Diabetes Self-Management Blog

We’ve all read about people with Type 1 climbing mountains, dancing ballet, or playing professional football. But people with Type 2 are thought by many to be overweight and sedentary. Last week I learned different. It’s an interesting story.

You occasionally hear from diabetes educators about “thin Type 2s,” but for a long time, I thought they didn’t really exist. I thought they were misdiagnosed Type 1s or 1.5s. I figured they had either LADA (Latent Autoimmune Diabetes of Adults) or MODY (Maturity Onset of Diabetes of the Young).

My reasoning went like this: Type 2 diabetes is driven by insulin resistance. Insulin resistance has many causes, but the main ones are physical inactivity and stress. So how could a very active person develop Type 2?

Well, now I know. If you have the right genes, stress can drive even a very active person to Type 2 all by itself.

Last week, I spoke at a support group for people with Type 2. Two of the group members, one man and one woman, were not only thin, but very active. The man kept tapping his foot and rocking his legs back and forth. The woman kept moving around in her chair. Both the man and the woman talked of exercising a great deal.

In my experience, people with Type 2 don’t move as much as these two do. They don’t fidget. They conserve energy. (Readers — has that been your experience?)

Saving energy is vital to survival where life is physically demanding and food is scarce. In a culture like ours, where food is plentiful and physical activity is discouraged, being an energy-saver can contribute to health problems, including Type 2 diabetes.

Solving the puzzle
At first, I thought, “You guys aren’t really Type 2.” In the past, I had actually helped a number of fit 1.5s by diagnosing them (over the phone!) after their doctors had mistakenly called them Type 2 and refused to give them insulin.

But when they started talking, a different picture emerged. The man spoke of being so worried about being late for the meeting that he had checked and rechecked to-do lists, packed and repacked his lunch, and rechecked the meeting schedule several times. “Every time a bus went by,” he told the group, “I would say ‘Damn,’ I should have been on that bus.”

And all this worry was for a support group meeting, not a job interview or a court appearance! He was a very nice man, but he talked fast and often and seemed stressed, even in the meeting.

The woman told us about getting in an argument on the phone after a light breakfast. It was some kind of political argument, and she said she was screaming by the end of it. Afterward, she checked her blood sugar, and it was 270. She said she is nearly always in the normal range, and thought it must have been the stressful phone call that caused the high reading.

Stress in Action
As readers will recall, stress is the “fight or flight” response. It’s for escaping a wild animal or fighting off a mugger. Stress raises your blood glucose and increases your insulin resistance, so that only cells involved in fleeing or fighting will use the glucose for fuel. It also raises your blood pressure so that glucose and oxygen can get to the muscles faster.

These thin, active people were reacting to the thought of being late, or to a political argument, like it was a life-or-death threat. Their bodies prepared to run or fight, getting all insulin-resistant, but all they were doing was talking on the phone or taking a bus. I saw them, and I realized it was true. Athletic people can develop Type 2.

After that, I steered the meeting to a discussion of stress reduction. One woman talked of a tai chi meditation program she goes to at her hospital. She says 30 minutes of meditation lowers her blood glucose so much that she has to be careful about hypos (she uses insulin.)

I had heard that meditation can help people with diabetes, but I hadn’t realized how dramatically. Probably, meditating reduced her stress, which reduced her insulin resistance, so her cells could take in more glucose.

I was really glad to have met this group. Their stories illustrated the stress/diabetes connection better than any experiment. And I sold three books, too. I hope they invite me back.

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Comments
  1. My uncle has T2, and is trim and fit. It runs strongly in our family (although I am the outlier, who managed to get T1). He was maybe a little overweight when first diagnosed, and has since kept very fit - and yes, he climbed a mountain - Kilimanjaro, two years ago. Staying fit helped him slow down the progress of the disease tremendously, but it has still progressed - he just started insulin therapy last year.

    So yes, there are slim T2s! Now then again, his sister is also a T2, and she fits the stereotype - overweight, sedentary, due to a number of other health issues - and her disease progressed about 10x as fast as his.

    Posted by Skipper |
  2. Yes, there are thin Type 2’s. I’m tall and a size 8/10. I exercise five times a week, and I have been exercising for 30 years. I still got Type 2.

