Type 2 diabetic but not overweight.

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JulieG11

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Hello there. I was diagnosed with type 2 diabetes about a year ago. My hbA1c result was 148! I was prescribed metformin initially but that was changed to glimepiride. My levels came down to 68 last time I was checked.
I do finger prick tests every day but my levels have recently started going up again. I am 5 ft 2 inches tall and weigh about 7.5 stone so my BMI is almost too low. I eat a fairly reasonable diet and run twice a week. Every time I research diabetes online it always says that losing weight is the best way to get your glucose levels down and nothing is mentioned about if you are underweight.
I was diagnosed with breast cancer in Nov 2020 and am now taking anastrozole and ibandronic acid. I am convinced that these may have caused my diabetes. My blood sugar levels started going up when my brand of anastrozole was changed too.
Does anyone have any suggestions that might help me to get my levels down?

Thank you in advance, Julie
 
Welcome Julie,

Sorry to read about your breast cancer and diabetes.
Sadly, a lot of diabetes literature and research forgets about those of us who do not need to lose weight.
Firstly, I need to caveat everything I write with "I am not a doctor". My knowledge is based on my personal experience and what I have picked up along the way.

Two things come to my mind reading your post
  1. How was the diagnosis made and was there any check to conform the type of diabetes? More than half the people with Type 1 diabetes were diagnosed as adults but there are still doctors who assume it is a childhood disease so over 30% of people diagnosed with Type 1 as an adult were first misdiagnosed with type 2. Maybe I am obsessed with this but as your BG is rising and you have a low BMI, this maybe something worth investigating.
  2. What is your "fairly reasonable diet"? The traditional healthy low fat diet is not great for people with type 2 diabetes who are unable to manage carbs. Many find that a low carb diet is best for managing their BG. Adding more fat can help to maintain weight. This can be through healthy fattier foods such as nuts and avocado.
 
juliegimblett@hotmail.co. said:
Hello there. I was diagnosed with type 2 diabetes about a year ago. My hbA1c result was 148! I was prescribed metformin initially but that was changed to glimepiride. My levels came down to 68 last time I was checked.
I do finger prick tests every day but my levels have recently started going up again. I am 5 ft 2 inches tall and weigh about 7.5 stone so my BMI is almost too low. I eat a fairly reasonable diet and run twice a week. Every time I research diabetes online it always says that losing weight is the best way to get your glucose levels down and nothing is mentioned about if you are underweight.
I was diagnosed with breast cancer in Nov 2020 and am now taking anastrozole and ibandronic acid. I am convinced that these may have caused my diabetes. My blood sugar levels started going up when my brand of anastrozole was changed too.
Does anyone have any suggestions that might help me to get my levels down?

Thank you in advance, Julie
Click to expand...
Even if you don't need to lose weight then by following a low carb dietary approach with plenty of protein and healthy fats will help your blood glucose levels but maintain weight.
Have a look at this link as that might give you some ideas about modifying your diet, many think they are eating a healthy diet but that is not always the case as it is still too high in carbs.
lowcarbfreshwell.com

Freshwell Low Carb Project - Home

lowcarbfreshwell.com lowcarbfreshwell.com
 
Hi @JulieG11 and welcome to the forum. Yes, there are a lot of us about who do not fit the media stereotype for T2 diabetes. It is true that losing weight is a good bet for controlling blood glucose but that only makes sense if you have the weight to lose. It is not good advice if, like you and me, @helli and a lot of others, you have not.

Looking at reducing your carb intake is a possible way forward - it is my primary control. No need to go mad, just use your meter to look at the sort of rises in BG you get after eating and look to see how that is affected to what you eat. Then make some deliberate changes to reduce carbs in meals and see how that affects the rise. If you read around the forum you will find many ideas about carb reduction, go for things that suit you and your lifestyle.

Above all, keep talking to your GP/DSN. If your medications for other conditions are a problem, then they should be able to look at alternatives.
 
I agree with @helli , @JulieG11 In your position, I’d want Type 1 ruled out. I’m sorry to hear about your cancer diagnosis. Is there a possibility that the drugs damaged your pancreas and it can no longer produce enough insulin for your needs? A C Peptide test would be useful as that would show how much insulin you’re producing, and is also one of the two Type 1 tests (the other being the Type 1 antibodies).

