Under 40, healthy BMI, but Type 2 Diabetes?

[Rich_036]

Hello - newbie here.

I have recently had a diagnosis of diabetes, and it looks to be Type 2. I'm a little shocked, sad and confused, to say the least.

At diagnosis (in late May) I was 37 years old (now 38) and had a BMI of about 24. I am white British, have a tall (189cm) and generally slim physique (85kg), and have a pretty active lifestyle (football once a week, cycling to work (6 miles) at least once a fortnight).

I do though have a sedentary desk job, and pewny arm muscles (my weight bunches around my middle... which is probably a risk... but my paunch was by no means big). I had drifted up in weight in recent years closer to about 89kg (on the cusp of overweight at 24.9 BMI), but lost some weight earlier this year pre-diagnosis (probably connected) - but I'd say my steady state for the past 8 years was about 87kg.

Is there anyone else who has a similar story? I feel fairly alone in being diagnosed with Type 2 diabetes at what feels like a young age and without significant risk factors.

My HbA1c was 83.

I have been put on metformin and statins. And since my diagnosis have gone on a bit of a crash diet (shakes for lunch, small no-carb dinner) to see if remission may at all be possible. I have also upped my exercise regime. So far I have dropped from a diagnosis weight of about 85kg to about 73kg. My waist size is down to about 30/31 inch.

I have bought a finger-prick glucose monitor and right after diagnosis I had a reading as high as 16mmol/l. But since going on to metformin and with my dieting, I am regularly getting fasting readings in the 5s and (less often) in the 4s. The highest spike I have had in the past month post-prandial is 7.8. While this makes me hopeful for my next HbA1c, clearly my crash diet is not sustainable long-term...

We have family history of autoimmune conditions (celiac, Crohn's, and a rare condition called CREST) - but not diabetes (as far as we are aware). So at first I wondered if it could be LADA. But it does not look like it from my antibody and C-peptide test results.

Given my age I have been particularly worried reading about how early-onset diabetes has more aggressive progression and higher risk of complications. It all sounds horrific...

Looking to hear the experiences of others and to share my story!

 

[Inka]

Welcome @Rich_036 🙂 Weight around the waist is a Type 2 risk. It sounds like you’ve made some great steps to improve things though so I’d hope your next HbA1C reflected that.

Diabetes risk and waist measurement

You might be wondering what waist measurement has to do with your risk of type 2 diabetes. Or what a healthy waist size is. Well, on this page we will explain why it is so important. Our video with Rohit and Usha will show you how to measure your waist properly. If you find that your waist size...

www.diabetes.org.uk

.

 

[saffron15]

@Rich_036 welcome to the forum. If you are type 2 aiming to rid yourself of belly fat and go for remission is a very good idea. Lots of people on here have managed this and I agree given your age to go for remission is a very sensible idea. I'm retired and at diagnosis was fat. It's been a year and I am much less fat!
My guess would be you may be on the cusp of type 1 but I am not a medical professional. A lot more adults are diagnosed 1 than is given credit. There are a number of people on here who were diagnosed type 2 and changed to 1. Your own drastic change of diet may mask it. However given your age ethnicity and weight I assume you've had the appropriate range of tests.
There maybe type 1s who can give more advice.

My Internet went down and I see but have not yet read inkas post - hers are always worth reading.

 

[HayleyR]

Hi @Rich_036 and a very warm welcome from me 🙂 . You've certainly put a great deal of effort in so with any luck your next test will show that it's all been worthwhile. There are lots of friendly Type 2 members here who will be better placed than me to offer advice so hopefully a few will share their experiences. Keep us updated...

 

[sabrina_cyk]

Hello - newbie here.

I have recently had a diagnosis of diabetes, and it looks to be Type 2. I'm a little shocked, sad and confused, to say the least.

