Type 2: Low BMI people

[Roytaylorjasonfunglover]

What % of T2 are people in the underweight or lower end of normal weight category? And why is this ? Simply because of less organ pressure in the gut region? Do skinny people like me who eat chocolate and sweets burn it quicker ? Surely I'm not invincible ?

A typical number thrown about is that 20% of diagnosed type 2-s have a normal bmi, which is a bmi between 18.5 and 24.9. But that healthy bmi is probably not healthy for most people. For instance with my height, 188cm, my "normal" weight could be anything between 65 kg, or 88 kg! Thats a difference of 23 kg! and if those are 23 kgs of fat or muscle bmi says nothing about.

So bodyfat is a better indicator, and since I am a male I have memorized healthy bodyfat and stuff for men, women I need to look up, but if every man in the world had a bodyfat of 5.5% which is healthy btw, and loads of muscle, we would not have diabetes type 2 in the world. Having a bmi of 22.5 is not that much use if you have a bodyfat of 20% for instance, so there you have it, bodyfat matters more than bmi.

 

[SunnyExpat]

I'm one of the 80%.

I ate my way to being diabetic.
No excuses about being diabetic, or insulin resistant, and putting on weight, I just ate my way to it.
But my BMI is always going to be high, as I know I have high muscle mass, and high bone density.
But having said that, I had to go positively skinny, to the point of looking ill, to reverse it.
And I was still at the top end of the healthy BMI scale.
But I still had to achieve the normal range having said that, so it's not a completely inaccurate scale.

 

[Kristin251]

I have always been thin with an athletic type build but my stomach was always the largest part of me. My weight rarely varies by more than 5 pounds. I have been through all the stages of diabetes with the same weight except the blip of not being diagnosed as type 1 and losing too much weight.
My husband is 6'5 and 230. Loads of muscle and little fat ( well a bit more these days thanks to stout beers) but he is always considered obese on the BMI scales. Far from.
I think cleaning up our diets that help us lose weight also help us gain sensativity and it's not just about wright but the foods we eliminated that caused high bs and also caused insulin resistance.

Just my thoughts...

 

[Dark Horse]

Okay, so you're saying Pizzorno is a quack and that those who did the NHANES study are quacks too. Keep in mind he didn't do the original research. He's just reporting what was found in the research. I haven't read the original study. Have you? Perhaps we should both do that before dismissing the finding that obese people with no POPs levels don't have type 2 diabetes and obese people with high POPs level have significantly more type 2 diabetes.

I don't know enough yet, but I'm concerned so I'm putting this information out there in the hopes that those far smarter than I will evaluate this research.

I should add here that when my diabetes journey began in my early 20's, I weighed in the 95 - 105 pound range, ate a reasonably healthy diet - (breakfast was an egg and toast, lunch was whatever the school lunch was, and dinner consisted of meat or poultry with one to two vegetables and rice or potato; desserts were mimimal, a small square of chocolate) - but grew up in an household that was regularly sprayed with chemicals to control for fleas (inside) and roaches (outside). I don't know what my POPs - (persistant organic pollutants) - levels are, but it would be interesting to find out.

There have been several studies which show an association between POPs and type 2 diabetes. Although such an association could be due to POPs being a cause of type 2 diabetes, it is also possible that the metabolism of type 2 diabetics is such that they tend to accumulate POPs more than non-diabetics. Further research is needed to prove causation.

You might like to read this more recent systematic review and meta-analysis:- http://www.ncbi.nlm.nih.gov/pubmed/26119400

Basically it says that both persistent and non-persistent endocrine disruptors may affect the risk of type 2 and ... more research is needed.

 

[Winnie53]

Thank you @Dark Horse for finding that 2015 abstract. Pizzorno acknowledged in his 2016 lecture that correlation doesn't equal causation.

I think the important thing to remember is that it's been 22 years since the NHAMES III study was published, and this is still being discussed in the literature. As I said, I'm still reeling from this information. I have to make my comment brief because I'm running late, and my diabetes group meets tonight.

 

[satkins]

T2 is a condition of insulin resistance, and you can have insulin resistance at any weight.

However, the longer you have insulin resistance, the more likely you are to gain weight. There are quite a few T1s who gain weight through insulin resistance too.