    Posted by Donna C |
  3. Thanks for writing, Donna and Skipper. Donna, I have two questions: Have you been evaluated for Type 1.5 diabetes (LADA or MODY)?
    Also, how stressed would you say you are?

    David

    Posted by David Spero RN |
  4. The book “Why Zebras Don’t Get Ulcers” is a good layman’s source for understanding the “fight or flight” response and how you can manage it. (I’m a Type 1, but experienced with panic attacks in college–that’s how I heard about it.)

    Posted by Chris Opsal |
  5. I am a thin type 2. My diabetes is genetic as both my mother and maternal grandfather became type 2 at about age 60, like me. I am not insulin resistant, my pancreas does not product enough insulin. I exercise at least 3 times a week, more in the summer months. I play tennis and softball (doubleheaders) often on the same day. I have been on Lantus for about 5 of the 8 years since I was diagnosed with type 2.
    Stress is definitely a factor in my blood glucose level but I do not believe it had anything to do with my becoming diabetic.

    Posted by Bob R |
  6. I have even another angle for you. I was diagnosed about 5 years ago. I am for sure type 2 and started insulin last December. I am not overweight and also pretty active. According to the Veteran’s Administration mine was brought on by exposure to Agent Orange. My civilian endo is a little skeptical of this but there is no history of Diabetes in my family.

    I am not a type A personality and the only time I was stressed was many years ago when getting shot at.

    Robinhood16

    Posted by Robinhood16 |
  7. In my mother’s generation, 7 out of 9 of them had type 2 diabetes. My grandmother, and at least 5 of her 13 siblings (I never knew the rest of them) had diabetes. Only 2 of my mother’s siblings were obese. While not what I would call thin, the rest were normal weight or only slightly overweight. And their diabetes was definitely type 2.

    Although I am overweight now, I had gestational diabetes when I was pregnant and not overweight.

    I believe type 2 diabetes is really many different diseases rolled into one diagnosis, and some forms have a stronger genetic component than others. The type in my family seems to be strongly influenced by genetics.

    Posted by Beth |
  8. What great stories and comments! It seems that many causes of diabetes remain unknown.

    Bob R, I would say you are not Type 2, no matter what your doctor calls it. You say you are not insulin resistant; you just don’t make enough insulin. That’s not Type 2, but I am very glad they have you on insulin. I guess the label doesn’t matter so much.

    Robinhood, I knew about the Agent Orange connection and mention it in my book Diabetes: Sugar-Coated Crisis. It’s real; that’s why Vietnam vets can claim Type 2 diabetes as a service-related disability. Other environmental chemicals have also been associated with Type 2.

    And as Beth says, there is a strong genetic factor also. There’s a lot more going on here than the “it’s all about eating too much” crowd admits.

    Posted by David Spero RN |
  9. My father and sister were (both now deceased) slender type 2’s. Neither were stressed personalities. I’m an obese non-diabetic. My brother was a type 1. His daughter a type 1. My granddaughter is a type 1. Neither of my daughters are diabetic.

    Posted by Arlene |
  10. David: You asked if I have been tested for LADA or MODY. I have not. I was diagnosed as pre-diabetic after an oral glucose tolerance test. I took the test because my sister (who is several sizes smaller than I am) was diagnosed as a diabetic a year earlier. My numbers were 102 fasting, 217 after 30 minutes, 212 after 1 hour, and 170 after 2 hours. My A1c runs about 5.8%. I count my carbs very carefully and I exercise. My stress level is low as a general rule. There are exceptions from time to time.

    I’m curious why you asked about the testing.

    Posted by Donna C |
  11. I am a thin, active, “type 2″. At least that was my diagnosis. I take 4 insulin shots a day of about 2-3 units each. I am not insulin resistant, metformin did not work for me, just diet and exercise caused me to lose even more weight. I had gestational diabetes, even though I gained no more than 20 pounds with each pregnancy. There is no diabetes in my family other than 2 deceased grandparents, none in aunts, uncles, cousins, parents, or siblings. I did not test positive for LADA and have not been tested for MODY because of cost. I hate the expression “you don’t look like you have diabetes.”