At diagnosis (in late May) I was 37 years old (now 38) and had a BMI of about 24. I am white British, have a tall (189cm) and generally slim physique (85kg), and have a pretty active lifestyle (football once a week, cycling to work (6 miles) at least once a fortnight).

I do though have a sedentary desk job, and pewny arm muscles (my weight bunches around my middle... which is probably a risk... but my paunch was by no means big). I had drifted up in weight in recent years closer to about 89kg (on the cusp of overweight at 24.9 BMI), but lost some weight earlier this year pre-diagnosis (probably connected) - but I'd say my steady state for the past 8 years was about 87kg.

Is there anyone else who has a similar story? I feel fairly alone in being diagnosed with Type 2 diabetes at what feels like a young age and without significant risk factors.

My HbA1c was 83.

I have been put on metformin and statins. And since my diagnosis have gone on a bit of a crash diet (shakes for lunch, small no-carb dinner) to see if remission may at all be possible. I have also upped my exercise regime. So far I have dropped from a diagnosis weight of about 85kg to about 73kg. My waist size is down to about 30/31 inch.

I have bought a finger-prick glucose monitor and right after diagnosis I had a reading as high as 16mmol/l. But since going on to metformin and with my dieting, I am regularly getting fasting readings in the 5s and (less often) in the 4s. The highest spike I have had in the past month post-prandial is 7.8. While this makes me hopeful for my next HbA1c, clearly my crash diet is not sustainable long-term...

We have family history of autoimmune conditions (celiac, Crohn's, and a rare condition called CREST) - but not diabetes (as far as we are aware). So at first I wondered if it could be LADA. But it does not look like it from my antibody and C-peptide test results.

Given my age I have been particularly worried reading about how early-onset diabetes has more aggressive progression and higher risk of complications. It all sounds horrific...

Looking to hear the experiences of others and to share my story!

Hi @Rich_036 , welcome to the forum! I am glad to know that you have made positive steps! Hope your next test results will reflect your efforts 🙂
This forum has a lot of supportive people with similar experiences, please feel free to ask any question or share your stories here!

 

[Leadinglights]

It is very good you have already made some changes but finding an enjoyable regime that will be sustainable is a better option, so have a look at this link as it should give you some ideas. https://lowcarbfreshwell.com/

 

[everydayupsanddowns]

I have bought a finger-prick glucose monitor and right after diagnosis I had a reading as high as 16mmol/l. But since going on to metformin and with my dieting, I am regularly getting fasting readings in the 5s and (less often) in the 4s. The highest spike I have had in the past month post-prandial is 7.8. While this makes me hopeful for my next HbA1c, clearly my crash diet is not sustainable long-term...

We have family history of autoimmune conditions (celiac, Crohn's, and a rare condition called CREST) - but not diabetes (as far as we are aware). So at first I wondered if it could be LADA. But it does not look like it from my antibody and C-peptide test results.

Did you have your cPep and antibody checks back as numbers? How many antibodies did they test for? Good that those checks have been done, as it suggests your clinic had an open mind about your diabetes type - particularly in the light of autoimmune conditions in your family (and they do love to flock together!)

Sounds like the changes you have been making are working really well by the look of the changes in your BG meter results - so you could expect to see a positive change of direction in your next Hba1c.

Given your family history though (and the length of time some people with LADA can retain beta cell function and insulin production) in your shoes I’d be keeping an eye over how things go over the coming months/years, just in case things start to drift upwards again despite your best efforts?

 

[HeatherC92]

Hi,

My story sounds very similar to your story, I’m early 30s. Slim at about 47kgs with a bmi of 18. I was diagnosed with an Hba1c of 84 and have done the exact same as you and absolutely crash dieted with virtually no carbs in my diet however I do not intend to loose any weight as this would put me in the underweight category so I’m struggling. My numbers have been similar to yours and I’m not sitting at 5s and 6s while taking metformin.

I have also been tested for all three antibodies and they came back negative.

Sounds like I’m very similar and have very similar worries about early onset .

