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Underweight with prediabetes

gowest12 said:
I do eat protein and fat but I was vegetarian years ago and started eating meat again but I’m not mad on meat and I struggle with protein ideas and fat. I used to eat a lot of pasta being Italian and my meals were never protein fat and carbs it was mainly carbs!!!
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I used to be vegetarian too (are we actually the same person.... :-) ?) I started eating meat again decades ago, but my heart really was never in it and my other half got most of my meat while I filled up on pasta etc. I think this is quite a common pattern. I did also have an ED in the distant past, but we won't go there unless you have a similar history in which case I can assure you that that is a common pattern too. Long story short, my history of being fully and healthily nourished has been, shall we say, chequered. It was really only when I got metabolically unhealthy and looked and felt frail and ill in middle years that I started taking this stuff seriously. By seriously, I mean being as serious about being properly nourished as I am about taking essential medication - food is medicine, and I had to start seeing it that way and treating it that way. It sounds joyless, doesn't it? But the good news is that, once I had once and for all got over my reluctance to eat enough meat, fish, eggs, full-fat dairy, masses of veg and nuts and seeds etc, I started to feel so much better that it because a positive pleasure and no chore at all. The only person worse off is my other half, who doesn't get half my meat and fish any more. None of this might resonate with you in any way, of course. But if some of it does, I hope there might be some ideas for you.
 
Redshank said:
I am also prediabetic and was not overweight. When I started low carb I also lost weight I didn't wish to lose.
The sample diet you have put here looks very low in calories, and also low in fat. When I started I did a detailed food diary for a week, weighing the food that I ate. I worked out the carbs, but also the calories - and the calories were far too low. I needed to eat more cheese, nuts, avocadoes. (I dont eat meat) As an example I have a handful of walnuts with my lunch which is a good calorie boost. I have some cheese as a snack, or some more nuts.

Much of the advice published is for people who want to lose weight. As other people have said, your score of 42 is only just in prediabetes so there is no need to panic over that. Any exercise you can do, and I imagine swimming would be very good.

Trying to go low fat and low carb will almost certainly mean you lose weight as you only have protein left. Eating more fat fill help.
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This is all so true. It isn't just a matter of eating fat and protein, it is eating ENOUGH fat and protein, particularly when a person is compensating for lower carb. Low fat + low carb = weight loss, just as you say.
 
AGC_68 said:
Don't panic mate, 42 really isn't so bad, certainly not the end of the world.
You are just in the borderline zone.
"Slim" doesn't necessarily mean your body composition is low in fat. It might be but you really can't always tell so easily. BMI is a good guide for assessing risks for large populations, but not always so for an individual. Some people have a low BMI and very little body fat and can still be T2 diabetic. Some can be high BMI and have a fair bit of body fat and not be anywhere near T2 diabetic. It all depends on your personal adipose fat threshold, once you exceed that you're going to start to get into trouble at some point unless you do something about it.