    Posted by Becky |
  12. I too am a “thin” type 2 - I am 47 and 5′5″, weight 1321bs. and have had diagnosed type 2 for 8 years now. My mom was a juvenille diabetic and insulin dependant all her life, I attribute the genes to my condition. I treat it as seriously as any type 1 does and it has kept me on a low drug doseage for many years. the indicator I would end up with type 2 was gestational diabetes when I was pregnant at 20 and the doctor’s proclamation I would end up with onset diabetes regardless of my weight.

    Posted by Andrea L. |
  13. IM T2 NEED TO LOSE WEGIHT PLEASE SOMEONE HELP I HAVE HAD NO SUCESS IM ACTIVE BUT CANT SEEM TO LOSE PLEASE ANYONE HELP

    Posted by francesca hylton |
  14. I”M an obese type 2 diabetic and would love to know how to lose weight. Can anyone help?! Could someone tell me what to eat. There are so many conflicting ideas. I”d appreciate any help. I’m desperate. Kathy

    Posted by Kathy |
  15. I have been diagnosed for a little over 10 years. I am tall and relatively thin (having lost 35 lbs. in the last 18 months). My sugar was under pretty good control on meds but the stress at my job has escalated so much that I have been extremely high in my numbers. I did not realize how much the stress affected me until my boss was out on the office for a week. By Friday, my numbers were down by over 125 points. My doctor wants me to go on insulin. I want a new job!

    Posted by Karen |
  16. Donna, the reason I asked about LADA or MODY is because too often doctors label people “Type 2″ and refuse to give them insulin, when they really are insulin-deficient. The label doesn’t matter; what counts is that you are getting correct treatment. If your A1C is 5.8%, it seems like you are doing the right things, so not to worry about labels.

    Francesca and Kathy, Diabetes Self-Management has published many articles about weight loss — see them here: http://www.diabetesselfmanagement.com/articles/Weight-Loss/
    But I would encourage you to focus more on your blood glucose and blood pressure than on your weight. Weight is not as important as those other numbers.

    Posted by David Spero RN |
  17. I was overweigt for about a year out of my 50 years, and I’m type 2–although I haven’t been evaluated for the other conditions mentioned. This is nothing more than ignorance on the part of the public.

    Posted by rick |
  18. I am 77 years old and was diagnosed with type 2 diabetes 30 years ago. I am presently 5″ 3″. 110 lbs. I have never known a “fat” day in my life. I exercise regularly, eat properly, have never smoked, and drink only a little wine on rare occasions. I resent the assumption that it due to my life style that I am diabetic.

    Loretta

    Posted by Loretta |
  19. I am a very active woman “of my age” and I have Type 2, and obviously has had for 13 years. I weigh a whole 110 lbs, I was never overweight, I ate heart healthy, I exercised, I hiked and spent hours in the gardens when weather permitted.

    I was experiencing ‘odd’ symptoms when I was about 50 years old, not the typical diabetes symptoms - slight weight gain tho diet/exercise the same, I just had the feeling something was not right. My doctors assured me I was fine, my A1C was always 6 or lower (only because I was in control and not realizing it), they would give me a pat on the shoulder and say you are just getting older…slow down, etc etc.

    Well when I was about 59 years old I was suddenly going blind (there was stress in my life at this time) and the doctor had nerve to say “I know your family history you are not diabetic, (if she knew, she would see family history of diabetes) eye doctor doesn’t know but if you are concerned, come in next week”…well duh this ole lady showed up next morning, my blood gloucose was over 900 !!! and the doctor was fired.

    And I am still that same ole active woman with an now an A1C of 5.2 (controlled with metformin) and a doctor who keeps telling me I am not a teenager, quit acting like one ROFL.

    Goes to show not all Type 2 fit your profile.

    Posted by Gayle |
  20. I am also a thin type 2 diabetic. I am 5 ft 2 in and weigh 115 lbs. I am 42 years old, do not drink more than 3-4 drinks per month, do not smoke, and exercise a few times per week. Last 3 months my A1C was 8.9, and I am now taking 5 shots of insulin per day and about 14-22 units each shot. I had gestational diabetes when I was 28 and it never went away altogether. It is frustrating that everything I read about type 2 diabetes says that losing weight will cure me. I do have a stressful life, and maybe stress is the cause of my diabetes type 2. Does any one know if there are any good soures on thin type 2 insulin dependent diabetes that helps us deal with this or understand it better?