My personal view (based on experience) is that our bodies cope for years with insulin resistance before they fail enough to start the weight gain. Often the typical 'fat T2' has had insulin resistance and possibly even actual diabetes for YEARS before the diagnosis. And if their T2 had come on quicker, or the doc had noticed the signs earlier, they may well have been diagnosed T2 while still slim...

Unfortunately, even doctors seem to believe that getting fat is a moral failing, not an insulin imbalance. Until they grasp that basic concept, we will still see people unnecessarily doomed to a kind of helpless obesity, while following official diet guidelines.

I got insulin intolerance issues 10 years before the weight gain started and 30 years before I hit the arbitrary T2 diagnosis level.

This was me to a "T". I weighed between 190 and 210 pounds (about 6 feet tall) from about the age of 16 right until about 5 or 6 years ago when my weight started to climb. Had I not just thought that I was an over eating pig and actually went to a doctor now and then I might have found out sooner that I was actually a type 2. But from what others say, the doc would have most likely agreed with me that I was over eating. It wasn't until I had to have a cyst removed that I finally got my BP checked and BG and Thyroid. Now I'm on meds for all three but I've got things starting to turn around. I plan on being drug free (except for maybe thyroid) in a year.

 

[anniebananie]

I agree with Brunneria - although a few years back I would probably have been one of those in the ignorant 'why don't fat people eat less and do more exercise" camp. It's not until you have a diagnosis (pre-diabetes in my case) and are threatened with lifelong medication that there is much incentive to understand the true processes that go on in the body. My BMI had always been in the healthy range but I had noticed that my body's 'set-point' (the weight it liked to stay at regardless of what I ate or did) had risen in stages over the preceding 10 years or so. When I was younger it was 55kg, then 58 kg then 63 then 65. The increases were getting quicker and I didn't seem to be able to do anything about it. I was trying to mostly eat the so called healthy diet, cutting down on fats and eating wholegrain everything and I was just getting fatter even though I was doing a lot of exercise.
The only reason I had ever checked my blood sugar levels was because my mother had been diagnosed as type 2 in her late 70s despite being quite slim so without that impetus i'd probably never have checked and never have come to this site or discovered the wonderful dietdoctor.com. I had had gestational diabetes ( was not overweight then and did not put on much weight in pregnancy and lost it all immediately after the birth) but the doctors then hadn't been overly concerned and it wasn't until recently I learned this meant you were more at risk for getting type 2 later on
Since following the low carb high fat lifestyle I have lost over a stone and reduced my HbA1c to normal levels. Unfortunately for me it hasn't ended my problems, as I am aware that if I went back to my previous high carb diet as advised by the NHS, then my problems would start again.
Losing weight hasn't cured my insulin resistance and I still get spikes if I eat high carb foods.

Your description of yourself completely describes me. I have been so confused. I have always had a BMI under 24, have always been athletic and active, but I did have borderline gestational diabetes and two big babies - one 8.9lbs and the second 9.3. Like you, my weight was climbing incrementally with no change in diet or exercise over the last 20 years.
Last August, age 57, BMI 23.5 (but about 10 lbs over my regular weight at 147) I was diagnosed with pre-diabetes. It threw me for a loop, sent me to dietdoctor website, I started LCHF, and lost 10lbs, but I have been testing my blood sugar and I spike, too, if I have carbs. I think I am on this for life.
Can I ask, how long have you been doing LCHF? How is your fasting BG and lipid profile? My fasting BG is still around 5.4, with almost no carbs. But I am not getting the spikes and the hypoglycemia, and I have no hunger. I want my FBG to come down more. I am testing my blood sugar with a meter, I can see I really spike with carbs and sugar. (I also seem to spike with too much protein, like skinless chicken breast.)
I wondered if I could ask you more about your experience: What you can eat, what you must avoid? You sound so similar to me that I would love to learn from your experience.

 

[dbr10]

@zed007
My understanding is that "skinny" type 2's have fatty liver. They, you, still have a problem. The good news? Dark chocolate, 70% cocao or higher, is low carb. A glass of red wine is too.

I think that may be a factor; but, in my case, the problem is insufficient insulin. I agree that dark chocolate and red wine seems to help - at least when you've drunk enough.

