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Can You Be Skinny And Have Diabetes?

6 Signs Your Type 2 Diabetes Might Really Be Type 1

6 Signs Your Type 2 Diabetes Might Really Be Type 1

Reviewed by endocrinologist Stanley S. Schwartz, MD, emeritus Associate Professor of Medicine at the University of Pennsylvania and George Grunberger, MD, FACP, FACE, Chairman of the Grunberger Diabetes Institute, Clinical Professor of Internal Medicine and Molecular Medicine & Genetics at Wayne State University School of Medicine and President of the American Association of Clinical Endocrinologists. Up to 10%1 of people with type 2 diabetes may actually have a form of diabetes known as latent autoimmune diabetes in adults, or LADA, where the immune system slowly destroys insulin-producing beta cells. That’s the conclusion of a string of studies that have looked at this mysterious high blood sugar problem since it was first recognized by Scottish endocrinologists in the late 1970s.2 Yet 39 years later, most of the estimated 3 million or more Americans with LADA think they’ve got type 2 diabetes. That misdiagnosis can cause frustration, misunderstandings and even health problems, says endocrinologist Stanley S. Schwartz, MD, an emeritus Associate Professor of Medicine at the University of Pennsylvania. “If your doctor is not thinking about the possibility of LADA, he or she may not prescribe the diabetes drugs early on that could help extend the life of your insulin-producing beta cells,” Dr. Schwartz says. “With LADA, you lose the ability to produce insulin much more quickly than the typical type 2. But a doctor who believes you’re a type 2 may hesitate to prescribe insulin when your blood sugar levels rise, thinking that a healthier lifestyle and higher doses of other medications will work.” As a result, your blood sugar could skyrocket, increasing your risk for diabetes complications, says George Grunberger, MD, FACP, FACE, Chairman of the Grunberger Di Continue reading >>

Yes, I'm Diabetic And Yes, I'm Skinny

Yes, I'm Diabetic And Yes, I'm Skinny

Okay, here's the deal: There's basically two forms of diabetes: type 1 and type 2. Logical enough names, I suppose. Type 1 diabetes is an autoimmune disorder: something goes haywire in the immune system, and the patient's body destroys their own ability to manufacture insulin. Blood sugar skyrockets, they feel like crap, and if they don't get onto insulin, they die. This used to be called Juvenile Diabetes Type 2 diabetes is more of a mystery. It's insulin resistance -- the body makes enough insulin, it just doesn't work right. It's often associated with obesity, and people can manage it through losing weight and exercising lots. This used to be called Adult-Onset diabetes Recently, adults have begun contracting type 1 diabetes. In fact, this has probably always happened -- it's just that years ago, people dropped dead and nobody thought that much about it. When an adult contracts type1 diabetes, it usually takes a while. Kids go diabetic over the space of days or weeks. Adults go type 1 diabetic over years. Some people call this type 1.5 diabetes, or LADA (Latent Autoimmune Disorder in Adults). I'm 5'9, I weigh 150 pounds. My BMI is around 21. I'm not obese in anyone's book, and I'm pretty active -- particularly with these rambunctious kids of mine. My pancreas isn't making enough insulin anymore, so I can't process carbohydrates. Left to itself, my blood sugar tends to climb. For the last six weeks, I've managed to control my blood sugar with an insanely strict, almost entirely carb-free diet and rigorous exercise. It hasn't been enough,and frankly, it wouldn't be possible for that to be enough. I'm on small doses of insulin now, and I take some fast-acting insulin before every meal or snack. I will do that for the rest of my life. Over the next few years, my immune s Continue reading >>