Building muscle is always a good idea. Bullet proof your body for older age.
If you want to build muscle resistance training is the way to go. You don't need a gym or anything fancy. Press ups, squats, inverted rows under a table .. you can get started with no equipment. Plenty of stuff out their to help e.g. You Are Your Own Gym
You can supplement with a pair of adjustable dumbbells and get plenty done at home without wasting time or money on gyms.
For blood sugar control even a 20 min brisk walk after a meal helps enormously, Find what you enjoy and do it. Muscle is good for you as you age anyway in so many ways, but some people just don't enjoy resistance training and they then don't do it despite good intentions and feel bad. Be honest with yourself and just do something to start with, walk if you enjoy walking, eat plenty of protein in all your meals to stimulate muscle synthesis, keep the carbs low and keep the fats healthy but also under control. Once you're moving more and feeling more positive, start adding some press ups, squats etc. as you get better at them and see benefits you'll do more, do more demanding versions of the exercises, continue to get stronger and build more muscle. I don't know what your body compositions really is. If your fat composition is too high you will need to be in a calorie deficit to ensure your body uses your fat stores as fuel. Up your protein, use protein shakes if you have to, the body becomes more anabolic resistant as we age, exercise and protein intake counter that. Don't worry so much about your A1C of 42 . Eat what you need to fuel your activity and build your body, keep the food healthy and not processed. Don't obsess about your BG levels, measure your fasting levels in the morning and see how it is affected over time as you change your diet and exercise more. Remember 42 isn't that bad .. if you start to look to skinny and feel tired or frail you need to eat more, adapt to the changes you see. Getting too fat and the fasting BGs are trending up? Eat less of what is causing that and move more, getting too skinny, too tired, not building muscle, not moving much eat more of the right things while tracking your fasting blood glucose and looking at your body composition. But don't obsess, and don't be scared, one step at a time, one day at a time. Every now and then you will need to adjust, again just do it, one day at a time. You'll be fine.
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Can I ask you a question as I’ve found that measuring height to weight ratio gives me a total different result than my bmi. If anyone can give me some advice as I’ve looked it up and can’t seem to find the reason. I’m 4ft 11 and weight 100 pounds my bmi is 18 which is normal but very close to underweight and when I checked my weight to height ratio my waist measures 30 inches and that makes me slightly overweight? I notice if I do put on abit of weight it tends to go on my tummy area. I want to gain weight all over as I feel awful so slim how can I gain all over and why is my tummy area coming up as overweight for my height if my bmi is underweight?
 
gowest12 said:
Hi I’m 49 years old but feel like I’m 100! I just hate all this I really do. With the food i dot think I can stick to extremely low carb like 20-30 a day as I really struggle with that but could I do low carb as opposed to keto say 100 carbs a day? And is it still ok if you do 100 carbs a day to add more fats and protein? Im scared if I have too many carbs I must keep fat low im so confused. I th k keto is abut much for me but I can do low carb
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Am like you slim prediabetic and aim to get about 100g carbs a day. I did have to increase fats and protein to stop me losing weight.
Have you tried the grain free granola recipes avaible online? I think a portion (45g looks tiny) is about 500 calories so a good way to increase both fat, protein and calories if that is what you need.
Anxiety and depression are common problems for me too. Having the granola ready to eat in the fridge can make for easier mornings. Other days i have scrambled eggs or full fat greek yoghurt with berries. Hope these suggestions help.
 
gowest12 said:
Can I ask you a question as I’ve found that measuring height to weight ratio gives me a total different result than my bmi. If anyone can give me some advice as I’ve looked it up and can’t seem to find the reason. I’m 4ft 11 and weight 100 pounds my bmi is 18 which is normal but very close to underweight and when I checked my weight to height ratio my waist measures 30 inches and that makes me slightly overweight? I notice if I do put on abit of weight it tends to go on my tummy area. I want to gain weight all over as I feel awful so slim how can I gain all over and why is my tummy area coming up as overweight for my height if my bmi is underweight?
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You have just described the excess-carb-intolerant body - the one that the official lit on type 2 diabetes (and prediabetes) means when they say 'genetic predisposition', according to my understanding at least. Another way to talk about it, that I way prefer, is you have a particular fat storage pathway - and that path is - straight to your tummy!

And if you were slender/slim when young, you did not get lots of fat cells, and when later you were eating lots of carbs (in relation to fats) they filled up the fat cells you have, and then filled up the fat cells on your organs - the liver, and your pancreas being the dynamite organs for developing blood glucose regulation malfunctions.

So yes - the waist height ratio is a really good measurement to track and look at in relation to your blood glucose regulation. Getting your waist to be less than half your height is the measurement that it is suggested is optimal for good health (and for good blood glucose regulation).

How can you gain all over? Well - your fat storage pathway is part of what gives you the body type you have. Probably you take after family members with the same body type as you? Whether you are narrow or wide or angular or curvy or muscular - these things run in families. Have a good look at your same sex parent and their body, brothers and sisters etc, and take note of what they are eating? (or how they looked and ate if past tense.) Cousins too can be handy too, to take note of, in terms of bodies and food and drink. (And activity levels and muscle etc.) Looking at family members can help guide you for good (and for bad - as I have alerted family members to the habits that lead me to type two, so they could avoid it.)

