Weight loss in thin Type 2’s

[lengward]

I was diagnosed with Type 2 in the first week of November 2014 with a high HbA1c of 60 mmol/mol. My weight just before diagnosis had been stable at around 92 kg for many years which, for my height of 6ft 2in, was just above my healthy weight range of 65.4 to 88.7 kg (according to BMI). So I was of a tall thin body type carrying some excess weight on my tummy and top of my body.

I was put on 2 Metformin tablets a day. I made immediate changes to my lifestyle, cutting out the high levels of carbohydrates that I was eating, learning from my glucose meter, and doing a lot more exercise ( eg. lots and lots of fast walking, some sport, three 15 minute sessions of high intensity exercise a week).

I have lost 11 kgs in three months dropping me to 81 kg (BMI of 22.6) – but there is no sign yet of my weight stabilising. This is still within my supposedly healthy weight range but it is starting to bother me that there is no sign of my weight stabilising despite the fact that I do eat plenty of healthy food, lots of protein and have not given up saturated fat. People comment on how thin I look, my shoulder feel boney and my bottom feels increasingly uncomfortable to sit on.

I just wondered if there are any other thinnish, or normal weight on diagnosis, Type 2s out there who could share what has happened to their weight. Most of the weight management guidelines are about the benefits to overweight diabetics of losing weight.

I see my doctor this coming Thursday 12th Feb for a three month review where we will see what has happened to my HbA1c.

Cheers,
Graeme

Thursday 12th update to above:

My initial blood test results on T2 diagnosis on the 31/10/14 were as follows:
HbA1c = 60 mmol/mol, Total cholesterol=5.5 mmol/l, HDL=1.2 mmol/l, LDL=3.7 mmol/l.
I have just had my results after three months on lowish carb diet plus exercise and they are as follows on the 12/02/15: HbA1c=45 mmol/mol, Total cholesterol=4.5 mmol/l, HDL=1.4 mmol/l, LDL=2.8 mmol/l.

So promising results moving in right direction, at least for the moment. In particular I did not want to go on statins which is what my doctor had wanted to do at the beginning but the improvements to Chol/LDL have averted that.

Thank you all very much for sharing your experiences of weight loss for the leaner types in the replies below. I feel more confident now that I can be healthy in this skinnier state as long as I can find the right balance of low carb + nutrition/calories + exercise.

Thanks for the suggestion that 'it's important to do weight/resistance training too', for raising my awareness of the GAD and c-peptide tests, the possibility of LADA and the Harris Benedict formula to calculate what your calorie intake should be.

I appreciate you all taking the time to post replies,
Cheers and regards,
Graeme

PS on HbA1c units from http://www.diabetes.co.uk/hba1c-units-converter.html.
45 mmol/mol (IFCC) equivalent to 6.3% (DCCT) equivalent to 7.4 mmol/L

 

[Totto]

If your bg is fine I don't think you should worry. I was BMI 23.8 at diagnosis and low carb took me to 21.5 until I quit smoking and gained quite a lot, still on same kind of diet but I trust that will sort itself in time.

So what does your bg readings look like?

 

[urbanracer]

Hi Graeme, I'm an insulin dependent T1 but reading through your post it seems that you've changed a lot of things about your lifestyle within a short space of time. So it would be difficult to pin point any one thing if you are concerned about excessivè weight loss.

I myself am over 6' and was about 85kg before diagnosis. I was a bit overweight and had tried the 5:2 diet for a while. When I got down to to around 78kg I stopped the diet but found that weight kept falling off, even without exercise, which is a classic symptom of diabetes. I seem to have stabilised at 74/75kg now but I do feel that I am too thin. I seem to find it difficult to put weight back on whilst low carbing.

If you are happy that you are eating enough food and don't feel hungry then maybe you could reduce the exercise for a while to see if your weight stabilises?

 

[Arab Horse]

I am a fairly newly diagnosed T2 (July 2014) and when I cut the carbs I too started losing weight even though I am eating plenty of calories, probably more than I was previously as the fats I now eat are very high calorie. I am 5' 3" and weighed 8 stone 8- 10 lbs, I am now at 7 stone and seem to have stabilised there. It is the thinnest I have ever been in my adult life, previous low was just under 8 stone. I was a tubby child but lost the weight in my teens and have never been overweight since.