Are you using something like MyFitnessPals to count your calories? I use that to put on weight as I’m naturally very slim. You can set a daily target then make sure you eat up to that number. Avocados and nut butters are good for weight gain.
 
JulieG11 said:
I was diagnosed with breast cancer in Nov 2020 and am now taking anastrozole and ibandronic acid. I am convinced that these may have caused my diabetes. My blood sugar levels started going up when my brand of anastrozole was changed too.
Click to expand...

Sorry to hear about your diabetes diagnosis. But so pleased you survived your breast cancer @JulieG11

This systematic review into raised glucose following breast cancer treatment seems to link it more to weight gain which is apparently common during chemo.


When multiple medical things happen in sequence it’s only natural to join the dots between them, but I wonder if this was just an unfortunate coincidence in this case? Particularly if you do end up having T1 or LADA - which are autoimmune in nature and just happen with their own inconvenient timings
 
helli said:
Welcome Julie,

Sorry to read about your breast cancer and diabetes.
Sadly, a lot of diabetes literature and research forgets about those of us who do not need to lose weight.
Firstly, I need to caveat everything I write with "I am not a doctor". My knowledge is based on my personal experience and what I have picked up along the way.

Two things come to my mind reading your post
  1. How was the diagnosis made and was there any check to conform the type of diabetes? More than half the people with Type 1 diabetes were diagnosed as adults but there are still doctors who assume it is a childhood disease so over 30% of people diagnosed with Type 1 as an adult were first misdiagnosed with type 2. Maybe I am obsessed with this but as your BG is rising and you have a low BMI, this maybe something worth investigating.
  2. What is your "fairly reasonable diet"? The traditional healthy low fat diet is not great for people with type 2 diabetes who are unable to manage carbs. Many find that a low carb diet is best for managing their BG. Adding more fat can help to maintain weight. This can be through healthy fattier foods such as nuts and avocado.
Click to expand...
Hi there,
My diabetes was diagnosed following a blood shot eye! I was sent to the eye hospital and told I had retinal vein occlusion and advised to get a vascular check up with my GP. It was at that check up that I was diagnosed.
Interesting what you say about type 1. I will mention this to my diabetic nurse.
 
Inka said:
I agree with @helli , @JulieG11 In your position, I’d want Type 1 ruled out. I’m sorry to hear about your cancer diagnosis. Is there a possibility that the drugs damaged your pancreas and it can no longer produce enough insulin for your needs? A C Peptide test would be useful as that would show how much insulin you’re producing, and is also one of the two Type 1 tests (the other being the Type 1 antibodies).

Are you using something like MyFitnessPals to count your calories? I use that to put on weight as I’m naturally very slim. You can set a daily target then make sure you eat up to that number. Avocados and nut butters are good for weight gain.
Click to expand...
Hello there.
I had a scan on my pancreas because I am not a typical candidate for type 2 diabetes. It didn't show any abnormalities apart from some kind of cyst which was checked further.
 
JulieG11 said:
I had a scan on my pancreas because I am not a typical candidate for type 2 diabetes.
Click to expand...
Likewise, and mine showed no abnormalities either. As an added bonus my GP had asked for a complete upper body scan - neck to groin - and all my other internal organs showed nothing untoward either.
 
everydayupsanddowns said:
Sorry to hear about your diabetes diagnosis. But so pleased you survived your breast cancer @JulieG11

This systematic review into raised glucose following breast cancer treatment seems to link it more to weight gain which is apparently common during chemo.


When multiple medical things happen in sequence it’s only natural to join the dots between them, but I wonder if this was just an unfortunate coincidence in this case? Particularly if you do end up having T1 or LADA - which are autoimmune in nature and just happen with their own inconvenient timings
Click to expand...
I found the article interesting as I was diagnosed with breast cancer in April 2019 - successfully treated by surgery and chemo. Like Julie I am on anastrozole for another 5 years. I don't think I put on any weight during the treatment but have since lost weight as now on low carb diet . I was diagnosed with type 2 May 22. However diabetes is 'endemic ' in my family so with me I think it is more genetic factors than cancer treatment.
 
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