My mum has type 2 diabetes and was diagnosed at same weight/ lifestyle factors as my self.

 

[Leadinglights]

Hi,

My story sounds very similar to your story, I’m early 30s. Slim at about 47kgs with a bmi of 18. I was diagnosed with an Hba1c of 84 and have done the exact same as you and absolutely crash dieted with virtually no carbs in my diet however I do not intend to loose any weight as this would put me in the underweight category so I’m struggling. My numbers have been similar to yours and I’m not sitting at 5s and 6s while taking metformin.

I have also been tested for all three antibodies and they came back negative.

Sounds like I’m very similar and have very similar worries about early onset .

My mum has type 2 diabetes and was diagnosed at same weight/ lifestyle factors as my self.

Welcome to the forum, a few people indeed do have a similar story to yourselves and many of the dietary regimes assume that weight loss is needed so although you need to limit your carb intake you need to replace those carbs with protein and healthy fats to maintain your weight as in the absence of carbs you have to get your energy from somewhere and that has to be those foods.
I recommend this link as it should point you in the right direction. https://lowcarbfreshwell.com/

 

[trophywench]

You sound to me like you're what is known as TOFI - thin outside, fat inside. Hence you just don't look like you need to lose weight but to be honest, most of us could do with losing a bit in middle age, just that most of us don't bother until OOOPS, now I've ben told I have type 2 diabetes.

 

[Rich_036]

Thank you everyone for your warm wishes - bowled over and really grateful for your thoughts!

@HeatherC92 that is so intriguing you are in a similar situation. I’m amazed you had a HbA1c of as high as that with such an age and BMI. Perhaps the family history is a key - I’m not aware of any T2D in my family, but perhaps there might have been at some point in history without us knowing. But to be in our 30s and low BMI feels really odd. It’s a lot to take in isn’t it. I hope you are OK and hope things go well! Do stay in touch.

@everydayupsanddowns my Cpep number was 964 pmol/L. On my NHS app it shows the GAD test, but the result says ‘not tested. Negative for GAD antibodies by Diabetes screen’. As this suggests, there is also a result for a Diabetes AB screen (GAD, IA2, ZNT8), and the result there gives an Islet cell antibody level (reading of 2 U/mL). I must admit I don’t quite understand the result, but it gives a reference range of 0-20. From what I have read a reading of 2 isn’t high enough to indicate the presence of antibodies?

Definitely will be keeping an eye on things. In an ideal world I would like to see if I can try to come off metformin (not sure when that would be, but definitely not yet) and try to maintain BG in a non-diabetic range through lifestyle. But I fear this may not be possible and am realistic about that.

 

[Rich_036]

You sound to me like you're what is known as TOFI - thin outside, fat inside. Hence you just don't look like you need to lose weight but to be honest, most of us could do with losing a bit in middle age, just that most of us don't bother until OOOPS, now I've ben told I have type 2 diabetes.

Yes I do fear that. I think you are probably right. Particularly given my body type (scrawny upper body, weight concentrated around belly…). Though at 38 I don’t know if that’s quite yet defined as middle age! Getting there, yes! But under 40 is considered to be early onset diabetes and - while not unheard of - is unusual, isn’t it? Particularly for a healthy BMI and reasonable fitness level.

 

[Eddy Edson]

Hello - newbie here.

I have recently had a diagnosis of diabetes, and it looks to be Type 2. I'm a little shocked, sad and confused, to say the least.

At diagnosis (in late May) I was 37 years old (now 38) and had a BMI of about 24. I am white British, have a tall (189cm) and generally slim physique (85kg), and have a pretty active lifestyle (football once a week, cycling to work (6 miles) at least once a fortnight).

I do though have a sedentary desk job, and pewny arm muscles (my weight bunches around my middle... which is probably a risk... but my paunch was by no means big). I had drifted up in weight in recent years closer to about 89kg (on the cusp of overweight at 24.9 BMI), but lost some weight earlier this year pre-diagnosis (probably connected) - but I'd say my steady state for the past 8 years was about 87kg.

