Underweight and frustrated

I don't think that you are doing anything wrong - for some people diet changes are not effective, particularly if you need to inject insulin, there is no alternative.

Hi @ambera1,

Welcome to the forum.

Has your doctor tested you for Type 1 diabetes? As you are young and slim, and your blood sugars are still higher than normal on low carb, this is a distinct possibility.

40% of type 1's are misdiagnosed as type 2's at first. If you are doing everything right and things don't make sense you could be a type 1 instead. Losing weight and high blood sugars when you aren't eating high carbs could be signs of type 1, just eating some chocolate shouldn't do it.

I'm not saying you are, I'm just saying keep it in mind just in case.

ambera1 said:

Hi Ziggy

Thanks for your response. There has been no mention of Type 1 but I will mention it to the doctors.

My dad is pre diabetic and my grandma has type 2 diabetes so the doctors have mentioned the genetics could be the cause. That being said I am much younger that my dad and his score is on the lower end of 40s.

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Hi @ambera1,

This really might be worth exploring with your doc. Keeping my fingers crossed that you get some answers soon.

ambera1 said:

I am currently being tested for diabetes. I am a 27 year old female and have always been a healthy and slim weight.

My Hba1c in October was 48 (plus elevated liver enzymes) and in December was 47 (liver enzymes improved). The doctor has requested to retest in March due to being borderline.

I have been working very hard to improve my diet and have been exercising 2-3 times a week for the past few years. My diet has never been ‘bad’ however I do love chocolate. I initially greatly reduced sugar intake and only ate wholewheat carbs, now I am on a Keto diet, consuming maximum 70g of carbs a day but most days a lot less than this. Having bought a fit bit it has become rather easy to track my macros.

Although I am eating high fat foods I am constantly hungry and have unintentionally lost 1 stone in weight since the change in diet. I am now classed as underweight.

The most frustrating thing is I have purchased a blood glucose monitor and my fasting blood sugar in the mornings is consistently mid to high 6 and 2 hours after my evening meal I am reaching between high 9 and more recently as high as 12.

What am I doing wrong here and does anyone have any advice for me. Will I start to see improvements the longer I try this? As you can imagine cutting out most chocolate also carbs has been tough in itself and frustrating that I am still not seeing normal scores since doing Keto.

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Keep at it, and don't forget your protein. I think things are hard for those of us who find we mislay valuable weight if we take our eye off the ball for a moment. And we don't get much sympathy, do we? In your shoes, I would be paying some careful attention to eating nutrient-dense, low carb food and plenty of it. Preferably with three square meals a day and no snacking, although I would loosen that constraint if you have a lot of weight to recover. One thing that I have found is that I mustn't be scared of protein. Fat is fine for satiety, but if you aren't getting enough protein to meet your needs, you're going to lose weight, and it's good weight you're losing - muscle etc. You can't afford to lose that and neither can I. For what it's worth, I lost some weight unintentionally recently, and am now eating astonishing (to my friends and relatives) amounts of good meat and fish (oily in particular) and cheese and eggs to make it up. Nearly there now. But it takes constant careful attention. I'm much older, and I am sorry that, aged 27, you have to pay real attention to what you eat, but there you go. With luck, learning about good nutrition now will set you up for a healthy life.

ambera1 said:

I am currently being tested for diabetes. I am a 27 year old female and have always been a healthy and slim weight.

My Hba1c in October was 48 (plus elevated liver enzymes) and in December was 47 (liver enzymes improved). The doctor has requested to retest in March due to being borderline.

I have been working very hard to improve my diet and have been exercising 2-3 times a week for the past few years. My diet has never been ‘bad’ however I do love chocolate. I initially greatly reduced sugar intake and only ate wholewheat carbs, now I am on a Keto diet, consuming maximum 70g of carbs a day but most days a lot less than this. Having bought a fit bit it has become rather easy to track my macros.

Although I am eating high fat foods I am constantly hungry and have unintentionally lost 1 stone in weight since the change in diet. I am now classed as underweight.

The most frustrating thing is I have purchased a blood glucose monitor and my fasting blood sugar in the mornings is consistently mid to high 6 and 2 hours after my evening meal I am reaching between high 9 and more recently as high as 12.

What am I doing wrong here and does anyone have any advice for me. Will I start to see improvements the longer I try this? As you can imagine cutting out most chocolate also carbs has been tough in itself and frustrating that I am still not seeing normal scores since doing Keto.

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70 Grams a day max, is not keto. It's low carb, but it won't kick you into ketosis. (That's usually 20 grams of carbs or less) And right now I don't think you should aim for ketosis either. The others here are right. Get back to the doc and request C-peptide and GAD tests. You wouldn't be the first one to get a T2 diagnosis when T1 or another type are more likely. There's plenty of slim T2's, but if you're underweight, that's.... Cause for further testing.

Hi Ambera.reading this thread and wondering how you are now. Did you get back to the doctor, any answers?
Just my so you know I am a slim prediabetic and lost a lot of weight after diagnosis. Seems my new normal is BMI 16.8

Self funding your tests may help you.
Info is always good, in my world.

but please don’t judge the NHS too harshly.
Doctors, nurses and consultants all work to professional standards.
It would be highly unprofessional to spend NHS money on appointments, tests and treatments on people who are not showing symptoms that hit the diabetes tick boxes, to merit further investigation.

If your HbA1c has dropped to below 48, then, according to the NHS, you don’t need more until you go over the line (the line of 48). Then, even if/when you do, it is rare for most diabetics (90% of whom are T2) to get sent to an endocrinology clinic. First line of defense is usually diet and exercise - which you seem to be deploying successfully. Medication comes later, when/if diet and exercise fail.

many pre-diabetics see the numbers you have been getting. Sometimes for decades. But they don’t know about it because they don’t have a glucometer.

I agree that it is EXTREMELY FRUSTRATING.
happened to me.
My numbers hovered around 48, I clamped down and went keto. My numbers have been well below that for years now, and my doc has forgotten I exist.
It is hard work maintaining the low levels, and I get no assistance, checks, tests or medication, but frankly, I have always taken responsibility for my own health, and I can easily monitor my own blood glucose and (With more effort) restrict my own eating.

If you get the further testing done privately you will be a step further along, but even if you end up as LADA, you will still just be monitored until the time comes for medication to be introduced.
There are LADAs here on the forum who have extended their Honeymoon for years by doing what you are doing now (low carb) in order to preserve their beta cell function for as long as possible.

ambera1 said:

Hi there

My GP referred me to the consultant at the hospital and I waited 5 months to be told this week that they aren’t going to do any further testing as I am borderline and therefore pre diabetic with my hba1c at 48.

They said I can just go on metformin if I’m concerned.

I’m worried that I might be MODY or LADA but they aren’t interested.

So upset, frustrated and disappointed! Think I will save up to have a C peptide and GAD antibody test done privately.

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I am sorry that you are having a frustrating time. It is disappointing that they are not more interested in getting to the bottom of why a fit and active young person, eating way fewer carbs than the average, is getting readings like yours. It just doesn't add up. Might you consider asking for a second opinion?