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Anyone not overweight?
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Michael_Dansinger_MD posted:
About 90% of people with type 2 diabetes are overweight--about 10% are not.

This week I'd like to learn more from those who are not overweight. Is there anyone out there who was lean when first diagnosed? Is your body weight normal now but your glucose is still elevated? Any clues about what caused the diabetes in your case?

Type 2 diabetes results when the insulin-producing beta cells of the pancreas are not working well, and dying too fast, and therefore cannot make enough insulin to get the digested glucose into the tissues and organs.

The beta cell death and dysfuction occurs in all people with type 2 diabetes, but is more pronounced in those who are lean.

We don't know much about what is killing the beta cells. To solve this mystery we might find the most clues in people who have type 2 diabetes despite being lean, since it takes a lot more beta cell killing/dying to produce diabetes in someone who is lean rather than obese, and this might help us identify factors that cause beta cell death other than obesity.

Please share your story and any clues about what may have caused your diabetes.

Michael Dansinger, MD
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missy99687 responded:
I have NEVER been over weight - NEVER!

It worries me about the reason why my beta cells are dieing faster...

What would you like to know?

My immediate family does not have diabetes with one exception, that being my father who was JUST dx'd this past year. He has become overweight in his late 70's - he's now 81.

I was usually underweight until after I was married, then I gained enough to be in normal weight range but NEVER over weight - I asked my dietitian about that too and she said that I could STILL gain weight and she wouldn't care.

I was active, and had none of the diabetic warning symptoms - everything with me could easily be explained - never got that thirst thing and no extra bathroom trips.

My own doctor and nurse didn't believe I was diabetic either. She said I didn't fit the profile, and her nurse told me that insurance companies were too strict, and just don't want to pay out - I'm not sure what he meant by that... but...my doc said she'd do another test and see.

SURPRISE! The strict insurance company was CORRECT!!!
 
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arealgijoe responded:
I had my first D-dragon scare when I was 14 (hospitalized) & told I would end up on shots. I told them I was not about the hear another word, and got better, I was quite thin. .

I failed my first job phsyical after HS but did get in the Navy. Had another scare, admited to sick bay, had to pass a urine sugar test the next morning, guess I did.

The first time I got sick, a sore throat, after the Navy I eventually landed in the hospital where I was first Dx'd w/Diabetes. This particular scenario, (sore throat).is more common to type-1. Problem was I was considered too old for T-1 and far too young for T-2. I started insulin a little over a year after that. No I was med to thin. Several times my TYPE-? has been called into question, but never checked out.

My diabetes reguardless of LABEL vaires, get worse and even gets better from time to time and can even change overnight w/o ANY obvious logical reason. My own theory is that mine is more of an odd autoimmune case that varies with my level of autoimmune activity at any given time. I am now doing better after almost 2 years of total lack of natural insulin... Fun-e thing was it was more stable & predictable during that time. reguardless of mode I seem to be sensitive to carbs no matter what they are (other than speed of absorbition, like spike from OJ etc).

(*&*( GOMER Labeled T2, but more like Type-O as in Orphan!
 
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arealgijoe responded:
I notice a lack of mention of INSULIN RESISTANCE, or did I miss it?

My understanding: Insulin resistance creates an additional demand for more insulin per pound of body mass. This can over work the beta cells, over working a body part can cause it to fail or function less well, puntended. It's not unusual for LADA's to be mis-typed as type-2 when its more like a slow onset type-1 (using more typical T-1 in children as the referrence)

Diabetes is a rather complicated beast, not to mention variances in people, their metabolism, heriditary factors, which might be reflected more directly in both insulin resistance and beta cell health or disfunction.

Another factor could be illnesses like pancreatitis, of which I had 3 possable bouts of, which can in and of itself cause reduced beta cell capacity/function.

My mother was diabetic, the visiting nurse did not show up for a couple days to give her insulin shot, she died in a coma soon after. IMO you may find its not any single factor, but a combination of factors.......

(*&*( GOMER sez good luck.
 
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missy99687 responded:
My medical team asked everyone about their families, and many had close family members that also had diabetes, but I didn't...one great uncle, and two great aunts (Uncle Billy's sisters) had diabetes - my medical team said they didn't count as diabetes does not skip generations, but I personally do NOT believe that!

My dad's sister got diabetes, but she was older and was also overweight. I don't know if she had gestational diabetes or not, she had 4 children. I don't remember any stories except the one my dad is convinced of, where she got a terrified scare by nearly picking up a snake that was on the floor of her kitchen. The snake was still and she thought it was a belt belonging to her youngest son. When she reached for it, of course it moved!

My dad is CONVINCED that she got diabetes because of the scare! I told him that, that didn't make her get sick, but he won't change his mind. My aunt wasn't terribly over weight, but she was over weight. No one else to my knowledge had diabetes...Only the five I told you about.
 
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missy99687 responded:
Oh, forgot to mention that only my dad and his sister were over weight in their later yrs before they became diabetic.

I don't think my mom's family were over weight...they passed away before I could remember them...mom said that Uncle Billy who use to baby sit me, died shortly after his one foot was amputated due to diabetes complications. I've seen photos of him, but he wasn't over weight. None of mom's family members were of the ones I remember or saw photos of.
 
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missy99687 responded:
Re-reading your post Dr D - I feel my diabetes was family related and skipped a generation.