Is there anyone else who has a similar story? I feel fairly alone in being diagnosed with Type 2 diabetes at what feels like a young age and without significant risk factors.

My HbA1c was 83.

I have been put on metformin and statins. And since my diagnosis have gone on a bit of a crash diet (shakes for lunch, small no-carb dinner) to see if remission may at all be possible. I have also upped my exercise regime. So far I have dropped from a diagnosis weight of about 85kg to about 73kg. My waist size is down to about 30/31 inch.

I have bought a finger-prick glucose monitor and right after diagnosis I had a reading as high as 16mmol/l. But since going on to metformin and with my dieting, I am regularly getting fasting readings in the 5s and (less often) in the 4s. The highest spike I have had in the past month post-prandial is 7.8. While this makes me hopeful for my next HbA1c, clearly my crash diet is not sustainable long-term...

We have family history of autoimmune conditions (celiac, Crohn's, and a rare condition called CREST) - but not diabetes (as far as we are aware). So at first I wondered if it could be LADA. But it does not look like it from my antibody and C-peptide test results.

Given my age I have been particularly worried reading about how early-onset diabetes has more aggressive progression and higher risk of complications. It all sounds horrific...

Looking to hear the experiences of others and to share my story!

I was older than you (57) and a bit podgier (BMI 25 point something) but otherwise maybe similar. The big thing is not BMI but visceral fat, and the best proxy measure for that is wast-to-height ratio: over 0.5 means high likelihood of visceral fat accumulation => liver insulin resistance => pancreas fat => insulin insufficiency => T2D.

At diagnosis my W2H was 0.54 and my HbA1c was 89.

(Note that "waist" here isn't trouser size - https://www.nhs.uk/health-assessment-tools/calculate-your-waist-to-height-ratio.)

Losing 10kg brought things back into line for me. I restricted carbs along the way because people say you should, but this certainly wasn't the cause of the weight loss and I doubt that it made much difference to how fast I got to "remission". These days I eat lots of healthy carbs (fruit, wholegrains) and it's just fine.

The good thing is that starting from a low-ish BMI is that you probably need to lose less weight to normalise things and, more importantly, it may be easier to keep the weight off. Simple mindedly: the fact that I wasn't obese or particularly overweight to start with, despite being hardly at all mindful of what I ate, probably indicates that I'm less subject to powerful urges to eat. In practical terms, easier to cut junk & keep it cut, with a little bit of effort and mindfulness.

 

[HeatherC92]

@Rich_036 i do wonder if genetics play a big factor in my case. I am getting my c peptide tested however it was taken non fasted so I do wonder how much this is going to be accurate from what I’ve read. I live in Scotland and don’t have access to my medical records through an app yet so all I know is that my antibodies are “negative” it would have interesting to compare

 

[JimmyBlue]

