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BMi reading just in
- Thread starter Darren w
- Start date
- Status
Lauras87
Well-Known Member
- Relationship to Diabetes
- Type 1
I know it's driving you mad but you are classed as normal with the bmi you've given
Darren w
Well-Known Member
- Relationship to Diabetes
- Type 2
I will quote the letter
Mr w was reviewed at an outpatient appointment on 9th may by my colleague (dsn) and I .
Mr w is using levimere insulin 18 units am and 8 units pm , he reported no recent hypos . Blood glucose levels are 10 -17 mmols /l , with the occasional reading of 6/7 mmols /l metformin is also taken . Some mornings the patient reported waking late and missing dose of levimere , approx 1/2 times a week
Dietary intake consists of breakfast ( 3. Shredded weat) and an evening meal . Eg steak and chips .
The paitiant is concerned with his low weight . Previous the paitiant reports a weight of 75kg (15% loss) .
I would be greatful of you could please prescribe supplements 3 per day for 2 months for the indication of disease related malnutrition .
Fortis up bottle 3x day = 900cals and 36g protein
I have enclosed a form for paitiant .... Etc ..
That's end of letter . Any help I would like to exept please guys and girls . Daz x
Mr w was reviewed at an outpatient appointment on 9th may by my colleague (dsn) and I .
Mr w is using levimere insulin 18 units am and 8 units pm , he reported no recent hypos . Blood glucose levels are 10 -17 mmols /l , with the occasional reading of 6/7 mmols /l metformin is also taken . Some mornings the patient reported waking late and missing dose of levimere , approx 1/2 times a week
Dietary intake consists of breakfast ( 3. Shredded weat) and an evening meal . Eg steak and chips .
The paitiant is concerned with his low weight . Previous the paitiant reports a weight of 75kg (15% loss) .
I would be greatful of you could please prescribe supplements 3 per day for 2 months for the indication of disease related malnutrition .
Fortis up bottle 3x day = 900cals and 36g protein
I have enclosed a form for paitiant .... Etc ..
That's end of letter . Any help I would like to exept please guys and girls . Daz x
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Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
Hi Darren, please be reassured that your weight, whilst on the low side, is not so bad. You are about 3 points above what I was at diagnosis, and in fact until I was 30 years old my BMI was around 17.5. I think you need to go back to your GP as you need to discuss with someone your perceptions about your weight and appearance. It's not uncommon to feel this way, so you are not alone in worrying, but you need to discuss it with someone. Is this a new thing for you in recent months? How much weight have you lost recently to make you feel this way?
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
Darren is fairly recently diagnosed and just on levemir, so his doses are probably still under review from his team.
Have to say, it sounds very much to me like you are a Type 1.5 (a slow-onset Type 1) rather than a Type 2 Darren. When are you next due to see your GP? Ask him/her for clarification about your diagnosis. How often are you testing your blood sugar levels? Have you started a food diary so that you can assess your food intake properly? Sorry for all the questions, but it will help people to make suggestions of where to seek help and how to tackle things. You don't need to feel this way, but you do need help to lift you out of the negative feelings you are having.
Copepod
Much missed Moderator
- Relationship to Diabetes
- Type 1
Here's a bit more explanation of BMI, with a calculator - you can enter weight and height in either metric or imperial units. http://www.nhs.uk/tools/pages/healthyweightcalculator.aspx?WT.mc_id=101007
This BBC website http://www.bbc.co.uk/health/tools/bmi_calculator/bmi.shtml allows you to slide across a graph, which shows you easily how changing just weight can affect BMI. More difficult to change height, once you're an adult, although as it's virtually impossible to measure your own hight correctly, and most people tilt their head forward, with proper measuring, many adults "gain" about 1cm in height.
A BMI of 20.9 is clearly within normal range (18.5 to 25.0). When your weight was 75kg, with same height 5ft 11in, your BMI was 23.07, also within the healthy BMI range.
However, the fact remains that you are concerned, so you need a better explanation from the professionals dealing with you. Analysis of body compostion (% of fat, muscle, water etc) would be helpful. Some gyms have such scales - you stand on with bare feet; some machines are more sophisticated and have handles, too, so composition can be calculated for each limb. Your results on a single day aren't so important as changes from week to week or month to month.
The letter gives you the ideal reason to go back to your GP and ask them to explain. And while you're there, ask to have body composition calculated and referral to a dietician.
This BBC website http://www.bbc.co.uk/health/tools/bmi_calculator/bmi.shtml allows you to slide across a graph, which shows you easily how changing just weight can affect BMI. More difficult to change height, once you're an adult, although as it's virtually impossible to measure your own hight correctly, and most people tilt their head forward, with proper measuring, many adults "gain" about 1cm in height.
A BMI of 20.9 is clearly within normal range (18.5 to 25.0). When your weight was 75kg, with same height 5ft 11in, your BMI was 23.07, also within the healthy BMI range.