Diabetes Can Strike—hard—even When Weight Is Normal

Diabetes Can Strike—hard—even When Weight Is Normal

We tend to think of type 2 diabetes as a disease that afflicts people who are overweight. But it can also appear in people with perfectly healthy weights—and be more deadly in them. A study published today in the Journal of the American Medical Association indicates that normal-weight people diagnosed with type 2 diabetes have double the risk of dying from heart disease and other causes than overweight people with diabetes. Such apparent “protection” by excess weight has been called the obesity paradox. It’s been seen with other conditions, like heart failure and end-stage kidney disease. Overweight or obese people with these conditions seem to fare better or live longer than their normal-weight counterparts. That doesn’t mean gaining weight is a healthy strategy. Instead, it probably means that something else besides weight—like the amount of fat around the waist—may be contributing to the onset and severity of type 2 diabetes. Diabetes types There are two basic types of diabetes. Type 1 diabetes occurs when the body stops making insulin. This happens when the immune system mistakenly attacks insulin-making cells in the pancreas. Without insulin, cells can’t absorb sugar (glucose) from the bloodstream. The resulting high sugar levels in the blood damages nerves, arteries, and other tissues. Type 1 diabetes often appears early in life, but can happen later. People with type 1 diabetes must take insulin. Type 2 diabetes occurs when cells become resistant to insulin’s “open up for sugar” signal. Exactly why this happens is still something of a mystery. But excess weight contributes to it, since fat cells affect how the body uses glucose and produces insulin. Lack of physical activity also plays a role. Medications that make muscle and other cells mor Continue reading >>

Are You A Skinny Fat Person? 10 Steps To Cure The Skinny Fat Syndrome

Are You A Skinny Fat Person? 10 Steps To Cure The Skinny Fat Syndrome

The common wisdom is that if you are overweight you are unhealthy, and if you are thin, you are healthy. But new research points to just how dangerous being skinny can be — if you are a “skinny fat” person, that is. The medical term for this is “MONW,” or metabolically obese normal weight, which I prefer to refer to as being a skinny fat person. It means you are under lean but over fat — not enough muscle and too much fat (especially belly fat). It seems it is better to be fat and fit than thin and out of shape. While we know that 68 percent of the American population is overweight, and that most have diabesity — being somewhere on the continuum of pre-diabetes to Type 2 diabetes — the shocking news from a study published in the Journal of the American Medical Association is that nearly 1 in 4 skinny people have pre-diabetes and are “metabolically obese.” What’s worse is that if you are a skinny fat person and get diagnosed with diabetes, you have twice the risk of death than if you are overweight when diagnosed with diabetes. Perhaps having that extra muscle on your body from having to carry around those extra pounds protects you. Studies on teenagers found that 37 percent of the skinny kids had one or more signs of pre-diabetes such as high blood pressure, high blood sugar, or high cholesterol. Wait — almost four out of 10 normal-weight kids are pre-diabetic? It is bad enough that one-third of kids are overweight or obese in America, but now it appears that only about 20 percent of children in America are healthy. In other words, 8 out of 10 children in America are overweight or have pre-diabetes or Type 2 diabetes. In my medical practice I see this all the time. Jim came in for a “wellness check up” and felt happy about his weight. His BMI Continue reading >>

Doctors' Message To Asian Americans: Watch Out For Diabetes Even If You're Young And Thin

Doctors' Message To Asian Americans: Watch Out For Diabetes Even If You're Young And Thin

The Silicon Valley techies visiting his office were typically slender Asian Americans in their 30s who worked out regularly and ate healthy meals. But, as Sinha repeatedly found, they either already had or were about to get diabetes. It wasn't. What Sinha noticed a decade ago is now supported by a growing body of scientific research: Asians, in part for genetic reasons, are disproportionately likely to develop diabetes. They get the disease at younger ages and lower weights than others, experts say. Diabetes, a condition in which blood sugar levels are higher than normal, often remains undiagnosed until it's too late, especially in Asians who haven't historically been considered high-risk. It's the seventh most common cause of death nationwide and can lead to blindness, amputations and strokes. To prevent the insidious disease from gaining ground among the country's fastest-growing minority group, doctors and health advocates are trying to increase diabetes testing and treatment for Asian Americans, including Chinese, Indians and Filipinos. Diabetes is largely preventable, experts say — but only if people know they are at risk. "We began with diabetes is not a big problem in the Asian community" to now thinking "simply being Asian is a risk factor," said Dr. Edward Chow, an internist who has worked in San Francisco's Chinatown since the 1970s. In Los Angeles County, Asian American adults have the lowest obesity rate of any ethnic group, at 9%, compared with 18% of whites and 29% of Latinos and blacks. But 10% of Asian Americans in L.A. County are diabetic, compared with 7% of whites, despite Asian Americans' drastically lower obesity levels. Scientists think the mismatch is because obesity is a measure of weight, not necessarily fat — the real culprit in diabetes. A Continue reading >>