    Posted by Kennedy |
  21. I have been a diabetic since age 50 and am now 77 I too had blood level of 900 and was 80 pounds over weight, I changed my life style and took meds,, but as year went buy my sugar would go from 140 fasting to now 275 fasting, I am on max metformin and max glucatrol my aic is 11.5 ,I told my doctor that after all these years my desire to have some confort food is back and i can excercise any more as i get chest pain when wlaking and short breath.
    How ever my doctor said i have the best blood numbers he has seen with the exception of my blood sugar,,,I told him at my age i dont feel i want to venture into new area like insulin,,,Maybe after it gets to 400 at fasting ,
    I know about every thing written on diabetes by Johns Hoppkins and Mayo Clinic and that if i live to age 80 I will no doubt be on a kidney machine, But its my choice that i am tired of the fight and the pills that give me blaot and gas and all the years eating bland and tasteless food, and the constant worry and glued to a glucose meter,
    I can see ok and wlak some take my bass boat out and sit and puff my pipe, Every one to there choice is my belief ,,,not the doctors .

    Posted by john |
  22. The distinction of type 1 and type 2 diabetics can be done by the serum insulin levels. The autoimmune type 1 have serum insulin that are lower than normal usually below 3 units /dl. The type 2 usually have levels above 20 units. The type 1 most likely have normal insulin receptor counts on the cell wall. The type 2 have markedly reduced insulin receptors on the cell wall, due to the very high level of insulin in the blood stream.
    The thin diabetics are most likely on their way to being an auto-immune type 1, but not quite yet there. Heat shock proteins (HP60) has been implicated. Streptomyces reticuli has also been suggested as the culprit. No reports yet on serum insulin levels on thin diabetics or insulin receptors on cell wall of thin diabetics.
    climaco

    Posted by c climaco |
  23. I am a 42 year old, size 4, athletic female who found out today that I am considered to be pre diabetic (fasting blood sugar of 109). I run 4-5 miles about three times a week, walk or do the eliptical on the other 2 or 3 days and lift weghts about 3 times per week. I have exercised reguarly since I was 16 and always ate a healthy diet, limiting sweets, not eating fried foods, no beef in the last 10 years. I have never been overweight, did not have gestational diabetes with any of my three pregnancies.

    I guess once again, life proves to be unfair. The doctor did state that, “If you had not taken such good care of yourself, you would have been diabetic 20 years ago.” Still I am more than a little frustrated with this.

    I do feel anxious at times, but it is not a regular occurence.

    Any one else with a similar story?

    Posted by JoAnn |
  24. Joann, I want to encourage you to be tested for insulin production and anti-insulin antibodies. You may have LADA or MODY (which we have written about). And check your hemoglobin A1C.

    It would also be good to check a few blood sugars after meals to make sure you don’t spike too much, because that might need to be addressed. (See my blog entry this coming Wednesday about that.) With your numbers, if you keep up your healthy life you’ll be fine! At worst, you might have to cut down on refined carbs and sweets even more.

    Posted by David Spero RN |
  25. Interesting data and case.

    I wonder if the writer you responded to was limiting grains, breads etc. Limiting sweets is good place to start but grains , breads, pasta get overlooked. Most folks do not realize that grains, flour and bread can output glucose as good as sugars and sweets.

    I did not see an overall calorie input number as well.

    Posted by jim snell |
  26. I was diagnosed with gestational diabetes at 18 but it never went away. Initially though, they said borderline and then gave me the really long, couple blood draws, testing. They sent me to a dietitian and had me recording my levels but never mentioned a type.
    I suspect I had it before pregnancy though due to the symptoms that other doctors had just brushed aside, even the passing out and seizures which went from once a month up to a couple times a week to multiple times per day during pregnancy. I was 5′3″ and 122 lbs at age 18, but have never been able to get back to that weight before pregnancy. I am now 105, 26 yrs old and it took a long time to get there. My 2nd pregnancy maxed out at 123 lbs. Only person I am aware of in my family is my Aunt. I have done really good with my diet and exercise until this last year or so and I can feel the difference in everything.I also (just found out from this article), believe stress played a major role.
    I actually need to go back to the doctor (scared to death of hospitals and doctors, I actually start panicking, lol) because I just have too many issues popping up that are becoming consistent enough to interfere with what I am doing.