I am probably going to start the Newcastle diet next week to try and reverse my diabetes so expect to lose even more but I feel well and am not hungry, the high fat foods keep you full for longer than carbs. I am guessing that you will stabilise soon but your GP should discuss anything you are concerned about with you. I have never seen my GP, just the biabetic nurse!

 

[Mike d]

Hi AH

Think we've been down this road before. Your diet looks great, so does weight given you do a lot of exercise.

What are your recent numbers if I may ask?

Mike

 

[LucySW]

I wouldn't stop the exercise. I'd look at your calorie levels, and incorporate more fat. Jenny Ruhl's calculator ? http://www.phlaunt.com/diabetes/33614154.php

I'd also ask for a GAD antibodies test to see if you are in fact a type 1.

 

[jack412]

more fat
to stabilise on low carb, you may be eating 60-70% of energy from fats
put what you eat in to my fitness pal or similar, make sure you are getting your calories. I think you will be under your RDA
I would have the protein at 20%E for now.

 

[Arab Horse]

Hi Mike

I have my breakfast when I get up (rather than two hours later when I have done the horses) now and it is usually in the mid to high 5s or occasionally low 6s. If I do the horses and then eat it is in the high 6s to the mid 7s. My lunch time ones are usually OK pre and post but my evening post is almost always high (mid 7s to low 10s) and I put that down to sitting in front of the telly rather than being on the go as I am the rest of the time.

I have only had 2 HbA1cs done; one at diagnosis = 10.6mmol/L and one at six months which was 6.5 so a lot better but room for improvement. However, I was doing the diabetic UK low fat, moderate carbs for a lot of that time and getting nowhere!!!! Should be lower than that now.

PS My previous post should have said "Diabetic nurse".

 

[LucySW]

more fat
to stabilise on low carb, you may be eating 60-70% of energy from fats
put what you eat in to my fitness pal or similar, make sure you are getting your calories. I think you will be under your RDA
I would have the protein at 20%E for now.

I'm on 80% fat, 15% protein, 5% carb, or 30g carb, 80g protein, 180g fat. Those percentages are of total calorie intake. (I don't count calories but carbs/protein, but you have to have done sort of framework.)

 

[Tweetypie]

I wasn't particularly overweight at diagnosis but had definitely been heavier than i was used to for a number of years (had always been a skinny kid and slim in my teens, but then put on weight following an op in my 20's). I am also tall. I lost weight very suddenly after diagnosis as I cut back on a lot of carbs (stress is also a very effective but not preferred weight loss tool). Never had I been more concerned about the weight dropping off at that time. After a few months though, things petered out and I relaxed too much and actually put weight on! You just have to find a balance of calories that work for you.

If you want the weight to stay on, I'd suggest eating more cream, cheese, bacon and mayonnaise for example as this makes me put weight on. Also nuts and seeds are very calorific. Obviously carbs are not a good idea but just generally upping your food intake through loads of good veggies (especially avocado) and moderate amounts of protein are a good idea. Have you tried drizzling oil or melting butter over veggies? You just have to try and sneak in calories wherever you can really, see what helps and what doesn't.

In terms of exercise, it's important to do weight/resistance trianing too as you need strong muscles, what you don't want is to be losing muscle. I am currently still aiming for a BMI of 19, which is still o.k, but I cannot seem to get below 10 stone now, so I know I need to change something as I am hovering just above the 10 stone mark. Trouble is, I need more muscle too.

 

[jack412]

I'm on 80% fat, 15% protein, 5% carb, or 30g carb, 80g protein, 180h fat. Those percentages are of total calorie intake. (I don't count calories but carbs/protein, but you have to have done sort of framework.)

from what I've gathered and I could be wrong
even too much fat won't put weight on with LC..and some ketogenic diets are around 80% fat
fat will give you energy and stop you losing weight with the right amount of protein
when you cut carbs, the protein manages your weight
if your weight is stable at 15% protein..all is well..if not, take it to 20%
I'm in loss mode and should keep around 60-70g a day protein which is my RDA, but I think i cheat cause I'm on a plateau

an extra 1,ooo cal of fat and they still weren't putting on weight, only when protein was increased did the weight go up.

