for a routine health check unless they already have these for some reason. This includes an HbA1c. (not just a BG test). The problem lies if all the tests come out normal because you then have to wait 5 years for the next one. I would also love to know what the take up is - and how many don't bother to go.
 
Because I'm in America, I get to see the actual bills for the blood tests done at routine annual medicals. It comes out to several hundred dollars (this year, 776 dollars for that single phial of blood), even without the HbA1c -- which my doctor's surgery does not do unless the BG test is high. If these tests are done as part of the annual "wellness" medical they are fully covered by my health insurance.

What happened to me is that I skipped six annual "wellness" checks in a row (my fault -- the surgery sent me letters annually reminding me that this was A Good Idea and entirely covered by insurance). When I finally bothered to turn up in February of this year, the BG check was through the roof. My doctor then ordered an HbA1c, which used to be routine, but is now done only if BG is high. (BTW the A1c was then billed at an additional 71 dollars, added to the 776 dollars for all the other blood tests.) Once again, I did not pay a single penny, it was all covered by insurance.

The diabetes issue is tricky. For those with Type 2, it is insidious because you can have it for years, and it can be quietly ruining your health, with no symptoms. It is just conceivable that I had it for six years prior to diagnosis (my HbA1c in 2009 at the previous check was 5.5% or 37). Or, maybe I only had it for a few months before diagnosis in February 2017.

As a diabetic, I now feel it imperative that anyone having a "regular medical" should automatically get an HbA1c test!!!! Diabetes, in particular Type 2, is such a common disease nowadays (and has such serious implications) that I really don't understand why it would not be tested for.

Coming back to @Guzzler's point, my doctor (for whom I have a lot of respect) was not worried about me (pre-diagnosis) because he had stereotyped me as "not overweight" although this year he had flagged my file as "need to rule out hyperglycemia" due to that 5.5% A1c in 2009. As it turned out, he was unable to rule it out -- he was forced to "rule it in" sadly.
 
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I had been taking high dosages of steroids for years diabetes is a well known side effect yet it was never checked for. It was not till I reported a loss of sensation in my feet to my neurologist that a HbA1c was done even then my GP refused to acknowledge that I was in fact diabetic. Regular screening should be carried out if only for those at known high risk of diabetes.

When you go to the doctors they will usually check your BP as a matter of routine why not carry out a simple finger prick test as well. It won't be definitive but would give some sort of indication that further investigation may be required.
 
JohnEGreen said:
I had been taking high dosages of steroids for years diabetes is a well known side effect yet it was never checked for. It was not till I reported a loss of sensation in my feet to my neurologist that a HbA1c was done even then my GP refused to acknowledge that I was in fact diabetic. Regular screening should be carried out if only for those at known high risk of diabetes.
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It may be down to how aware the doctor is. My friend is on high dose steroids permanently. She has 3 monthly HbA1c tests alongside the ones she has for her condition. After 3 years of this she is still non-diabetic according to the HbA1cs. She has been lucky ... so far.
 
JohnEGreen said:
I had been taking high dosages of steroids for years diabetes is a well known side effect yet it was never checked for. It was not till I reported a loss of sensation in my feet to my neurologist that a HbA1c was done even then my GP refused to acknowledge that I was in fact diabetic. Regular screening should be carried out if only for those at known high risk of diabetes.

When you go to the doctors they will usually check your BP as a matter of routine why not carry out a simple finger prick test as well. It won't be definitive but would give some sort of indication that further investigation may be required.
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Oddly enough over the years I've had my bgl's tested more often than my BP. Shocking that they didn't as a matter of routine check your bgl's as you were on steroids.
 
My mum is a skinny t2d. She was dx'd years ago but I only found out recently by accident. She never told me and one of the carers just happened to mention it.

I was an obese t2d. Now I am a normal weight t2d. I have lost a great deal of weight and am still having the same bgl response to carbs that I had in the beginning. My hbalc is now 39 ( 4 weeks ago), but I am still diabetic.

I think for some of us the weight thing might be something of a red herring. There is a lot of autoimmune disease in my family. We have hashimotos, t1d, multiple sclerosis etc and something one of my grandchildren seems to have invented for himself. Some of us are fat, some thin. As my mum had 5 sisters and 1 brother and they all had children I have lots of cousins. The majority of us have some autoimmune health problems.