However, the fact remains that you are concerned, so you need a better explanation from the professionals dealing with you. Analysis of body compostion (% of fat, muscle, water etc) would be helpful. Some gyms have such scales - you stand on with bare feet; some machines are more sophisticated and have handles, too, so composition can be calculated for each limb. Your results on a single day aren't so important as changes from week to week or month to month.
The letter gives you the ideal reason to go back to your GP and ask them to explain. And while you're there, ask to have body composition calculated and referral to a dietician.
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Hello Darren,
I haven't met you so my opinion is not that relevant. However, the pictures that ypauly posted of you didn't look bad in my eyes. You looked a normal weight. I guess ypauly's opinion would be even more telling though!
But, as Northerner says, you really need to be talking to someone directly and getting to the bottom of your weight loss. Don't delay, start getting the help you need right now.
To be honest, it does seem that your physical health is being affected by you being so low emotionally. I understand (second hand) how this can be so debilitating, but if you get the right help you will get better.
Best wishes,
Andy 🙂
I haven't met you so my opinion is not that relevant. However, the pictures that ypauly posted of you didn't look bad in my eyes. You looked a normal weight. I guess ypauly's opinion would be even more telling though!
But, as Northerner says, you really need to be talking to someone directly and getting to the bottom of your weight loss. Don't delay, start getting the help you need right now.
To be honest, it does seem that your physical health is being affected by you being so low emotionally. I understand (second hand) how this can be so debilitating, but if you get the right help you will get better.
Best wishes,
Andy 🙂
ypauly
Well-Known Member
- Relationship to Diabetes
- Type 1
My opinion is Darren is thin but not freaky thin (though when I pointed this out he pointed out that he was wearing two pairs of trousers). We did have a chat about this but I don't know what's best to fatten somebody up as we are usually reading about the exact opposite and with darren feeling a bit down I don't think his appetite is normal.
We did say that as darren is a smoker and that won't help his appetite that he would 3/4 times a day when he fancied a smoke have a small snack like a biscuit instead, but this will take time to have an affect.
Daz
It will take quite a lot of time as there isn't a magic switch, just a target you can work toward one step at a time.
We did say that as darren is a smoker and that won't help his appetite that he would 3/4 times a day when he fancied a smoke have a small snack like a biscuit instead, but this will take time to have an affect.
Daz
It will take quite a lot of time as there isn't a magic switch, just a target you can work toward one step at a time.
DeusXM
Well-Known Member
- Relationship to Diabetes
- Type 1
One thing I'm surprised no-one's mentioned so far (and sorry if there's a reason for this), but Darren, you really need to start eating more.
You are being prescribed supplements for malnutrition, which suggests to me you need to urgently increase the amount and variety of what you eat. From the notes you kindly posted, I'd wager you probably need to eat another 1000 calories a day just to maintain your weight. I really think you do need to start looking at how you can add more food into your current diet.
While your BMI is 'normal', you're clearly not happy with it and as someone has pointed out, you can easily afford to gain another 10Kg and still be in a normal range.
You also might also be able to make some very easy gains without changing much in your currently lifestyle. If you develop an effective routine for waking up in the morning, you should definitely stop losing and start putting on weight.
Insulin allows you to store fat and stop metabolising your body fat and muscle tissues. If you forget to take your insulin in the morning, it won't matter how much you eat. Your body won't be able to use it, so it'll start eating itself. If you can break the cycle of missing your morning Levemir, you will get your BGs under control, which will do wonders for your state of mind, and you'll also stand a much better chance of getting your weight to where you want it.
Hang in there buddy. I know it's tough. Take baby steps in the first instance, you'll be surprised how far they can take you.
You are being prescribed supplements for malnutrition, which suggests to me you need to urgently increase the amount and variety of what you eat. From the notes you kindly posted, I'd wager you probably need to eat another 1000 calories a day just to maintain your weight. I really think you do need to start looking at how you can add more food into your current diet.
While your BMI is 'normal', you're clearly not happy with it and as someone has pointed out, you can easily afford to gain another 10Kg and still be in a normal range.
You also might also be able to make some very easy gains without changing much in your currently lifestyle. If you develop an effective routine for waking up in the morning, you should definitely stop losing and start putting on weight.
Insulin allows you to store fat and stop metabolising your body fat and muscle tissues. If you forget to take your insulin in the morning, it won't matter how much you eat. Your body won't be able to use it, so it'll start eating itself. If you can break the cycle of missing your morning Levemir, you will get your BGs under control, which will do wonders for your state of mind, and you'll also stand a much better chance of getting your weight to where you want it.
Hang in there buddy. I know it's tough. Take baby steps in the first instance, you'll be surprised how far they can take you.