 

[Mike d]

Hi Mike

I have my breakfast when I get up (rather than two hours later when I have done the horses) now and it is usually in the mid to high 5s or occasionally low 6s. If I do the horses and then eat it is in the high 6s to the mid 7s. My lunch time ones are usually OK pre and post but my evening post is almost always high (mid 7s to low 10s) and I put that down to sitting in front of the telly rather than being on the go as I am the rest of the time.

I have only had 2 HbA1cs done; one at diagnosis = 10.6mmol/L and one at six months which was 6.5 so a lot better but room for improvement. However, I was doing the diabetic UK low fat, moderate carbs for a lot of that time and getting nowhere!!!! Should be lower than that now.

PS My previous post should have said "Diabetic nurse".

Thanks AB

 

[Tweetypie]

from what I've gathered and I could be wrong
even too much fat won't put weight on with LC..and some ketogenic diets are around 80% fat
fat will give you energy and stop you losing weight with the right amount of protein
when you cut carbs, the protein manages your weight
if your weight is stable at 15% protein..all is well..if not, take it to 20%
I'm in loss mode and should keep around 60-70g a day protein which is the RDA

Yes, what to do eh? It's such a balancing game isn't it? I'm not very good at maths and have still to master my perfect formula. I'm also not very good at measuring things, I just go with the flow.....

 

[DeejayR]

I have never been overweight for my height, but I had a small spare tyre which I read could be a bad place for fat since it might be constricting the internal organs around the middle (technical term)
Then I was diagnosed pre-diabetic, adopted the NHS healthy plate diet and cut out cakes, sweets, puddings and pastries. That lost me a lot of weight including muscle fat and I became skeletal. I also moved to Type 2
Then I found the forum and started my own version of low-carb-high-fat eating which has stopped the weight loss and levelled my BS nicely (so far). I like being skinny because I have a mild heart condition and don't need to have more overall mass for my everyday activities.
My version of LCHF is actually less carb (no pasta, rice, bread or root veg) and lots more fat but since I don't carb count I can't give percentages. All I can say is I eat as much as I want and my weight is always 68kg in the morning and 70kg in the evening. So I must have accidentally found a balance.
*edit* Some people here say they feel the cold more with weight loss. I did too at first but oddly I now feel the cold less than I did when I was heavier.

 

[Daibell]

Hi. If your weight continues to drop without any really low-cab diet and your blood sugar still remains high then LADA becomes likely and I would ask for GAD and c-peptide test. You have obviosuly had some excess weight but not much so I would see how things go over the next few weeks and check your sugars regularly to ensure your blood sugar doesn't start going up. See the GP quickly if it does. Let us know how things go.

 

[graj0]

I was diagnosed with Type 2 in the first week of November 2014 with a high HbA1c of 60 mmol/mol. My weight just before diagnosis had been stable at around 92 kg for many years which, for my height of 6ft 2in, was just above my healthy weight range of 65.4 to 88.7 kg (according to BMI). So I was of a tall thin body type carrying some excess weight on my tummy and top of my body.

I was put on 2 Metformin tablets a day. I made immediate changes to my lifestyle, cutting out the high levels of carbohydrates that I was eating, learning from my glucose meter, and doing a lot more exercise ( eg. lots and lots of fast walking, some sport, three 15 minute sessions of high intensity exercise a week).

I have lost 11 kgs in three months dropping me to 81 kg (BMI of 22.6) – but there is no sign yet of my weight stabilising. This is still within my supposedly healthy weight range but it is starting to bother me that there is no sign of my weight stabilising despite the fact that I do eat plenty of healthy food, lots of protein and have not given up saturated fat. People comment on how thin I look, my shoulder feel boney and my bottom feels increasingly uncomfortable to sit on.

I just wondered if there are any other thinnish, or normal weight on diagnosis, Type 2s out there who could share what has happened to their weight. Most of the weight management guidelines are about the benefits to overweight diabetics of losing weight.