Sent from my LG-D620 using DCUK Forum mobile app

 

[Kristin251]

Someone else meantioned chicken breasts spiking them. The idea with LCHF is to add some healthy fats, you don't have to gob it or eat bacon grease and butter on everything . Something Like mayo or avocado. This will slow the spike and keep it lower. I too need to moderate my protein. In the absence of carbs gluconeogenisis can happen rapidly. Adding some fat will slow the gluconeogenisis. I eat a half an avocado at every meal to prevent a protein spike but I still need to moderate protein
Red wine or unsweetened spirits with dinner always gives me a better fasting

 

[Pinkorchid]

I was diagnosed T2 6 months ago after my annual blood test but I had been prediabetic for a few years before that
I am 77 and have never been overweight. Most of my adult life...apart from when I was pregnant... I weighed about 8st 3/5lb I did put on a few pounds when I hit the menopause to about 8st 10 lb . Once I was diagnosed with T2 I stopped eating all sugar stuff no rice or pasta ..never had much of any of that anyway and didn't have a sweet tooth and was always low on the bread and potatoes I started on Metformin and that is when I lost some weight. I am now about 8st 5 lb and I am happy with that. I have good blood levels my last HbA1c was 42 down from 46 when diagnosed and my daily blood levels are mostly in the 4's 5's and 6's so I don't think even though I am skinny and always have been that I am a late onset Lada

 

[Winnie53]

I think that may be a factor; but, in my case, the problem is insufficient insulin. I agree that dark chocolate and red wine seems to help - at least when you've drunk enough.

Sent from my LG-D620 using DCUK Forum mobile app

[giggle]...

Just for clarification, the low carb recommendation for red wine is no more than one 5 oz glasses for women, two for men. I found I even have to limit the chocolate. [sigh]... I continue to happily enjoy my one glass of wine, two sometimes, but that's rare...

My understanding is that type 2 diabetes is an "insulin resistance" problem, not due to "lack of adequate insulin". However, if type 2 diabetes is untreated and allowed to progress, insulin levels can be depleted over time leading to LADA or type 1 diabetes, but it's complicated because those two conditions are autoimmune conditions (or the pancreas was damaged by infection, specific drugs, cancer, etc.). Type 2 diabetes, on the other hand, is not an autoimmune condition.

The more I learn, the less I understand...

 

[dbr10]

[giggle]...

Just for clarification, the low carb recommendation for red wine is no more than one 5 oz glasses for women, two for men. I found I even have to limit the chocolate. [sigh]... I continue to happily enjoy my one glass of wine, two sometimes, but that's rare...

My understanding is that type 2 diabetes is an "insulin resistance" problem, not due to "lack of adequate insulin". However, if type 2 diabetes is untreated and allowed to progress, insulin levels can be depleted over time leading to LADA or type 1 diabetes, but it's complicated because those two conditions are autoimmune conditions (or the pancreas was damaged by infection, specific drugs, cancer, etc.). Type 2 diabetes, on the other hand, is not an autoimmune condition.

The more I learn, the less I understand...

Such is Life I'm afraid. I just have the occasional glass.

Sent from my LG-D620 using DCUK Forum mobile app

 

[seadragon]

Your description of yourself completely describes me. I have been so confused. I have always had a BMI under 24, have always been athletic and active, but I did have borderline gestational diabetes and two big babies - one 8.9lbs and the second 9.3. Like you, my weight was climbing incrementally with no change in diet or exercise over the last 20 years.
Last August, age 57, BMI 23.5 (but about 10 lbs over my regular weight at 147) I was diagnosed with pre-diabetes. It threw me for a loop, sent me to dietdoctor website, I started LCHF, and lost 10lbs, but I have been testing my blood sugar and I spike, too, if I have carbs. I think I am on this for life.
Can I ask, how long have you been doing LCHF? How is your fasting BG and lipid profile? My fasting BG is still around 5.4, with almost no carbs. But I am not getting the spikes and the hypoglycemia, and I have no hunger. I want my FBG to come down more. I am testing my blood sugar with a meter, I can see I really spike with carbs and sugar. (I also seem to spike with too much protein, like skinless chicken breast.)
I wondered if I could ask you more about your experience: What you can eat, what you must avoid? You sound so similar to me that I would love to learn from your experience.