Redkite
Well-Known Member
- Relationship to Diabetes
- Parent of person with diabetes
Hi Darren,
I agree with DeusXM - I think it would be hugely beneficial to your health and sense of well-being if you could aim for a regular sleep/wake routine and eat 3 meals a day with sufficient calories and nutrients. (Sorry if I've misinterpreted but sounds like you skip lunch?).
Please see your GP (not the diabetes nurse who sounds totally unsympathetic). Make a list of ALL your concerns so you don't come away frustrated - if it's anything like our GPs you might need to make a double appointment to discuss more than one thing. I would suggest you include the following (based on what you've posted):
* feeling depressed - make the GP understand that this is more than just normal anxiety following diagnosis of diabetes.
* losing weight - although you are still a perfectly healthy weight, you have lost 11kg quite quickly. You want to know whether this is due to diabetes reasons (high BGs/lack of insulin), or too few calories, or indeed some other reason if that is what is at the back of your mind.
* is your diagnosis of T2 correct or should you be tested for T1 or another variant?
* could you have another condition e.g. Overactive thyroid which leads to weight loss?
* ask to be referred to a dietician (a.s.a.p.) for proper advice.
* DON'T LET HIM FOB YOU OFF 🙂
In the meantime, I would go as far as saying don't worry too much about your BG levels in the short term. Concentrate on eating 3 balanced meals a day (have you got the Carbs and Cals book to help count calories?), keep a food diary of everything you eat, to take to your dietician's appointment, and take your insulin as prescribed. A pattern will emerge, and you and the doc will be able to see if you need more or less insulin.
Chin up! 🙂
I agree with DeusXM - I think it would be hugely beneficial to your health and sense of well-being if you could aim for a regular sleep/wake routine and eat 3 meals a day with sufficient calories and nutrients. (Sorry if I've misinterpreted but sounds like you skip lunch?).
Please see your GP (not the diabetes nurse who sounds totally unsympathetic). Make a list of ALL your concerns so you don't come away frustrated - if it's anything like our GPs you might need to make a double appointment to discuss more than one thing. I would suggest you include the following (based on what you've posted):
* feeling depressed - make the GP understand that this is more than just normal anxiety following diagnosis of diabetes.
* losing weight - although you are still a perfectly healthy weight, you have lost 11kg quite quickly. You want to know whether this is due to diabetes reasons (high BGs/lack of insulin), or too few calories, or indeed some other reason if that is what is at the back of your mind.
* is your diagnosis of T2 correct or should you be tested for T1 or another variant?
* could you have another condition e.g. Overactive thyroid which leads to weight loss?
* ask to be referred to a dietician (a.s.a.p.) for proper advice.
* DON'T LET HIM FOB YOU OFF 🙂
In the meantime, I would go as far as saying don't worry too much about your BG levels in the short term. Concentrate on eating 3 balanced meals a day (have you got the Carbs and Cals book to help count calories?), keep a food diary of everything you eat, to take to your dietician's appointment, and take your insulin as prescribed. A pattern will emerge, and you and the doc will be able to see if you need more or less insulin.
Chin up! 🙂
Some very good advice given here Darren.
Just a thought, if when you go to the GP you feel you are not being heard or understood - what do you think to printing off your posts on here and taking them with you. (all of them).
Even if the GP doesn't have time to read them in your limited time appointment, maybe you could suggest leaving them with the GP so they can read them when they have more time - and could then maybe contact you to arrange a futher appointment.
I hope you do get some help soon and start to feel better.
Just a thought, if when you go to the GP you feel you are not being heard or understood - what do you think to printing off your posts on here and taking them with you. (all of them).
Even if the GP doesn't have time to read them in your limited time appointment, maybe you could suggest leaving them with the GP so they can read them when they have more time - and could then maybe contact you to arrange a futher appointment.
I hope you do get some help soon and start to feel better.
PattiEvans
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
I note in the first post on this thread where you quote the letter it says BGs are generally between 10 - 17mmol/L. That in itself could very easily be the cause of your weight loss and inability to gain weight. You are eating but your body is unable to use the food you eat which means that the glucose from the food is just sloshing about in your veins whilst your body is eating it's own fat. That's why T1s lose weight before diagnosis, their body is in starvation mode.
Perhaps you aren't T2, or perhaps you are but your pancreas has given up the ghost. It looks like you need a bolus insulin at mealtimes as well as Levemir. Has anyone suggested this to you?
I think it would be worth sitting down with your Doctor and discussing these issues and perhaps suggest to him that you have a trial on a bolus insulin.
Perhaps you aren't T2, or perhaps you are but your pancreas has given up the ghost. It looks like you need a bolus insulin at mealtimes as well as Levemir. Has anyone suggested this to you?
I think it would be worth sitting down with your Doctor and discussing these issues and perhaps suggest to him that you have a trial on a bolus insulin.
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