I see my doctor this coming Thursday for a three month review where we will see what has happened to my HbA1c.

Cheers,
Graeme

I'm sorry about your diagnosis, pleased that you have managed to lose weight, but incredibly jealous. You are very lucky to have a metabolism that works properly. As a long term dieter, by which I mean I have reduced my calorie intake for the last 8 years, nearly 1 kg per week is pretty **** good, but as you say, now might be the time when you want that to stop.
Cutting out carbs reduces calorie intake by a lot, I found that 2 slices of toast for breakfast, 2 oatmeal baps at lunch and a banana in the afternoon was 700 calories, which out of an allowance of maybe 2000 is a lot. I think you have to go some to make up 700 cals with more fat, only my opinion.
Have you used something like the Harris Benedict formula to calculate what your calorie intake should be, it's surprising how much you multiply that number by if you do any exercise at all. Also, your calorie requirement is affected by how much you weigh as well.
Just a quick question, did you mean your HbA1c was 60 mg/dL (15 mmol/L) because 60 mmol/L is 240 mg/dL.

 

[lengward]

I'm sorry about your diagnosis, pleased that you have managed to lose weight, but incredibly jealous. You are very lucky to have a metabolism that works properly. As a long term dieter, by which I mean I have reduced my calorie intake for the last 8 years, nearly 1 kg per week is pretty **** good, but as you say, now might be the time when you want that to stop.
Cutting out carbs reduces calorie intake by a lot, I found that 2 slices of toast for breakfast, 2 oatmeal baps at lunch and a banana in the afternoon was 700 calories, which out of an allowance of maybe 2000 is a lot. I think you have to go some to make up 700 cals with more fat, only my opinion.
Have you used something like the Harris Benedict formula to calculate what your calorie intake should be, it's surprising how much you multiply that number by if you do any exercise at all. Also, your calorie requirement is affected by how much you weigh as well.
Just a quick question, did you mean your HbA1c was 60 mg/dL (15 mmol/L) because 60 mmol/L is 240 mg/dL.

The units I quoted were HbA1c of 60 mmol/mol. The new mmols/mol values are known as the IFCC (International Federation of Clinical Chemistry) units. http://www.diabetes.co.uk/hba1c-units-converter.html
My new HbA1c after 3 months low carb + excercise is now 45 mmol/mol (IFCC) equivalent to 6.3% (DCCT) equivalent to 7.4 mmol/L

Thanks for the Harris Benedict formula suggestion, I shall definitely check this out.
Regards,
Graeme

 

[graj0]

The units I quoted were HbA1c of 60 mmol/mol. The new mmols/mol values are known as the IFCC (International Federation of Clinical Chemistry) units. http://www.diabetes.co.uk/hba1c-units-converter.html
My new HbA1c after 3 months low carb + excercise is now 45 mmol/mol (IFCC) equivalent to 6.3% (DCCT) equivalent to 7.4 mmol/L

Thanks for that, so am I right in thinking that we have mmol/mol (International Federation of Clinical Chemistry), mmol/L (described as the International Standard for measuring molar concentration) and mg/dl (US - mass concentration).
Getting tricky for old geezers like me LOL
Good luck with Harris Benedict, my opinion is that it's a good guideline but doesn't allow for metabolism (I call it the rate at which we burn calories) or medication which some people might poo poo.
My diet is usually constant as is my level of exercise, but I still gained while taking Rosiglitazone and later on taking Gliclazide. In the last two years that I've reduced my carbs to 80gms, my daily diet has been constant as has my exercise, yet I lost 3 stone in the first 5 months (whoopee) then nothing for 18 months (boo), then I had a TKR at the end of last November and lost 1 1/2 stones over Christmas up to about a month ago and now it's gone up a bit. I weigh everything and record everything so I know what I'm eating.
Presently looking at the effects of inflammation and anti inflammatory drugs and sleep patterns on "metabolism".
I think I can safely say that for some, dieting is not an exact science, not by a long shot.
Good numbers by the way, I don't know what I was smoking when I wrote the message, but I can see exactly where I went wrong.
BTW, I don't smoke, a long and distant memory (1981).