Slim And Healthy People Also Get Type 2 Diabetes

Slim And Healthy People Also Get Type 2 Diabetes

Overweight, an unhealthy lifestyle and old age are factors that many of us associate with people who are diagnosed with type 2 diabetes. But this isn’t entirely true. In fact, the disease can hit the slim, the fat, the young and the old. This diversity of patients does not make life easy for doctors and researchers, as it creates a need for a great variety of treatment forms. For example, lifestyle changes only work for some patients and not for others. The ideal time for an insulin fix also varies greatly, depending on the patient. However, now two Danish researchers have cracked part of this code. Based on data from a comprehensive English study, they have identified three subgroups of type 2 diabetes patients that have different diseases patterns. In addition to showing that diabetes is expressed in a variety of ways, the study surprises by showing that only 25 percent of the type 2 diabetes patients follow the course of the disease that scientists so far have considered to be the most common one. ”This finding is the first step towards more targeted prevention and treatment for patients with the different subgroups of the disease,” says Kristine Færch, a senior researcher at the Steno Diabetes Center, who co-authored the study. Classification determined by blood sugar Insulin is the key ingredient when we’re talking about type 2 diabetes. Insulin is produced in the body and works by transporting the energy from our food into the cells, where the energy is used. Type 2 diabetes occurs either: As a result of insulin resistance, where the insulin gradually loses its ability to transport energy from food to the muscles. As a result of problems with the beta cells, which are those that produce or secrete insulin. It was previously believed that the most common c Continue reading >>

Why Thin People Can Become Diabetic—and It’s Not Insulin Resistance

Why Thin People Can Become Diabetic—and It’s Not Insulin Resistance

There is a blatantly illogical explanation in medicine about Type 2 diabetes being caused by insulin resistance. On one hand, it is claimed that weight gain in the form of excess fat causes insulin resistance, and other hand, it is also claimed thin people, who by definition, do not seem to have to extra fat, can develop insulin resistance, too. In my view, this is contradictory and points to yet another reason that insulin resistance as the cause of Type 2 diabetes does not make sense. Let me give you four reasons why it makes no sense biologically that insulin resistance occurs in both obese people and thin (lean) people and causes Type 2 diabetes: 1. In obese people, the current medical teaching is that the accumulation of excess fat causes insulin resistance as well as impairs insulin-producing cells in the pancreas. Meanwhile, to explain why thin people get diabetes, it is believed that these people suffer from a rare genetic “defect” characterized by a lack of fatty tissue. In other words, on one hand, excess fat causes insulin resistance while on the other hand insufficient fat can also cause it. 2. The amount of fat tissue a person has is actually a function of the number of fat cells and the capacity of each cell to store fat (also called triglyceride). The number of fat cells increases from childhood ending with about 50 billion in an average adult. Obese adults do not have more fat cells than they had before, but they have larger fat cells, up to 4 times the normal size, when filled to capacity with fat. When a person loses weight, the number of fat cells remain the same, but each cell loses fat. We know that obese people who lose weight can lower their blood sugar and even reverse diabetes. But this presents another paradox: Why don’t obese diabetics w Continue reading >>