My feeling is to go with the good that you have got, as I am sure you body is not so very awful! And yeah - developing muscle is good, and physical activity for health and fitness is a definite good.

Can I tease you mildly? Don't go out on the street and yell out, "I feel awful so slim!" :D. You might be attacked by a plump/overweight/obese mob (of which I was one) plagued by our modern food and drink environment, that has made many of us with weight problems and ill with metabolic disease.
 
gowest12 said:
Can I ask you a question as I’ve found that measuring height to weight ratio gives me a total different result than my bmi. If anyone can give me some advice as I’ve looked it up and can’t seem to find the reason. I’m 4ft 11 and weight 100 pounds my bmi is 18 which is normal but very close to underweight and when I checked my weight to height ratio my waist measures 30 inches and that makes me slightly overweight? I notice if I do put on abit of weight it tends to go on my tummy area. I want to gain weight all over as I feel awful so slim how can I gain all over and why is my tummy area coming up as overweight for my height if my bmi is underweight?
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Overweight? That means you think you weigh too much. But what does that really mean? By what criterion are you overweight? Is weight really relevant to the conversation? Or is body composition more important? Where is your fat stored and what are the consequences of it being stored there? BMI doesn't really tell you this, it is useful when looking to predict what will happen to a large population's health over time. But there will always be people with a high BMI who are not only metabolically healthy, but also look like the archetypal Olympian athlete. On the other hand, there will always be people whose BMI is very low but they look like they are out of shape and carrying more fat than their BMI would suggest and have high blood sugar levels. Height to waist ratio is a little better but again, there will be outliers. So .. who's "overweight"? You are just in the borderline zone for T2 .. so perhaps you do have a little fat stating to accumulate internally where it is affecting you, We don't know for sure though from measures like BMI or even height/waist ratios. Nothing is really going to give anyone an absolutely accurate idea about their body composition and fat distribution except an MRI scan .. or an autopsy! LOL :playful: Not even all the techniques bodybuilders employ with skin calipers and various anatomical measures with tapes, or even DEXA scans are a guarantee of accuracy. They, in the end, rely on statistical regression equations derived from control groups and so when applied to individuals we will always have people who are outliers and get results that give them the wrong idea of their composition. Detailed derivation of the anthropometry for an individual is just not so straight forward.

Your body will not put fat into stores all over your body evenly if you have reached your adipose threshold. It will put on visceral fat and then eventually ectopic fat if you consume calories in excess to your requirements. Maybe you have some visceral fat or even ectopic that you could stand to lose, not possible to say. But if you reduce the daily calories you consume to below your body's daily needs then it will burn fat to make up the short fall. that is how you lose fat. Your body will lose fat from the ectopic compartment first, then visceral, then adipose. If you lose internal fat your A1C will also probably come down (unless there are other factors like meds etc. involved). If you want to build muscle, you must stimulate the synthesis of muscle. Eating enough protein will stimulate muscle synthesis, eating enough protein and resistance training will be even more effective in stimulating the synthesis of muscle. You can't build muscle without consuming protein. If you consume too many calories, no matter whether what macronutrient it is (protein, fat or carbohydrate) you will eventually store any excess to your requirements that your body does not excrete as fat. And your body will put that fat in the available compartment, if your adipose compartment (under the skin) is full it'll shove it in the visceral (the belly) compartment, if that's full it'll put it is the ectopic (organs and muscle) compartment. Of course, remember your diet must have enough micronutrients (vitamins, essential fats and minerals etc.) or deficiencies will lead to problems.

To make a change to increase muscle and lose fat, eat more protein, eat less calories, do some resistance training for muscle, do some cardiovascular exercise too in order to use more calories - walking is great. Be consistent over time .. when you achieve your required body composition start to increase you energy intake to match your daily needs so that you do not continue losing too much bodyfat. But remember you can't out exercise a poor diet. Muscle won't build without protein and stimulus and no one has enough time to weight train and do enough cardio to burn off a huge excess in calorie intake.
 