Recent studies are showing links between conditions. A huge study in india has highlighted a link between hypothyroidism and t2d.

At the moment t2d is not considered an autoimmune disease. But I think that will change. My dads family who are on the whole overweight dont have one single diabetic, either 1 or 2. But they still get tested. The skinny ones in mums family have very surprised gps when it turns out they are t2d.

I am lucky in many ways. I have found out before my hbalc was too high and I have many cousins to talk over family history and see patterns. I have lost a significant amount of weight and found a woe that gives me a healthier life style. But I think that unless the root cause of a link with t2d and autoimmune conditions is found and treated I will always be t2d, no matter how much weight I lose.

Even with the limitations of the nd study I am pleased that it was done. At least now there is hope for my childrens generation. But I am a bit concerned that the emphasis is being thrown onto weight.
 
I just calculated my Homa-IR using my last blood test results.
HOMA-IR was calculated according to the formula: fasting insulin (microU/L) x fasting glucose (nmol/L)/22.5.
I have a score of 0.5 which indicates I'm insulin not resistant. I was also diagnosed with extremely low insulin. Insulin resistance and low insulin - not a good combination that would make sense. Insulin resistance must elevate insulin levels.
 
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Hello. Happy to be here in the thin T2 diabetic

I have been diabetic for 10 years now. At diagnosis, I was 84 kgs and BMI of about 29. My HbAiC was 10% and my fasting was 13 mmols/l. I was immediately put on metformin, 500mgs once a day. I changed diet and exercised, and my weight went down to 79kgs. Withing 3 months, my FBS turned back to good ranges ie 5.8 to 6.3 mmols/l . With diet and exercise, I maintained it in that range until after 7 years. it started creeping upwards. For the last three years, I have been on and off metfortmin 500mgs and maintained my FBS in the ranges of 6.2 and 6.5 mmols/l. Three weeks back, after reading Dr Joel Fuhrman book, I started a vegan fruit diet, and have so far lost 3 ksg. . In the first week, my FBS was going down steadily from 6.5 to 5.8mmols/l. Surprisingly in the 2nd week of the veg diet, its started rising again, to 6.2, 6.3, 6.4 and this morning (week three of veg dier) i was shocked to find it at 7.0 mmols/l. AM now confused about this rise?? Anyone experirnced this??

Thanks
 
Mugi said:
Three weeks back, after reading Dr Joel Fuhrman book, I started a vegan fruit diet, and have so far lost 3 ksg. . In the first week, my FBS was going down steadily from 6.5 to 5.8mmols/l. Surprisingly in the 2nd week of the veg diet, its started rising again, to 6.2, 6.3, 6.4 and this morning (week three of veg dier) i was shocked to find it at 7.0 mmols/l. AM now confused about this rise?? Anyone experirnced this??
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Not personally but eating a lot of fruit is highly unlikely to help in lowering your blood sugars.. its well known that fruit can be extremely deleterious to T2's. Double whammy is that fructose is processed in the liver which can lead to NAFLD on top of T2.
 
Mugi said:
Hello. Happy to be here in the thin T2 diabetic

I have been diabetic for 10 years now. At diagnosis, I was 84 kgs and BMI of about 29. My HbAiC was 10% and my fasting was 13 mmols/l. I was immediately put on metformin, 500mgs once a day. I changed diet and exercised, and my weight went down to 79kgs. Withing 3 months, my FBS turned back to good ranges ie 5.8 to 6.3 mmols/l . With diet and exercise, I maintained it in that range until after 7 years. it started creeping upwards. For the last three years, I have been on and off metfortmin 500mgs and maintained my FBS in the ranges of 6.2 and 6.5 mmols/l. Three weeks back, after reading Dr Joel Fuhrman book, I started a vegan fruit diet, and have so far lost 3 ksg. . In the first week, my FBS was going down steadily from 6.5 to 5.8mmols/l. Surprisingly in the 2nd week of the veg diet, its started rising again, to 6.2, 6.3, 6.4 and this morning (week three of veg dier) i was shocked to find it at 7.0 mmols/l. AM now confused about this rise?? Anyone experirnced this??