Lose Weight With Type 1 Diabetes

Lose Weight With Type 1 Diabetes

WRITTEN BY: Cliff Scherb Editor’s Note: Cliff Scherb, Founder of Glucose Advisors and TriStar Athletes LLC, is a nutrition and fitness expert. He consults through virtually teaching his decision support system – Engine1 the app and its methodologies to aspiring T1 individuals and athletes. Cliff also creates custom training programs and insulin plans for endurance athletes, using Training Stress Modeling and real-time coaching. To inquire about coaching openings, FB LIVE sessions, and general questions please email [email protected] Losing weight can be difficult — add Type 1 diabetes to the mix with its daily management demands — and it’s even more of a challenge. I know, because I’ve been a Type 1 diabetic for 29 years and I’m also an endurance athlete. The internet is saturated in advice on how to lose weight with or without Type 1, so it’s hard to know what is worth while and what will just waste your time — or worse, can negatively impact your health. I’m not going to declare all out war on carbohydrates, or tell you can or can’t drink your calories in the form of olive oil, or feast and fast with cayenne peppers and maple syrup. No, the real distilled learning from my years of consulting and data analysis shows that a balanced, low-insulin diet with nutrient timing and activity is the best way to lose weight with Type 1 diabetes. It also helps you maintain brain and body function as well as energy levels. If you are reading this you’ve probably already given this some thought and know why it’s important to lose weight and/or lean out, but I maintain it’s all about performance! Performing means living a longer or healthier life or if you’re an athlete, it can also translate to beating out your competition. Things that Impact w Continue reading >>

The Causes Of Insulin Resistance In Type 1 Diabetes, Type 2 Diabetes And Prediabetes (video)

The Causes Of Insulin Resistance In Type 1 Diabetes, Type 2 Diabetes And Prediabetes (video)

Most people believe that people with type 1 diabetes are not insulin resistant simply because they are not overweight. This could not be farther from the truth. While insulin resistance affects many overweight individuals, many people with type 1 diabetes remain skinny their entire lives despite a large degree of insulin resistance (1–3). Over the past decade, I have helped many people with type 1 diabetes measure, track and reverse insulin resistance. In practice, 100% of all my clients with type 1 diabetes suffer from insulin resistance despite the assumption that they were insulin sensitive. By measuring their baseline insulin resistance, we were able to identify an impaired ability to utilize glucose as a fuel, and through dedicated diet modification and frequent exercise, some of my clients have reduced their insulin usage by as much as 60%. If you have type 1 diabetes, do not be fooled into thinking that you are insulin sensitive simply because you are skinny. Insulin resistance is a hidden condition, and affects both normal weight and overweight individuals (1–3). What Causes Insulin Resistance? Insulin resistance underlies all forms of diabetes, and is a condition which primarily affects your muscles, liver and adipose tissue. Many people think that diabetes is caused by an excess intake of sugar and candy starting from a young age. While eating artificial sweeteners and drinking soda can certainly increase your risk for the development of insulin resistance and diabetes, in most cases diabetes is caused by excessive FAT intake. The most important thing you can do as a person with diabetes is understand the following: Diabetes is caused by a fat metabolism disorder, which results in a glucose metabolism disorder. At the heart of all forms of diabetes is insu Continue reading >>

Can Thin People Get Type 2 Diabetes?

Can Thin People Get Type 2 Diabetes?

Almost 90 percent of people with type 2 diabetes are overweight or obese, according to government statistics, and it's known that carrying excess weight ups your diabetes risk. The reason is that fat interferes with your ability to use insulin — insulin moves sugar (glucose) from your blood to your cells, which need the sugar for energy. But don't think you're off the hook if you're thin — you still can be at risk for type 2 diabetes, even if you're not heavy. The risk for developing type 2 diabetes may be smaller if you're thin, but it's still real, especially if you're older, says Christopher Case, MD, who specializes in endocrinology in Jefferson City, Mo. It's not known exactly how many thin or normal-weight people have type 2 diabetes, but part of that may be because there is no standard definition for "thin," Dr. Case says. "They may not look obese," Case says, but any excess weight, especially around the stomach, is a risk factor. One of the reasons people can have high blood sugar and develop diabetes whether they're thin or obese is because weight, though a contributing factor, is not the only factor. Type 2 Diabetes Could Be in Your Genes Genetics plays a role in developing type 2 diabetes. Studies show that people who have a close relative (parent or sibling) with type 2 diabetes have a greater than three times higher risk of developing the disease than those with no family history, Case says. Genetics may explain why some people who are thin develop type 2 diabetes and why an obese person might not, he says. African-Americans, Asians, Hispanics, and Native Americans also are at greater risk for type 2 diabetes. Lifestyle Choices Raise Your Diabetes Risk These other risk factors, often associated with people who are overweight, can plague thin people, too Continue reading >>