Hi. Be aware that being slim with diabetes can mean you are a late onset T1 and not T2. Do increase your fats and proteins where you can. Ask the GP for the two tests for T1 i.e. GAD and C-Peptide. With T1/LADA, unexpected weight loss results from the body lacking insulin and hence can't metabolise carbs. It therefore burns stored fat to obtain energy.
 
gowest12 said:
Can I ask you a question as I’ve found that measuring height to weight ratio gives me a total different result than my bmi. If anyone can give me some advice as I’ve looked it up and can’t seem to find the reason. I’m 4ft 11 and weight 100 pounds my bmi is 18 which is normal but very close to underweight and when I checked my weight to height ratio my waist measures 30 inches and that makes me slightly overweight? I notice if I do put on abit of weight it tends to go on my tummy area. I want to gain weight all over as I feel awful so slim how can I gain all over and why is my tummy area coming up as overweight for my height if my bmi is underweight?
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And this is what TOFI describes. Thin outside fat inside. Meaning the weight you have is around your organs, the worst place to have it. If the same fat was placed all over your body it would result in the same bmi but different height to waist ratios.

And the reason you’ve had it go on your tummy is the insulin resistance and pre diabetes. It where we store fat created by the excess glucose circulating and where the high insulin we have trying to control dumps it (Insu is also a fat storage hormone that hinders fat burning). That same high insulin that we have for years before blood glucose is affected makes us more and more insulin resistant and takes us closer and closer to type 2. Body weight added by fats and carbs should be distributed to all the body’s cells better than those added by carbs in anyone with insulin resistance.

Your body composition is as important as overall weight. You could be the same height and 100lbs with a lot of body fat or 100lbs with lots of muscle - both would look completely different in the mirror and have different health outlooks. Yet another reason bmi is flawed.
 
gowest12 said:
Hi I was diagnosed prediabetic in may hba1c of 42 and was already slim but I’ve lost more weight now doing very low carb and my numbers aren’t all that great even on low carb around 30-40 a day. I don’t really exercise and I’m guessing I need to start I’ve never really exercised except walking. But I’m worried I’ve lost muscle as my upper arms look so skinny and like there is no muscle I’m feeling very depressed about all this I already suffer with anxiety and depression and feel really bad now. I really want to gain some weight but if I increase carbs my numbers will be worse. I don’t understand I can wake up with a 6.3 fasting number and it will continue to rise whether I eat or not till midday or 1. Then my postprandial numbers don’t come down till after about 3 hours. It would have been far easier if I had weight to lose. Can someone give me some advice as I’m close to giving up with everything now
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I would suggest that you find a gym with a Personal Trainer that specialises in diabetes. Join it & get personal training with that person. Not only will you gain weight & muscle with a diet and exercise routine that is tailored to your needs but that person will be able to help motivate you so you look forward to your gym sessions :)
 
ashMantra said:
I would suggest that you find a gym with a Personal Trainer that specialises in diabetes. Join it & get personal training with that person. Not only will you gain weight & muscle with a diet and exercise routine that is tailored to your needs but that person will be able to help motivate you so you look forward to your gym sessions :)
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Show me more than a PT in a gym that is anything other than carb focused. Add on that most will follow nhs eatbadly plate with its overload of carbs and advice that a diabetic can eat anything but actual sugar and you’ve a recipe for bigger problems. I’m sure there are a few but they are rare. Use the pt for exercise for sure but I’d be very wary of the diet advice they’d give.
 
