A leading Endochrinolgist advises a Thin Ty... - Diabetes India

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A leading Endochrinolgist advises a Thin Type-2 Diabetic! Interesting!

namaha
namahaModerator
5 Replies

Here is what a leading Endochrinolgist from a leading Hospital has to say to a T2 patient of 44 years old. The patient lost weight going from 49 kg to 38 kg in her dietary approach to control blood sugar...

The YouTube video link is attached at the bottom of this posting..... I'm sorry it is in Hindi....

If we recall whatever we have learned so far is being summarised below and our esteemed members are welcome to air their views which we would love to hear...😊

If you are an obese Type 2DM , you seem to be lucky since you may have a cure by natural means....

However, if you are Thin type 2 DM, you are still luckier...since you tend to learn more and more to keep yourself fit....😊

(1) Thin type-2 DM with Low BMI:

To check fasting serum insulin (without any drugs) and fasting blood glucose level and calculate your beta cell status by the formulae HOMA-B=(360xFI)÷(FG-63) where FI is fasing insulin in uIU and FG is fasting blood glucose in mg/dl.

If HOMA-B is less than 70, means you have poor beta cell function .. which means you may also have a very low level fasting insulin level less than 5 uIU.

In such a situation, while Carb counting and LCHF may be helpful to avoid glucose spike and also lower blood glucose levels, but due to lack of insulin level, you may not be able to put on weight and in fact you may keep on reducing weight and in case you eat excess calories more than your BMR in form of fat , it may get converted in to high blood sugar and high Triglyceride. (Insulin is a master hormone and is essential for metabolism of all the three Macro nutrients namely Carbs, Protein, Fat.......). Gradual weight reduction of a thin type underweight T2 could weaken your body, reduce longevity and could be fatal at times .. ..the research says thin type 2DM carry 3 times more risk of death than obese type 2's....

So the solution for you would be to consult your Endochrinolgist and take an insulin secretagogue......or take exogenous insulin....

Continue with your LCHF which could be helpful... and with exercise You can keep your drug dose to minimal so that you can control your blood glucose level... You can put on some weight.... you will feel energetic....quality of life will improve with least side effects...with well controlled blood sugar level... Even your declining beta cell function could be arrested and disease progression can be slowed down with the right drug and right dose....

Metformin for you perhaps would do no good except help reducing weight which is not desirable for an underweight... It is designed only for Obese type 2 for reducing weight and reducing IR....

(2) Obese type 2 DM

Your fasting Insulin levels are high.....with severe IR.. HOMA -B may not be an issue with you... your HOMA - IR is more than 2 as computed from HOMA IR =(FIXFG)÷405...

For an obese type-2, only with diet and exercise, he/she can control his/her diabetic conditions .... Combining LCHF/ Carbs. counting, Calorie counting with IF..... Eat less than your BMR...., exercise daily.... Reduce weight, enhance Insulin sensitivity .... and you have done it.... Though sustaining weight reduction may remain a challenge in the long run...unless he/she makes it a habit to follow these healthy norms...

5 Replies
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sandybrown

Is there any relationship between the waist measurement, BMI and insulin resistance?

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namaha
namahaModerator
in reply to sandybrown

Yes, there is a strong relationship between BMI and IR...

Higher the BMI, more the likelyhood of an IR....

If you bring down your BMI to a healthy level, your IR also will improve !

So the mantra for the obese type 2 is to reduce weight through all available options : A permutation and combinations of the tricks : LCHF, IF, Low calorie diet less than one's BMR, Physical exercise... Resistance training , Cardio..

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rnpath

this endocrinologists opinion is not correct on many issues.his advise also does not seem to be based on scientific evidence.many endocrinologists also hold such bias.

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sandybrown
sandybrown
in reply to rnpath

would it be possible to offer more explanation?

Thanks

Reply
achendada

Here the patient says she increased 5 kilograms body weight in 3 months, eating enough food including carb and non carb . 30 almonds daily with eggs, olive oil, green vegetables, sported gram etc.

It’s highly essential to keep healthy along with medication.

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