Skinny Type 2

[SkinnyD]

Hi all

First post - please be kind!

Two months ago, I was diagnosed as type 2. I found my GPs to be more interested in me as a case study rather than a patient though, because I was not overweight.

Have been trying to get up to speed with everything, what to do, not to do etc. However, so much information out there has a starting base that to be type 2, I must be overweight...

Some background - five years ago a blood test revealed I had very high cholesterol. I was overweight then, so wanted to lose weight rather than take statins. I got back down to a normal weight, but the cholesterol stayed high.

During those checks, my blood sugar was also recorded. A score of 43 came up two years ago. In mid 2019 that hit 48 - due to the time taken to get the results from my GP, a retest in late 2019 came up with 49...

I was immediately put on metformin (and statins). Normally I am active every day - a brisk 20 mins walk to work and the 20 mins back later. So, I have further cut out all sweet food (I wasn't eating that much anyway), turned white bread to brown, potatoes for sweet potatoes, brown rice... Food portions are strictly limited. Lots of veg, an apple day etc (concentrated orange juice in the morning has been banished though)

The result - I have lost a further 7kg and am probably underweight now. Doctor says I should get my blood sugars checked after three months of the diabetes diagnosis - so, the first week of March. Could be another 3kg down by then, which I have mixed feelings about to be honest.

Is this what I am supposed to be doing? Any advice appreciated!

 

[Toucan]

Hello @SkinnyD and welcome to the forum.
Yes, there is a lot of information around, and it can be confusing.
It sounds as if you are doing many of the right things to help your diabetes, with your walking and moving your diet away from sweet things. You may need to find out what other foods cause your Blood sugar levels to increase, and a good way to do this is by using a monitor to measure before and 2 hours after eating.
There is some useful information on the link test-review-adjust regarding this.
There is further general information for Type 2 s on the thread at the head of this section 'Information for Newbies' scroll down to the Type 2 section.

 

[rebrascora]

Hi and welcome.

Firstly I am surprised that they have started you on Metformin when your HbA1c is only just into the diabetic range. Can you give us an idea of how high your Cholesterol is? How are you managing with those medications? Hopefully no side effects.

Secondly, carbohydrates are carbohydrates, even brown so called healthy ones, so you might need to look at reducing your carb portions or even replacing them/some of them with low carb alternatives. If you need to stabilise your weight, then introducing more natural fat into your diet will help both to make you feel fuller for longer, provide you with slow release energy and slow or stop your weight loss. Not only that but more importantly it makes a low carbohydrate diet enjoyable and therefore sustainable.
Do you have a family history of cardiovascular disease? If so, a Mediterranean style diet might be best for you using mostly olive oil and oily fish and avocados and nuts as your sources of fat whereas many of us use full fat dairy (butter, cream, cheese creamy yoghurt etc) and fatty meat as well as those others I have mentioned.

Getting a Blood Glucose Meter and testing yourself to see what effect foods have on your levels will help you to tailor your diet to your individual diabetes, because we are all different in our tolerance for the carbs in certain foods and our ability to digest them, due to the variance of the individual gut biome. If your doctor is interested in you as a "unusual lab specimen" then he might be prepared to supply and fund a BG meter but if not, they are relatively inexpensive to buy (Apporx £15), but the on going cost of purchasing test strips can run up the finances and for that reason the SD Gluco Navii or the Spirit Health TEE2 blood glucose Meters which have the cheapest test strips @ £8 for 50 are recommended here on the forum.

It is also possible that you are not Type 2 but perhaps a form of slow onset Type 1 (sometimes referred to as Type 1.5 or Latent Autoimmune Diabetes in Adults or LADA) You get a diabetes diagnosis if your HbA1c becomes 48 or above and Type 2 is assumed if you are not a child or young person and or you are overweight. many GPs have no idea that Type 1 can develop at any age or that LADA exists. In the early stages of LADA, the patient may respond to Type 2 medication and/or diet changes, but eventually their pancreas will dry up and insulin becomes necessary. GAD antibody tests and C-peptide tests may not ID LADA in the early stages either so quite a few people get misdiagnosed or assumed Type 2 with no additional testing.