    Posted by Rose |
  27. i m 36 , slim 60 kg weight , diagnosed 15 days before , after loosing wt ,my fbs is 230 ,i m type 2 ,i never eat excess sugar ,my diet always simple and less , my mother is diabetic type 2 ,i will check my fbs after 3 days , please pray for me

    Posted by harvinder |
  28. I believe the foolish over focus on body fat as a cause of disbetes is miles off target.

    Thin or thick, key answer is whether you have balanced your energy consumption versus burn. That can happen thin or thick.

    Some folks can store excess carbs and energy over production as fat. Others have system that keeps them thin.

    The key is to keep the excess glucose floating around blood system down so that glucose storage of the skeletal muscle sites do not get saturated.

    The body stays in regulation as long as there is always room to store glucose in skeletal muscles.

    Sufficient heraty exercise and energy balance needed to prevent skeletal muscles from getting filled and saturated.

    Posted by jim snell |
  29. Harvinder, maybe you have Type 2 and maybe you don’t. I would ask your doctor about whether you might be a late-onset type 1 or have LADA. You might need insulin. If it turns out you really are Type 2, you will have to work hard to get it in control. But get checked for insulin production and antibodies if you can.

    Posted by David Spero RN |
  30. hi david ,today aug 4, my fbs is 85 with metfom 1 gm , rbs is 138 , i m trying best to control with diet n excercise , but what will i do for my loose muscle please help

    Posted by harvinder |
  31. Harvinder, it sounds like you are doing a great job with your sugars. Not sure what you mean by “loose muscles.” It could be nutrition, it could be lack of exercise, or it could be some undiagnosed condition. Have it checked out if you can.

    Posted by David Spero RN |
  32. Female, age 71, 5′5″, 108 pounds, diagnosed as type 2 one year ago. At time of diagnosis my BG was 289 and A1c was 11.5 Most recent A1c was 7.0 Family history of diabetes: one uncle and one of my five siblings, both diagnosed in their 60s or 70s when of normal weight.

    I’ve been underweight (103-112) most of my adult life, though I was up to normal weight at 122 when diagnosed. I’ve lost weight again since then, as my doctor will not prescribe as much medicine as I feel I need out of fear of my frequent hypos when I happen to eat late or too little in an individual meal. So my only choice to keep my blood sugars within reason is to eat less than I need. Current meds include 2000 mg metformin and 6 mg glimipiride daily.

    When I was initially diagnosed, the doctor put me on an 1800 calorie ADA diet with 50% of calories from carbs, plus metformin and Januvia. I tried that for a few days, but my BG readings before the next meal shot up to the 400s and 500s. I didn’t see that those meds helped at all, and I certainly wasn’t used to eating so much fruit and grains in the same meal. Next the doctor added the glimipiride at a lower dose, then up to the 6 mg I’m taking now. I’ve been keeping a careful dietary record the past few months, and I’m sure my doctor will be unhappy with what I’ve been eating. Average calories per day was 1839, of which 43% was fat, 20% protein, 32% carbohydrate and 4% alcohol. Frequent snacks on nuts and high-fat cheese is the reason the fat is so high. I’m a bit reluctant to substitute much more protein, as I had microalbumin in the urine in my last test. My LDL was only 70 last time, and my HDL was 63, so hopefully eating all that fat won’t prove to be a problem.

    I thought that at 108 pounds I’d be able to gain weight averaging over 1800 calories a day, but in two months I haven’t gained a pound. I hate exercise, so I reluctantly get my 30 minutes of aerobic dance in most days, but am otherwise quite sedentary. I am, however, a high-strung person and expect I burn a lot of calories that way, even though my daily life in retirement is about as peaceful and quiet as it can get. But when I read the news, my blood pressure often shoots up 20 points, so I’m obviously affected by stress often.