How To Lose Weight When You Live With Diabetes

How To Lose Weight When You Live With Diabetes

Losing weight can be difficult for anyone, and living with diabetes definitely doesn’t make it easier. However, there ARE people who set out to lose weight and end up so extraordinarily successful that you wonder if they have some inside information you don’t. That information EXISTS. I’m here to give you the rundown on how to successfully lose weight when you live with diabetes. In this post, I will go through: How to set realistic goals How many calories to eat How much protein, carbs, and fat to eat How much to exercise How blood glucose control affects your weight Without further ado…lets GET TO IT! Temper expectations at the start People these days have this intensive need for instant gratification. They want that 15 lbs gone by yesterday! While I’m all for efficiency, I’m going to be short and sweet and show reality with a pop quiz: True or false: it took more than a week to gain the weight you are trying to lose. The answer is undeniably “True”. So if it took you X number of months to gain weight, why would it take you a week or two to lose it? It doesn’t. It takes time and some concerted effort. Don’t expect to lose all of the weight immediately, but know that with proper habit formation and consistency, you WILL see the results you are after. The general rule for healthy weight loss is to aim for A MAX of 1-2 lbs. per week. It’s also quite common for people living with diabetes to take as long as 2-3 weeks before seeing any weight loss at all on a new diet. “Why?” you ask. Changing caloric intake and workout routines may require a reduction of insulin (or other diabetes medication) as well as diet manipulation, which takes a little trial and error to adjust. BE PATIENT. Once the ball is rolling, a slow and controlled weight loss makes Continue reading >>

Pregnant Ladies, Take Note: You Can Be Healthy And Fit And Still Get Gestational Diabetes

Pregnant Ladies, Take Note: You Can Be Healthy And Fit And Still Get Gestational Diabetes

The one-hour glucose test is something every pregnant woman is asked to take. For the test, you chug a sugary drink, wait an hour, have your blood drawn, and then go about your day. The test is designed to check for gestational diabetes, a form of high blood sugar that affects pregnant women, and most women don’t hear or think about it again. That’s how I was, until I was told that I seriously flunked mine—and I didn’t take the news well. In fact, I'm pretty sure I blurted out something like, "How is that possible?" After all, the typical gestational diabetes patient is someone who has gained a lot of weight during their pregnancy and doesn’t exercise often. (Two of the major recommendations for women diagnosed with gestational diabetes are to follow a healthy diet and exercise more.) At seven months pregnant, I haven’t gained much weight, I eat healthy, and I run four miles, five days a week. My doctor also told me in the same visit that my baby bump is “measuring small,” and she wants to keep a close eye on it. WTF is going on?! According to the Centers for Disease Control and Prevention (CDC) anywhere from one in 50 to one in 20 pregnant women has gestational diabetes, so this is a fairly common issue. I just didn’t think it would be my issue. But, apparently, you can develop gestational diabetes and be an otherwise healthy person. Like type 2 diabetes, “gestational diabetes is linked to excess weight gain and lack of exercise,” Anita Avery, M.D., an ob/gyn at Michigan State University, tells SELF. “However, plenty of otherwise healthy women who are in good shape can still develop gestational diabetes.” That’s why women are screened with a blood test, rather than just those who are thought to have a chance of having gestational diabetes ba Continue reading >>