@Rich_036 firstly welcome to the forum and like I did when I joined last October, the vast amount of knowledge here is impressive and very helpful.
I was diagnosed last October with a HbA1c of 86 and am now, according the diabetes nurse officially in remission. While I am older than you (63 at diagnosis) I was also around 84kg, wait was around 32/34 and at 6'2" definitely did not feel that I was in the diabetes risk zone. I also ran at least once and often twice a week, while also doing a lot of walking. When I met the diabetes nurse she called me an atypical diabetes patient. I also did exactly the same as you, cut the carbs to less than 50g/day for about a six weeks and upped my exercise levels which led to significant weight loss . I took 1 tablet of metformin reluctantly for 12 weeks following a bout of ill health in mid-November but stopped in mid February this year. My HbA1c is now down to 46 and if I am lucky it will fall further over the coming months.
My diet is a little carb richer now but still less than 130g/day and I have managed to put a about 1kg of weight back on but I am still under 80kg and there are days when it all comes off again and I am in the 73.5 to 74.5kg range. My waist is 31/32 which is a pain as I am slowly replacing my wardrobe to address this fall.
When I looked back at what may have triggered type 2, the fatty liver issue is certainly one possible factor as like you my weight was all around my waist. However, I also realised that my love of bread and rice may not have helped nor the lonely drives between home and the various places my projects took me which allowed me to eat sweet stuff or packaged foods like sausage rolls, Cornish pasties and other such delicacies. I also had to live away due to some projects and this meant eating out on a regular basis. Whether this is the cause of my diabetes I cannot definitively say, but the lifestyle clearly wasn't healthy even though I did some exercise at the time.
The other factor which may have been material for me, is stress. My work was often stressful and particularly the last six years before I retired in December last year. I notice that my BG may go up higher than normal when I get stressed even now (normally a bad round of golf) but in the main my BG tests are pretty good with a fasting level of around 5.4 to 6.4 and two hours after dinner in the 7.8 to 8.4 range.
You need to figure out what level of carbs you need to keep your BG in a good place, but it is likely to be higher than where you are now. Also check your calories to make sure that your intake is enough to maintain your lifestyle. I exercise most days and currently consume between 2,500 and 3,000 calories a day.

 

[JITR]

Hello - newbie here.

I have recently had a diagnosis of diabetes, and it looks to be Type 2. I'm a little shocked, sad and confused, to say the least.

At diagnosis (in late May) I was 37 years old (now 38) and had a BMI of about 24. I am white British, have a tall (189cm) and generally slim physique (85kg), and have a pretty active lifestyle (football once a week, cycling to work (6 miles) at least once a fortnight).

I do though have a sedentary desk job, and pewny arm muscles (my weight bunches around my middle... which is probably a risk... but my paunch was by no means big). I had drifted up in weight in recent years closer to about 89kg (on the cusp of overweight at 24.9 BMI), but lost some weight earlier this year pre-diagnosis (probably connected) - but I'd say my steady state for the past 8 years was about 87kg.

Is there anyone else who has a similar story? I feel fairly alone in being diagnosed with Type 2 diabetes at what feels like a young age and without significant risk factors.

My HbA1c was 83.

I have been put on metformin and statins. And since my diagnosis have gone on a bit of a crash diet (shakes for lunch, small no-carb dinner) to see if remission may at all be possible. I have also upped my exercise regime. So far I have dropped from a diagnosis weight of about 85kg to about 73kg. My waist size is down to about 30/31 inch.

I have bought a finger-prick glucose monitor and right after diagnosis I had a reading as high as 16mmol/l. But since going on to metformin and with my dieting, I am regularly getting fasting readings in the 5s and (less often) in the 4s. The highest spike I have had in the past month post-prandial is 7.8. While this makes me hopeful for my next HbA1c, clearly my crash diet is not sustainable long-term...

We have family history of autoimmune conditions (celiac, Crohn's, and a rare condition called CREST) - but not diabetes (as far as we are aware). So at first I wondered if it could be LADA. But it does not look like it from my antibody and C-peptide test results.

Given my age I have been particularly worried reading about how early-onset diabetes has more aggressive progression and higher risk of complications. It all sounds horrific...

Looking to hear the experiences of others and to share my story!

If it looks like an elephant ("weight around middle for past 8 years") and sounds like an elephant ("very low calorie diet" leading to "weight loss: 14 kg" and "waist: 30-31") then it probably is an elephant ("Type 2") *.

I lost 22 kg to get my HbA1c and waist down to where I wanted them to be. Keeping them there seemed challenging at first, but proved easy enough once I realised eating a healthy diet of natural foods and monitoring my weight was the name of the game.

Tip: I have used Cronometer, an app designed to monitor my macronutrients and micronutrients, since day 1 for weight loss and now for maintenance.

* Listen to Prof Roy Taylor's "Information for Doctors".