Hopefully that is not too much information overload, but if so apologies.

 

[SkinnyD]

Thanks for the replies.

Cholesterol came in at 7.0 for bad and 0.5 for good.

Two years of low sat fats consumption, weight loss, five plus portions of fruit and veg a day, porridge and granola resulted in 5.8 and 0.9 respectively. I think it's genetic and was likely the death of my poor grandfather (although they didnt check such things in his time).

Been on statins for two months. Initial twinges of muscle pain, which I was prepared for, have subsided. I am on the strongest category though.

I definitely have type 2 diabetes. Had a proper blood test to rule out LADA. The nurse taking my blood sample still had to ring my GP for clarification beforehand though. "Are you sure...? He doesn't look like a diabetic..."

Based upon what I have been trying to learn, a lot of the cholesterol lowering suggestions must raise blood sugar. Porridge, granola (which is sugary) and I was having lots of fruit each day - large banana, orange from concentrate). Other thought is that I have fatty cholesterol in my pancreas which is affecting insulin production. Any further weight loss, hopefully temporary, could shift that?

Just read your background Barbara and feel for all you must be going through.

 

[Drummer]

I was told to eat exactly those things for my high cholesterol - made not a bit of difference to that but I was almost spherical at diagnosis.
Type two diabetics cannot cope with starch or sugar - the sweet potato is higher in carbs than an ordinary one, so you are not doing anything towards lowering blood glucose.
I thing it very bad advice to tell someone to lower cholesterol at the cost of higher blood glucose levels - as high blood glucose is a known offender, but cholesterol is yet to be properly examined.

 

[SkinnyD]

A lot of good points there. I had an MRI just recently to check the damage to my arteries from five plus years of high cholesterol. Result? Zip. No sign of any adverse effects there whatsoever. Separate checks shows I have a resting heart rate of 55, supposedly excellent for my age.

 

[rebrascora]

At this early stage I think it is possible that LADA tests might not show up as your pancreas is clearly still producing plenty of insulin considering your minimally diabetic HbA1c result. If it was in the 70+ range it might be more obvious, but there have been Type 2 members of the forum (and some only negligibly overweight) with HbA1c results in the region of 100, who have brought it down into the normal range with low carb diet and exercise.

As regards my diabetes, I will confess I was gutted at diagnosis (the day after my birthday last year) and more gutted still (I shed a few tears) when I had to start on insulin 6 weeks later but actually I have a much healthier and enjoyable low carb high fat diet now and I lost a stone and a half which feels a whole lot better and I now fit into clothes I haven't worn for 30 years and I get regular health checks and make more time to look after my feet which have been painful for years with dry skin and keens and on the whole I think there are possibly more silver linings than negatives to the diagnosis although I still feel guilty that I am such a burden to the NHS.

 

[SueEK]

Hi @SkinnyD , definitely a myth that you have to be overweight to have T2. Many of us here are not overweight, never have been, no family history and yet here we are. Fortunately your levels are not too high and with a bit of adaptation you should be able to lower them. Increased my fat intake as I did not want nor need to lose any further weight and have managed to stabilise it plus keep my levels fairly low. Surprisingly my cholesterol which was high has come down to a normal range. As you can see I am also on a statin and medication for the diabetes and I’m sure if you take the advice above you will manage well. Good luck x

 

[everydayupsanddowns]

A lot of good points there. I had an MRI just recently to check the damage to my arteries from five plus years of high cholesterol. Result? Zip. No sign of any adverse effects there whatsoever. Separate checks shows I have a resting heart rate of 55, supposedly excellent for my age.

Good that your MRI and resting heart rate show a healthy CV system.