As I said before, I was NEVER overweight - I couldn't even join the military for 5 yrs because I was underweight. I only gained weight when I did join, because a doctor friend who I use to baby sit for, put me on a drink called (not sure of spelling) Sustrogin? Sustrocal was the one to lose weight, I was given the Sustrogin. It took awhile and I would eat a ramakin of noodles one night and go directly to bed on them, and the next night I'd eat a ramakin of egg custard, and the night after, back to the noodles, etc.

I finally gained the weight I needed for the military.

I was 105 lbs when I got married and I'm 5'6" in height. Was dx'd in 2002 in the winter and since then, on and off, whenever I got sick, I would loose some weight - I am now underweight again... so I try to gain weight, and still keep my A1c and bg numbers in range. The range I was given was 70/140 - not below 70 bg and not above 140, 2 hrs after ending my meal - that's how I've been taught by our hospital staff.

My last A1c was 6.4 - when I was 1st dx'd, my A1c was 8 - I wasn't healing well, but I had two accidents on my shins (book end marks) with a project I was working on with lumber in our garage. I smacked my shins one week, and just as they were healing, I smacked them again in a different accident, but with lumber...sigh...I was concerned about the long healing time, but thought, I had two accidents in the EXACT same place on both legs and I would keep an eye on them because they never got a real chance to heal, before the 2nd accident.

But before time went too far, the insurance company came out to the house to ask questions and take tests fm my DH & I. THEY were the ones who found the diabetes...which my medical staff didn't believe.
 
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DavidHueben responded:
When I was diagnosed in June of 2005 (A1C was 6.6% and FBG was 131), I weighed 265 pounds. I am 5'8" tall. I am now down to about 175 pounds. I no longer consider myself to be overweight. This is the weight I was at when I completed Army basic training in 1970.

David
 
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teddybear200 responded:
What do you consider overweight? My Drs say I am not. I will explain after your response. Thank you. Deb
 
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auriga1 responded:
I was underweight most of my life. I didn't start to gain weight until my late twenties. Now, I'm of average weight. My family is all lean. My mother was a diabetic, but her parents were not. My mother was very lean and when diagnosed, immediately put on insulin. Her mother had two siblings who were diabetic and insulin dependent, none overweight.

All I can think of, is (as you state) that we all have a gene causing beta cell death and dysfunction. My sugars would not come down without the help of insulin and exercise. If I don't use the insulin, my sugars would be 500. Have had that happen when I used insulin that I didn't realize was expired and no longer useful.

When diagnosed, I weighed in at 128 lbs. at 5'9" A.M. FBS's of 250 or higher. Two hours after, 435. My doctors didn't think oral drugs would do the trick. So insulin it is. This was in September, 2006.

Diabetes under control with 40U Lantus in the a.m. I use Humalog with meals, depending on what my blood sugar is (5-10 units), but if I keep the carbs to a minimum, the less I need to use. When I add exercise after a meal, I use even less to avoid lows.

So there it is. No obesity, but insulin-dependent diabetic.
 
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xring responded:
Well, doc, I'll never stop learning things here. Looks like I had it backwards.

With all the talk about the obesity/diabetes connection, I thought "the less weight, the less beta cell death."

I wish I could provide some input, but I was overweight at birth. I've been up to 405 lbs. & down to 183. (191 now, goal: 180, 6').
 
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auriga1 responded:
Xring, I was on the same wave-length as you. Diabetes and you must be overweight. This is all you ever hear.

My mom must have weighted 125 lbs., standing at 5'7", when diagnosed. Her sugars were in the 600's. I couldn't figure out why she always slept. I really thought this was one lazy mom with five kids to take care of. I vowed I wasn't going to have children if this is what it's like. Now I know, having experienced that awful fatigue that comes with high sugars. Taking four hour naps during the day, ignoring house work, not cooking meals because I was too tired. Really not caring about anything at all.

As you can see, I fit into that 10% that Dr. Dansinger speaks of. Can I go into diabetic remission? It would be great, but I must be realistic. I don't think I fit into that category. I say that only because without my insulin, my sugars are out of control, even when I don't eat.

Overweight at birth? What were you? A 15 lb. baby? Ouch. Your poor mother. LOL. You're doing great by the way with that weight loss.
 
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nightowl41 responded:
I could stand to lose about another 5 lbs., but after that my Dr. feels I would be underweight. I was always very thin, sometimes too thin, but put on about 15 lbs. after my hysterectomy. It took a good year to lose it, but I did. Even with that extra weight, my sugar levels were always low.

Over the years I did put on an extra 10 lbs, but never had any sugar problem, if anything it was quite low. Dr. is still confused as to why my A1C came back high, as she also said I don't fit the profile.

Last blood work I had everything, even my cholesterol was as normal as can be, and trust me, she did a LOT of blood work this past time, 4 months ago! I guess if she is stumped, I certainly am.

Oh well, hopefully someday, if we live long enough there will be an answer. JJ
 
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xring responded:
Auriga, I think I was overweight at conception.
 
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Casey602 responded:
I am a 46 year old male that was diagnosed with Type 2 in April of 2007. I am 6' 1" and weighed 215 at the most in my life. I had all the classic signs (thirsty, going to the bathroom all the time....) and then I lost a bunch of weight in a short period of time... So I was down to 190 without trying and decided to go to see the Dr. My BS was 348 and A1C was 13. Started on insulin and then to Medformin and now on Januvia. I have dropped my A1C to 6.2 (last blood work) and maintained 200 lbs. I have adjusted my eating habits and exercise as much as I can. No really family history that is known. (Back in the day, my parents and grandparent did not get checked for diabetes). So I do not fit the typical Type 2 diabetic person. It is all about moderation and watching how and what you eat along with exercise. Hope this information helps. KCC


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