 

[Eddy Edson]

I

Tip: I have used Cronometer, an app designed to monitor my macronutrients and micronutrients,

Another vote for Cronometer here, tho not so much nowadays as my diet has settled down into an embarassingly fixed pattern,

 

[Rich_036]

I was older than you (57) and a bit podgier (BMI 25 point something) but otherwise maybe similar. The big thing is not BMI but visceral fat, and the best proxy measure for that is wast-to-height ratio: over 0.5 means high likelihood of visceral fat accumulation => liver insulin resistance => pancreas fat => insulin insufficiency => T2D.

At diagnosis my W2H was 0.54 and my HbA1c was 89.

(Note that "waist" here isn't trouser size - https://www.nhs.uk/health-assessment-tools/calculate-your-waist-to-height-ratio.)

Losing 10kg brought things back into line for me. I restricted carbs along the way because people say you should, but this certainly wasn't the cause of the weight loss and I doubt that it made much difference to how fast I got to "remission". These days I eat lots of healthy carbs (fruit, wholegrains) and it's just fine.

The good thing is that starting from a low-ish BMI is that you probably need to lose less weight to normalise things and, more importantly, it may be easier to keep the weight off. Simple mindedly: the fact that I wasn't obese or particularly overweight to start with, despite being hardly at all mindful of what I ate, probably indicates that I'm less subject to powerful urges to eat. In practical terms, easier to cut junk & keep it cut, with a little bit of effort and mindfulness.

Thanks for your thoughts!

Have just measured my waist and currently 0.44 W2H, but this is after losing c10kg, so maybe I was over 0.5 pre diagnosis.

How long did it take to go into remission/how did you know you’d got there? How long have you managed to keep it down, and has it been tough? Sounds like you’ve done really well!

Also hopeful I can cut and maintain things. I didn’t pay too much attention to what I ate (at 37, and seemingly physically fit, it didn’t feel vital just yet… but clearly was an issue). So feels like lots of changes that can be made (and already have) easily… fingers crossed…

 

[Rich_036]

If it looks like an elephant ("weight around middle for past 8 years") and sounds like an elephant ("very low calorie diet" leading to "weight loss: 14 kg" and "waist: 30-31") then it probably is an elephant ("Type 2") *.

I lost 22 kg to get my HbA1c and waist down to where I wanted them to be. Keeping them there seemed challenging at first, but proved easy enough once I realised eating a healthy diet of natural foods and monitoring my weight was the name of the game.

Tip: I have used Cronometer, an app designed to monitor my macronutrients and micronutrients, since day 1 for weight loss and now for maintenance.

* Listen to Prof Roy Taylor's "Information for Doctors".

Yep - agree. Though I think if you’d seen my figure pre-diagnosis, you’d see that description of myself (weight round the middle) is a bit unfair on myself. Just a small paunch. Still in healthy BMI (though in hindsight too close to comfort to overweight) And also at 37 I thought there wasn’t a risk. My GP was very surprised at the HbA1c of 83.

But yes in hindsight I’m thinking more on it. Have also read Roy Taylor’s book since and now know a lot more.

Glad to hear you made great progress and that it was easy after a time to maintain. Gives me hope!

 

[Eddy Edson]

Assuming you have this kind of T2D, losing 10kg is likely enough to have zapped it.

Check out the DUK-sponsored ReTUNE trial, weight-loss remission for people with baseline BMI sub 27: https://www.diabetes.org.uk/about-us/news-and-views/retune-study-lower-body-weight Avg baseline BMI about 25, and avg weight loss required to get to remission 8%.

It took me about 9 months to get there. Based on HbA1c but really I knew things had normalised when my fasting BG was down below 5.0 mmol/l consistently.

That was September 2018, so I've maintained the weight loss & normalised glucose regulation for coming up to 7 years. It hasn't really been that big a deal, but that's because I got lucky with my genes in terms of hunger & satiety.