Skinny And 119 Pounds, But With The Health Hallmarks Of Obesity

Skinny And 119 Pounds, But With The Health Hallmarks Of Obesity

Claire Walker Johnson of Queens was a medical mystery. No matter how much she ate, she never gained weight. And yet Ms. Johnson, with a long narrow face, had the conditions many obese people develop — Type 2 diabetes, high blood pressure, high cholesterol and, most strikingly, a liver buried in fat. She and a very small group of very thin people like her have given scientists surprising clues to one of the most important questions about obesity: Why do fat people often develop serious and sometimes life-threatening medical conditions? The answer has little to do with the fat itself. It’s about each person’s ability to store it. With that understanding, scientists are now working on drug treatments to protect people from excess unstored fat and spare them from dire medical conditions. The need is clear. One in three Americans and one in four adults worldwide have at least three conditions associated with obesity such as diabetes, high cholesterol and high blood pressure — a combination of disorders that doubles their risk of heart attacks and strokes. In addition, 2 percent to 3 percent of adults in America, or at least five million people, have a grave accumulation of fat in their livers caused by obesity that can lead to liver failure. The detective work that led to this new scientific understanding of fat began with a small group of scientists curious about a disorder that can be caused by a gene mutation so rare it is estimated to affect just one in 10 million people, including, it turned out, Ms. Johnson. For much of her life, Ms. Johnson, 55, had no idea anything was amiss. Yes, she was very thin and always ravenous, but in Jamaica, where she was born, many children were skinny, she says, and no one thought much of it. She seemed healthy, and she developed Continue reading >>

Sugar Blues

Sugar Blues

Gestational Diabetes: A threat to mom and baby. At my 26-week OB appointment, I drank a bottle of extra-sweet soda—imagine Mountain Dew spiked with pancake syrup—and an hour later, submitted my arm for a blood test. I was being screened for gestational diabetes and, as a gym regular and healthy eater (except for those first-trimester French-toast binges), I wasn't worried. But the next day I learned that my blood sugar exceeded the cutoff level, and I'd need a more precise test involving an overnight fast, four blood draws and a soda twice as sweet as the first. This time I was worried. What were the chances that I could actually have gestational diabetes? If so, what would that mean for me and the twins I was carrying? How concerned should I be? These are hot-button questions in the medical community. High blood sugar during pregnancy, what doctors call gestational diabetes mellitus (GDM), now affects 5 percent to 8 percent of expectant women, up from 4 percent about 20 years ago. Doctors have known for decades that GDM puts women at risk for having large babies and Cesarean sections; new studies indicate it may have long-term consequences and that it poses risks at lower blood-sugar levels than previously thought. The good news is that proper treatment reduces these risks. A diagnosis might sound scary, says Danielle Symons Downs, Ph.D., an assistant professor of kinesiology at Pennsylvania State University in University Park, "but for a woman who takes it seriously and makes lifestyle changes, it could be the best thing to happen to her and her offspring." The Sugar Story Gestational diabetes develops when hormones from the placenta compromise a woman's ability to use the insulin produced by her pancreas. Though most women compensate by producing extra insulin to Continue reading >>

Thin And Type 2: Non-obese Risk Factors For Developing Diabetes

Thin And Type 2: Non-obese Risk Factors For Developing Diabetes

Emily got quite a surprise when she went for her annual physical exam. The lab tests taken showed that her blood glucose readings were in the range of someone with type 2 diabetes. Since Emily did not fit the usual appearance of someone with type 2 diabetes, her doctor ran the test again and checked for antibodies to insulin and her c-peptide levels, in case Emily was in the early stages of LADA (a slow moving version of type 1 diabetes). The test results were the same, however. Even though Emily, at 5 feet 2 inches and 115 pounds, had never been overweight in her life, she had type 2 diabetes. Emily was one of the 15 percent of individuals in the United States who develop type 2 diabetes even though their BMIs are squarely in the normal range (between 18.5 and 24.9). There can be a number of factors that come into play when a thin person develops type 2 diabetes. Genetics play a significant role in determining disease onset. A strong family history coupled with a sedentary lifestyle and poor eating habits can tip the scales in the wrong direction. So too can a previous diagnosis of gestational diabetes or the birth of a baby greater than nine pounds. Unfortunately for these individuals, their outside appearance is hiding a metabolic profile similar to overweight people who have type 2 diabetes. They are insulin resistant not from excess pounds per say, but from the places where some of their fat cells are stored, and often from a lack of exercise. Many normal weight people with type 2 diabetes have excess visceral fat. Visceral fat is the type of fat surrounding the body’s abdominal organs and is highly metabolically active, producing a variety of hormones that influence glucose and fat metabolism. Fat cells release fatty acids into the blood stream that can damage t Continue reading >>

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