gowest12 said:
Hi I was diagnosed prediabetic in may hba1c of 42 and was already slim but I’ve lost more weight now doing very low carb and my numbers aren’t all that great even on low carb around 30-40 a day. I don’t really exercise and I’m guessing I need to start I’ve never really exercised except walking. But I’m worried I’ve lost muscle as my upper arms look so skinny and like there is no muscle I’m feeling very depressed about all this I already suffer with anxiety and depression and feel really bad now. I really want to gain some weight but if I increase carbs my numbers will be worse. I don’t understand I can wake up with a 6.3 fasting number and it will continue to rise whether I eat or not till midday or 1. Then my postprandial numbers don’t come down till after about 3 hours. It would have been far easier if I had weight to lose. Can someone give me some advice as I’m close to giving up with everything now
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Hi, I was diagnosed at 45, told to go away & eat better & exercise more. To cut a long story short ended up at 6st & really unwell! GPs didn’t pay any attention really, one told me to fill up on mashed potato & brown bread! I carried on losing weight, my blood sugars were still too high, I ended up paying to see a consultant even though I couldn’t afford this but was getting desperate. I had the gad blood test, showed my pancreas had begun to mis behave so was immediately put on a low dose of insulin. It was such a relief to be listened to & treated properly, they told me it was late onset type 1 or Lada. Just thought I’d share my experience as was terrible at the time, through mid diagnosis I lost 2 stone in 6 months! Hope you get sorted soon
 
gowest12 said:
Hi I was diagnosed prediabetic in may hba1c of 42 and was already slim but I’ve lost more weight now doing very low carb and my numbers aren’t all that great even on low carb around 30-40 a day. I don’t really exercise and I’m guessing I need to start I’ve never really exercised except walking. But I’m worried I’ve lost muscle as my upper arms look so skinny and like there is no muscle I’m feeling very depressed about all this I already suffer with anxiety and depression and feel really bad now. I really want to gain some weight but if I increase carbs my numbers will be worse. I don’t understand I can wake up with a 6.3 fasting number and it will continue to rise whether I eat or not till midday or 1. Then my postprandial numbers don’t come down till after about 3 hours. It would have been far easier if I had weight to lose. Can someone give me some advice as I’m close to giving up with everything now
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What sort of levels are you seeing and before and after eating, what sort of meal?

Have you heard of dawn phenomenon? Basically your liver adds glucose to your blood when it thinks you need it (getting up/lower than it’s used to/exercise etc). It doesn’t always get it right in T2. That might explain your rising throughout the morning.

Did you check to see if you’ve accidentally gone low calorie as suggested above?

Do you know if you were ever checked before being diagnosed as prediabetic (when and what result?)
If your levels are continuously rising for no reason (ie without carbs in food) or you feel more and more ill or lose more weight after checking intake or your levels reach into the teens then go back to your dr sooner rather than later. If your levels get to the high teens without a known cause seek medical advice immediately whether you feel ill or not. As the post above shows a few people who are type 1 or LADA initially, get misdiagnosed as type 2 or getting there The dr should arrange tests for c peptide and antibodies to clarify what’s happening. I don’t say this to scare you - it is quite rare. But because it can happen it’s better to know what to look out for than it all go horribly pear shaped.
 
Outlier said:
This is why BMI should be seen only as a not-very-good tool, rather than gospel truth. Depending on where our particular body type likes to store fat, it will accuse us of being OBESE when we are nothing of the kind.
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I have known rugby players that are classed as obese due to the BMI but they have no fat on them just loads of muscle. My dn thinks I should loose a few more pounds but I have tried but still hover around 10.7 or below no matter what I do (apart from increasing weight if I eat peanuts). I swear its due to having more muscle mass now.
 
ashMantra said:
I would suggest that you find a gym with a Personal Trainer that specialises in diabetes. Join it & get personal training with that person. Not only will you gain weight & muscle with a diet and exercise routine that is tailored to your needs but that person will be able to help motivate you so you look forward to your gym sessions :)
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I would suppose a diabetes-expert personal trainer would be confined to very populated cities in OECD countries? I was pondering this when I was pushing my lawn mower uphill, thrashing the too-tall grass with the weedeater, wielding my axe splitting logs, and carrying boxes of firewood up steps and indoors. In my rural area, admittedly in an OECD country, but with backwards diabetes-advice and treatment nonetheless as is all too common globally, one can't even find diabetes experts in the medical centres let alone the wee gym I have locally.

Even so, I way prefer yardwork to gym culture. And it saves me money, doesn't cost me. I'm not a joiner, and definitely not into having a motivational speaker personal trainer. But we are all different!

Keeping fit and cardiovascular healthy in the different ways that suit us and according to our circumstances, for sure.
 
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