Thanks
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Fructose is a funny ol' carb. It can only be metabolised in the liver and what isn't used straight away is stored in the liver as fat leading to worsening Insulin Resistance and as has been said Fatty Liver Disease (NAFLD).
For those of us with Insulin Resistance there is another problem, fructose on its own should not raise bg much more than any other food containing glucose but through the polyol pathway plus IR the amount of fructose raises the bg to a level 10X that of the insulin sensitive person. (From 3% to ~30%)

I am not a fan of Fuhrman and your confusion after following his advice is no surprise.

I would advise eating lower carb/fructose fruit in small quantities with a healthy fat such as full fat Greek yogurt or double cream and after having had a low carb meal not as a stand alone snack. Such fruits are raspberries, strawberries and blackberries.

Edit for atrocious typos.
 
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Thanks a lot for your helpful responses. Actually I have realized that my fasting blood sugar is the highest, but the rest of the day, even postprandial is all in the right ranges. Could this be Dawns syndrome, and how can one use diet to manage it. If Dr Joel Fuhrman book is not good for diabetes, would kindly advise which other book that could be helpful. Thank you so much.
 
Mugi said:
Thanks a lot for your helpful responses. Actually I have realized that my fasting blood sugar is the highest, but the rest of the day, even postprandial is all in the right ranges. Could this be Dawns syndrome, and how can one use diet to manage it. If Dr Joel Fuhrman book is not good for diabetes, would kindly advise which other book that could be helpful. Thank you so much.
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Have you read Jason Fung Diabetes Code and Obesity Code? Both excellent books.
 
Hello. What your take on these foods. They are all being praised as the best foods fro diabetics, yet there is controversy about them if am trying to reverse diabetes.

1. Eggs

2.Fatty fish

3. Green leafy vegetables

4. Chia seeds

5. Greek yogurt

6. Strawberries
7. Flaxseeds
 

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Mugi said:
Hello. What your take on these foods. They are all being praised as the best foods fro diabetics, yet there is controversy about them if am trying to reverse diabetes.

1. Eggs

2.Fatty fish

3. Green leafy vegetables

4. Chia seeds

5. Greek yogurt

6. Strawberries
7. Flaxseeds
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Nothing wrong with those particular foods. No idea why they'd be controversial.
 
Hello. My fasting blood sugar sugar has got stuck at 6.7 mmo/l. I have been on veggies for two months now and have cut weight and now my BMI is 23. Why cant my blood sugar go lower than that?? Thanks
 
Mugi said:
Hello. My fasting blood sugar sugar has got stuck at 6.7 mmo/l. I have been on veggies for two months now and have cut weight and now my BMI is 23. Why cant my blood sugar go lower than that?? Thanks
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You don't say what vegetables you are eating, or in what quantities. Some vegetables are far higher in carbs than others. You might find the info. on Diet Dr helpful. https://www.dietdoctor.com/low-carb/vegetables
 
This is what am eating
1. Cauliflower

2. Cabbage

3. Avocado

4. Broccoli

5. Zucchini

6. Spinach

7. Asparagus

8. Kale

9. Green beans

10 Plus nuts and sweat potatoes in small quantities.
 
Mugi said:
This is what am eating
1. Cauliflower

2. Cabbage

3. Avocado

4. Broccoli

5. Zucchini

6. Spinach

7. Asparagus

8. Kale

9. Green beans

10 Plus nuts and sweat potatoes in small quantities.
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What are you eating for protein? IMO coping with impaired glucose tolerance + a vegan diet is quite a challenge and you will need to become pretty expert in nutrition. For another approach, have you looked at the timing of your last meal of the day? If it is too close to bedtime you risk digesting it all night and having a higher morning fasting bg. Personally, I am trying to finish eating before 7pm for a 10pm bedtime. I think before 6pm would be better, but I find it hard to do. Another strategy is to do 15-20 or more minutes of mild to moderate exercise after my evening meal. Several research studies have shown this helps lower bg for some but not all people, and I have seen posts by many Forumites who do it. Recently it worked for me - and then it didn't! Maybe worth a try. Good luck!
 
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