Hi @anniebananie. I've been low carb high fat since Mid July last year so almost a year now. When I got the pre diabetes diagnosis my doctor said she'd give me metformin and statins and I'd be on them for life and it was progressive and I'd probably end up on insulin. Well that precipitated my looking at everything I could find to avoid medication and found dietdoctor.com and this site which have been quite literally lifesavers. The doctor also said that most people need to lose weight but that I didn't have much to lose (and she held out no hope I'd ever be able to lose any!) My BMI was about 24 then.
I do intend to eat low carb for life as not only does it help with the insulin resistance/ carb intolerance/ call it what you will but I feel so much better and many minor health issues have gone away since I started this (including an irritating cough i used to get after every meal but don't now so maybe I really was allergic to carbs!) And incidentally I lost 8 kg without effort.
I avoid as much as possible all carby foods so no bread, pasta, rice, potatoes etc, eat loads of veg which is delicious if you sauté in coconut oil, add a dollop of creme fraiche, a half teaspoon of mustard and some peri-peri flakes for a bit of heat! Then I eat a lot of salad veg too and whatever protein things I fancy. I don't seem to spike with protein - ate two chicken legs last night about 10.30pm followed by a couple of squares of dark chocolate and some cream and this mornings fasting BG was one of my lowest for a while at 5.1
Do be aware that fasting BG is not necessarily the lowest of the day whatever the NHS tell you - In late afternoon or before evening meal I can be down to 4.5 ish whereas FBG is often 6.5 or above (see 'dawn phenomenon')
I was fanatical about testing for the first 6 months and wrote down everythgin I ate and tested before and at 1 and 2 hours after so I have a good baseline to work from and now i am happy I know most things that will raise BG. I also found that i can have the occasional carby thing and that if I work it off immediately (e.g. 15 minute brisk walk - or if it's raining I have been know to jog on the spot indoors) I can prevent spiking .
My regular treat is berries (raspberries , blueberries ) and double cream and I often have a glass of red wine or two at meals and a couple of squares of dark chocolate (well OK I actually eat Lindt's oragne intense with some cream which is probably not ideal ) and I don't really miss carby foods. If i'm out and there is some really delicious fresh warm bread i might have a little bit but am aware I then need to go for a walk after (works for me). I've also taken up weight lifting which is great for adding muscle and decreasing insulin resistance as well as adding strength.
Probably should not derail the thread further, so I am happy to discuss further if you want to send a private message.
I did go through the upset/angry/why me/ bit but think i am through the other side now and am actually grateful that I've been able to change my lifestyle (from the low fat, wholegrain, NHS approved) to low carb high fats, which has improved everything for the better.

 

[anniebananie]

Hi @anniebananie. I've been low carb high fat since Mid July last year so almost a year now. When I got the pre diabetes diagnosis my doctor said she'd give me metformin and statins and I'd be on them for life and it was progressive and I'd probably end up on insulin. Well that precipitated my looking at everything I could find to avoid medication and found dietdoctor.com and this site which have been quite literally lifesavers. The doctor also said that most people need to lose weight but that I didn't have much to lose (and she held out no hope I'd ever be able to lose any!) My BMI was about 24 then.
I do intend to eat low carb for life as not only does it help with the insulin resistance/ carb intolerance/ call it what you will but I feel so much better and many minor health issues have gone away since I started this (including an irritating cough i used to get after every meal but don't now so maybe I really was allergic to carbs!) And incidentally I lost 8 kg without effort.
I avoid as much as possible all carby foods so no bread, pasta, rice, potatoes etc, eat loads of veg which is delicious if you sauté in coconut oil, add a dollop of creme fraiche, a half teaspoon of mustard and some peri-peri flakes for a bit of heat! Then I eat a lot of salad veg too and whatever protein things I fancy. I don't seem to spike with protein - ate two chicken legs last night about 10.30pm followed by a couple of squares of dark chocolate and some cream and this mornings fasting BG was one of my lowest for a while at 5.1
Do be aware that fasting BG is not necessarily the lowest of the day whatever the NHS tell you - In late afternoon or before evening meal I can be down to 4.5 ish whereas FBG is often 6.5 or above (see 'dawn phenomenon')
I was fanatical about testing for the first 6 months and wrote down everythgin I ate and tested before and at 1 and 2 hours after so I have a good baseline to work from and now i am happy I know most things that will raise BG. I also found that i can have the occasional carby thing and that if I work it off immediately (e.g. 15 minute brisk walk - or if it's raining I have been know to jog on the spot indoors) I can prevent spiking .
My regular treat is berries (raspberries , blueberries ) and double cream and I often have a glass of red wine or two at meals and a couple of squares of dark chocolate (well OK I actually eat Lindt's oragne intense with some cream which is probably not ideal ) and I don't really miss carby foods. If i'm out and there is some really delicious fresh warm bread i might have a little bit but am aware I then need to go for a walk after (works for me). I've also taken up weight lifting which is great for adding muscle and decreasing insulin resistance as well as adding strength.
Probably should not derail the thread further, so I am happy to discuss further if you want to send a private message.
I did go through the upset/angry/why me/ bit but think i am through the other side now and am actually grateful that I've been able to change my lifestyle (from the low fat, wholegrain, NHS approved) to low carb high fats, which has improved everything for the better.