    Posted by Carol A |
  33. I am not Doctor but my own experience and looking at your numbers is suggestive of a nasty liver leak/dumps overloading your body.

    I was as high as 13.3 on a1c until liver shut up on its over release.

    How are you taking the metformin - one super dose once a day all at once?

    Have you checked your BG during midnight hours - 3 am to see what dawn effect is? Are numbers high in am - 200 on up?

    Your numbers suggest that dawn effect is being nasty.

    Here again you need expert medical help to unravel this problem.

    Posted by jim snell |
  34. Hi Carol,

    I usually agree with Jim Snell, but here I strongly disagree. I think most likely you are not Type 2 at all. Who ever heard of a Type 2 who can’t gain weight? I’d bet a lot of money you have very little insulin.

    Since your doctor seems relatively clueless, I wouldn’t want you to go to him about starting on insulin, but I hope you can find another doctor, preferably a diabetes specialist, SOON. You need better treatment.

    Posted by David Spero RN |
  35. Well, david; no sweat - you know more than me and as I said I am not Doctor and recommended she get expert help.

    Best wishes

    Posted by jim snell |
  36. Jim - I doubt that dawn phenomenon is much of a factor in my case, though it is hard to tell because of my sleeping and eating habits. I’m one of those individuals who usually goes to bed within a few hours of eating dinner, am only able to sleep three or four hours before waking up, then am totally unable to get back to sleep for at least three to eight hours (usually 3-5) and almost never am able to sleep again until I’ve had something to eat. So I usually eat in the middle of the night, often a full “first breakfast.” But on those occasions that I do manage to sleep through the night or avoid a middle-of-the-night meal, I don’t have a glucose reading higher than 180 (more usually 125-150) in the morning unless I had a meal higher in carbs than I should have the previous night. And even if I do eat in the night, I most frequently don’t have a reading before my “second breakfast” at 8 or 9 AM that is excessively high. On the other hand, though I’ve had many mild hypoglycemic episodes, none has ever occurred before noon.

    I take my metformin in a divided dose, 1000 with first meal after 6 AM and 1000 with dinner at 5 or 6 PM.

    Posted by Carol A |
  37. David, thanks for your response. Somehow I had feared from my other reading that’s what you might say - that I might not be a type 2 after all and should check that out with a specialist. But I was hoping not! My doctor asked last time if I wanted to be referred to a specialist and I said “Wait.” I guess what I fear is that I WILL need to go on insulin injections. That will be a very difficult adjustment for me because of my sleep and meal schedule (or lack thereof). I’ve had this problem for at least 20 years of not being able to get back to sleep in the middle of the night without eating. As long as I’m just on oral medications, I still have some flexibility of meal times depending upon how long I’m able to sleep, but I know meal times will have to be more precisely timed with insulin. I’ll be seeing my doctor within a few weeks, and will ask her to refer me to an endocrinologist.

    Question: To what extent is postprandial hypotension related to diabetes or insulin resistance? It just seems that when my systolic BP falls 20 points and occasionally up to 30 points after meals, that there is likely some relationship to glucose metabolism. I’d been bombarding my doctor with questions about my blood pressure changes for ages, and back in July 2006 she finally ordered an ambulatory blood pressure check. Unfortunately, I never got to see the doctor who interpreted it and he never bothered to ask for a daily log of meals and exercise to go with it, so while I could see the numbers showed what I’d been complaining about all along, nothing was noted about the relationship of BP to meals in his written interpretation. After more of my questions about PPH, my doctor referred me to a cardiologist. But he basically didn’t want to hear about it; he said a lot of people had highly variable blood pressure for a lot of reasons and as long as I wasn’t fainting from it, it really wasn’t “postprandial hypotension.” I’m wondering now if this might not have been a clue to potential diabetes way back then. Is this typical of any sub-category of diabetics? Or is the combination of problems purely coincidental?