There are some who suggest the problem with cholesterol is more connected with inflammation of blood vessels than the cholesterol itself. An acquaintance on another forum has had very high cholesterol for years (though with higher HDL than yours if I remember right) and similarly had an ‘all clear’ scan of blood vessels a year or two back.

Having said that, many large scale studies do show reduced relative risk at lower cholesterol levels.

T2 at normal weight or underweight is not common, but certainly not all that unusual. I’ve heard estimates of 10-20% of cases being normal weight or lower at diagnosis, but I don’t have a source for those numbers. Some people at normal weight do have high levels of ‘visceral fat’ around organs which inhibits their ability to work efficiently. Sometimes called TOFI (thin outside, fat inside)

 

[Nick Cliff]

Hi @SkinnyD. Sorry to learn of your diagnosis but welcome to the club.... the club of skinny type 2's in our case. Your posts indicate our symptoms and physiology seem quite similar (my numbers are in my signature and profile). Main difference is that I've had my diagnosis 10 years and it's only now that medication seems to have become necessary. So, once you have the condition under control you will hopefully find it to have only a limited impact on your life and lifestyle - and hey, who needs cake and chocolate anyway!
In my experience the NHS reaction is to quickly get you on to medication, without necessarily giving you the chance to improve diet and exercise, so it may be that being on medication may not be permanent. In my case I also had cholesterol above the limit when diagnosed with Type 2. However I didn't tolerate the prescribed statin, and after a trial stoppage I have not since had a cholesterol reading over the limit. Though "past performance is no guarantee of future performance"....
As a number of people have said, it's not just ditching things with added sugar, but reducing carb intake - something I have learnt recently from members of this forum - though for people like us there's a balance between reducing blood sugar and wasting away entirely 🙂. We're all different so there is no single, simple formula. I agree that using a blood sugar monitor to review the impact of different foods and diet choices will be informative. The most informative being to test before you eat, then 2 hours after finishing the meal.
Be good to know how you get on.
Regards, Nick.

 

[Docb]

And Hi SkinnyD from another skinny T2. What you will find is that you will have to turn your mind off when you hear the diabetes gurus telling all and sundry (including you) that your diabetes will go away if you lose umpteen kilos in weight. If you don't then you risk high blood pressure from shouting at people or the radio or the telly.

What I have found is that reducing my carb intake to a level that my system can cope with has done the trick. When it comes to pills, gliclazide, which is said to promote insulin production has a small but significant effect but even with it anything over much over 30g of carbohydrate taken in one dose will push my blood glucose into double figures before my pancreas sorts it out. My rank amateur interpretation is that for some reason other than getting overweight my pancreas has been getting less efficient as I have been getting older. It looks at the moment that as long as I don't overburden it, my blood glucose levels will say "normal".

 

[SkinnyD]

Hi all - thanks for the comments. Great to no longer feel alone in the unfamiliar circumstances I find myself. I think I can do more to reduce carb intake - will endeavour to replace that with more fat to stem further weight loss.

 

[Pine Marten]

Hi @SkinnyD, nothing to add to the excellent advice and information from the others except to say welcome to the forum!

If you have any questions do feel free to ask, and the good folk here will be pleased to help 🙂

 

[SkinnyD]

Hi all

Quick update - blood test came back with a score of 41, down from 49. Took three months of very careful eating, but seems to have paid off. Lost over 10kg in total, but since I was not overweight before I am aiming to put some of that back on, carefully.

 

[Leonora]

Hi there from another skinny diabetic. Great advice on this forum, isn't there? I was in your position and wasting away when I first went low carb. I was advised by forum members to eat more fat, which I have done, and now I'm at a weight I'm happy with. You do need to eat the right fats, though, so be a bit careful if your cholesterol is high. (Though the cholesterol debate is furious and still ongoing. Hahaha.) I added Greek yogurt, nuts and avocados into the mix of my diet and it seemed to do the trick. Good luck and well done on getting your levels down.