Wonderfully helpful reply. I love your approach and attitude.

 

[zed007]

Hello again
I'm.off to GP about this
Putting it off too long
Bit frightened

 

[Winnie53]

@zed007 let us know when you get your test results back. I don't for a minute believe diabetes is progressive if you use a diet such as the LCHF diet, exercise, and regular or periodic glucose monitoring to manage it.

When I was re-diagnosed with type 2 diabetes last year, 10 years after I'd crossed over from pre-diabetes to type 2 diabetes, I was very upset. In a frantic search for information on the internet, I learned about the LCHF diet. Within three days, I had a new glucose meter, and started the LCHF diet and walking. Blood glucose levels stabilized within 4 weeks, for some it takes only 1 week, and I kept doing it because it worked.

What I've come to realize over time is that diabetes likely saved my life because I was eating too many processed foods such as sandwiches made with bread, perhaps a cookie afterward. Today I eat an organic, whole foods diet that excludes unhealthy processed sugar, seed oils, and for the most part grains. And all my health markers are now within or just above the normal range.

It's been a gift.

While an occasional indulgence is okay, now that I've been eating this way for more than a year, I can't image going back to regularly eating "normal" foods (i.e. processed).

It sounds like you've caught your diabetes early, and lucky for you, found you're way here.

 

[zed007]

@zed007 let us know when you get your test results back. I don't for a minute believe diabetes is progressive if you use a diet such as the LCHF diet, exercise, and regular or periodic glucose monitoring to manage it.

When I was re-diagnosed with type 2 diabetes last year, 10 years after I'd crossed over from pre-diabetes to type 2 diabetes, I was very upset. In a frantic search for information on the internet, I learned about the LCHF diet. Within three days, I had a new glucose meter, and started the LCHF diet and walking. Blood glucose levels stabilized within 4 weeks, for some it takes only 1 week, and I kept doing it because it worked.

What I've come to realize over time is that diabetes likely saved my life because I was eating too many processed foods such as sandwiches made with bread, perhaps a cookie afterward. Today I eat an organic, whole foods diet that excludes unhealthy processed sugar, seed oils, and for the most part grains. And all my health markers are now within or just above the normal range.

It's been a gift.

While an occasional indulgence is okay, now that I've been eating this way for more than a year, I can't image going back to regularly eating "normal" foods (i.e. processed).

It sounds like you've caught your diabetes early, and lucky for you, found you're way here.

Why are you saying I've caught it early when I haven't even been tested . I am upset now.

I have a bmi 18-18.5, I'm slim fit and active . No family history . I drink lots of water and eat fruit n veg , but my diet could be a bit better, but it's not terrible .

I have to wait 10 days for a blood test .

Today I have consumed 4 litre which is higher than my usual 2-2.5l during this thirsty month or so.

 

[zed007]

I understand low carb concept but how is high fat good for you!

 

[Winnie53]

@zed007, I apologize.

I thought you had reason to believe you have pre-diabetes or type 2 diabetes.

You wrote earlier, "Hello again. I'm off to GP about this. Putting it off too long. Bit frightened."

Is there a reason either you or your healthcare provider think you have diabetes?

I'm confused.

 

[zed007]

Yes I've been thirsty a lot recently.