    Posted by Carol A |
  38. Like JoAnn above, I have never been even close to overweight. 5′8″; 134-138 lb., was never over 120lb. until menopause in late 40s. Now 66, diag.@ 63. Always serious exerciser, quite fit. (Resting pulse 56, very fast recovery from activity). Never smoked; occasional glass of wine. People think I’m 15 years younger, & I don’t even dye my hair. But… Fasting gluc. stuck @108, A1c stuck @5.8-9. Metformin 500mg qd. Always have eaten right even before diagnosis. Mother mid-90s & siblings in 60s all fine, even the sedentary overweight junk-foodie. So… Why me? How can I get those #s down? Dr. not worried, but I sure am. Amputations, blindness, shortened life don’t hold much appeal.
    Thin sibling does have an autoimmune disorder ( not diabetes). Is this maybe connected?

    Posted by MAS |
  39. I am a woman, 5 foot 5 and 133 pounds, recently diagnosed pre diabetic with a FBG of 110 and an A1c of 5.7. Last summer my FBG was 105, and before that, 95, before that, 91, and before that, 101. (that’s 3 years worth of data. I only had the A1c this last time)

    My dad is type 2 but wasn’t diagnosed until age 75, and he has been overweight with a ‘pot belly’ since his 40’s or younger. His mother had diabetes which was diagnosed in middle age and needed insulin right away, and his father had marginal diabetes.

    I thought I’d be ’safe’ because I am not overweight. When I hit menopause a year ago and went off the pill, I gained around 5 to 7 pounds around the midsection that I couldn’t get rid of.

    Since my prediabetes diagnosis a week ago, I went seriously low carb. What I have noticed is 1) some wooziness/dizziness in the morning, and 2) I feel much better in the afternoon than I used to. I used to get sleepy in the afternoon after my (high carb) lunch, starting around 3 or 4 pm. But, I don’t want to lose much weight! I figure my ideal is 127.

    Do you think it’s possible (improbable, probable) that I am in the beginning stages of LADA, based on my numbers? Or is it more likely to be T2?

    Kerri W.

    Posted by Kerri Watson |
  40. By the way, I am 49 years old. Forgot to mention that…

    Posted by Kerri Watson |
  41. Hi Kerri,

    I can’t diagnose you. Unfortunately, you would need some blood work to find out if you have a mild case of LADA, and even more extensive (expensive) labs to look for MODY. I would work with the low-carb diet — it’s working in the afternoon, maybe some changes will help you in the morning. You might also look into vinegar, bitter melon, or other nondrug approaches we have written about.

    MAS,

    I tend to agree with your doctor — not to worry. But you might look at some diet changes or the ideas in the paragraph above this one. Guessing one of those will get your numbers into the normal range (which isn’t that far away.)

    Posted by David Spero RN |
  42. Thanks for your encouragement back in November to see a specialist. You were right. I’m not a type 2. After a year and a half of treating me as a type 2, my doctor finally referred me to an endocrinologist. I was diagnosed with LADA, showing both GAD65 and 1A2 antibodies. I’m now able to eat 500-1000 calories more a day on insulin without having my BG go into the stratosphere. In the two weeks since starting insulin I’ve already been able to gain a couple of pounds from my low of 105.

    Posted by Carol A |
  43. I just started on medication and I wonder if I should not be. Should I just try to reduce stress? I do have genetic disposition thru both grandmothers. No doubt I should consult with my doctor, but would like your input.

    Posted by Randel |
  44. Hi Randel,

    I can’t prescribe, but if you are truly Type 2, the only medicine I believe in is metformin. (The new incretin drugs, too, but I’m guessing that’s not what you’re on.) Consider reducing carbs, moving more, taking a spoon of vinegar before or with meals, or other suggestions you can find on our Web site or on others.

    Posted by David Spero RN |
  45. Hey everyone! Please be aware of MODY (maturity onset diabetes of the young)!

    In MODY, people like, were diagnosed at young age (I was at 12) and are thin (BMI 17 or 18), and the slightly elevated sugar/glucose levels remain like that for years, without any complications (but sometimes not).

    MODY is genetically inherited and runs in families, but often relatives do not know about it. Often diabetics type 1 or 2 are misdiagnosed and mistreated and instead they have MODY!!

    These can be your thin type 2 people!

    Posted by Irpsit |

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