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Unintentional weight loss

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Carol Nash

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Hi everyone, I’ve just joined the forum and would welcome any insights/advice from members. My husband (70) has had type 2 diabetes for over 15 years. Around two years ago he started losing weight (although at the time he wasn’t overweight). This wasn’t intentional - he has a good balanced diet. He is now looking frail after losing a couple of stone. He has been checked out by the doctor and has had a number of tests but nothing can be found to cause this. I am assuming it is connected to the diabetes and wondered if this had happened to any forum members?
 
Hi, welcome to the forum.
I think a number of people might suggest that despite his age that he may be actually Type 1 or LADA which is not often considered if people are more mature but there are many instances where this is proving to be the case where meds and diet are not keeping levels acceptable and people are loosing weight especially if other causes have been ruled out.
There are tests available that could confirm/ rule out a diabetic reason. So it may be worth while asking for those tests, c-peptide and GAD antibody tests and also an up to date HbA1C.
 
Leadinglights said:
Hi, welcome to the forum.
I think a number of people might suggest that despite his age that he may be actually Type 1 or LADA which is not often considered if people are more mature but there are many instances where this is proving to be the case where meds and diet are not keeping levels acceptable and people are loosing weight especially if other causes have been ruled out.
There are tests available that could confirm/ rule out a diabetic reason. So it may be worth while asking for those tests, c-peptide and GAD antibody tests and also an up to date HbA1C.
Click to expand...
As the OP husband has been T2 for 15 years, unless he has been on insulin for the majority of them it’s pretty unlikely that it could be misdiagnosed T1. The weight loss would have started far earlier than 13 years in, a T1 simply can’t go 13 years without insulin.

How are your husbands blood sugars and what medications is he on? Diabetes only causes weight loss if your levels are high, so it could be something else. Hopefully the GP will find the cause soon.
 
Welcome Carol!

Not being a doctor my opinion isn't worth much, but I would say that there are many possible causes for unintentional weight loss, many of them having nothing to do with diabetes, and in yr position I would keep at yr doc to investigate further.

If it's T2D-related I would have thought you'd also see pretty high BG levels => lots of urination, plus some loss of appetite. (Anyway, I lost some weight before my T2D diagnosis and it was probably due to those factors.)

Good luck getting to the bottom of things!
 
LADA can come on very slowly and although slim it took me around 7 years for to need Basal/Bolus insulin. I wouldn't bother with a GAD test but a C-Peptide would show what his insulin level is and what action might be needed.
 
It rather depends on the medication he was on if you consider LADA. An ageing pancreas that has been flogged by medications to produce insulin, it may well have given up the ghost and become unable to produce insulin. That might be an explanation, but I agree with @Eddy Edson that you would expect high BGs and other symptoms like excess urination if that were the cause.

There are a standard list of tests for unexplained weight loss, including Addison's disease, so I wonder if all relevant tests have been carried out.
 
Carol Nash said:
Hi everyone, I’ve just joined the forum and would welcome any insights/advice from members. My husband (70) has had type 2 diabetes for over 15 years. Around two years ago he started losing weight (although at the time he wasn’t overweight). This wasn’t intentional - he has a good balanced diet. He is now looking frail after losing a couple of stone. He has been checked out by the doctor and has had a number of tests but nothing can be found to cause this. I am assuming it is connected to the diabetes and wondered if this had happened to any forum members?
Click to expand...

Hi there Carol. As you cab see your question has resulted in a number of suggestions/potentials, although nobody here is in a position to diagnose your husband.

How well is your husband's diabetes held under control? Does he use any medication, and test his blood sugars? If so what do his blods run at on a day-to-day basis?

Secondly, is your husband otherwise well? Does he have any other health conditions? Does he have a decent appetite and enjoy his food?

Lots of other conditions (not all of them sinister I'm pleased to say) can lead to weight loss, from an off-kilter thyroid gland to shortness of breath in some circumstances.
 
If they have done tests and cannot find the reason then surely they would also have done diabetes tests. In fact, as he is diabetic, I would have thought that would be the first line of testing. Therefore if they say they cannot find a reason, it stands to reason it is not diabetes related. On the other hand, losing weight unintentionally there is something wrong, and the testing should continue with other things as well as diabetes, because they are obviously missing something. I know a mother and son who were losing weight and blood tests were coming back in normal range. In fact the mother was accused of being anorexic and her son too. They were not. However it turned out to be that they were both hypothyroid. Normally someone who is hypothyroid would be adding weight on for no apparent reason, so losing weight is extremely rare. However when they found a doctor who didn't just dismiss them as mental cases, and treated their thyroid, they started to normalise. A rare doctor indeed. I presume they have tested his B12. They must have tested for the likelihood of more serious things.
 
This is only a guess, but your husband's weight loss could be due to pancreatitis where the pancreas has stopped producing the digestive enzymes that break down food and also produce sufficient insulin.
The reason I'm suggesting this is that when first diagnosed as T2 I had lost an awful lot of weight but my GP failed to pick this up, but eventually as a result of a MRI scan it was discovered that my pancreas was compromised and I was prescibed pancreatic enzyme replacement therapy (PERT) and that has helped me regain most of the weight I'd lost.
 
Welcome to the forum @Carol Nash

Sorry to hear about your husband’s weight loss. Hope you can get to the bottom of it and that it’s something which is relatively easily resolved.

Let us know what they find out if any more checks are run.
 
@Carol Nash

Two thoughts from me. Firstly as he’s been T2 for over 15 years has he been on Metformin all that time? Metformin (and any proton pump inhibitors such as Lanzoprozole usually prescribed for reflux) can cause B12 deficiency which in turn can cause lack of appetite and weight loss. Has the Doctor run blood tests for B12 deficiency and if so, can you find out the results? There’s a range of “normal” for these results and although your hubby may fall within that range, if he’s towards the bottom of it, he may need treatment, which is a pretty simple series of injections to put things right.

The second is that thyroid issues go hand in hand with diabetes and if he has an overactive thyroid that can cause weight loss. I lost just over a stone during lockdown. I was very pleased... but actually it was due to being slightly over-medicated for under-active thyroid as I discovered later.
 
Hello everyone, thank you so much for your responses so far. Some of you have asked about my husband’s general health. Besides taking Metformin tablets for the diabetes, he takes tablets for high blood pressure and high cholesterol. He has a good appetite, his blood sugar level is kept in good control. He does tire very easily and feels the cold. He does a fair walk everyday.
 
Hi again @Carol Nash overactive thyroid can cause fatigue (see https://www.btf-thyroid.org/coping-with-fatigue). Once again, there is a range of “normal” and maybe your hubby is drifting towards the top end? Worth googling. Not suggesting this is the answer, but that it may give you a platform to discuss with the GP.
 
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