Can one be "healthy" and still get type 2 diabetes?

Here is my latest article at

It features John, a man who had a healthy and active life style, yet was diagnosed with type 2 diabetes.

You betcha… Lots of ways to get Type 2, besides being obese and not exercising…

Why would you think that you can’t be healthy and have diabetes? I guess I am not getting the relevance. There are many people who are obese/overweight and never get diabetes; there are many more people who never use the “E” word (exercise) let alone do it and don’t have diabetes. There are very healthy thin, normal weight, exercising people who have diabetes…please tell me why you think that you are thinking here. The whole idea of a diabetic not being a healthy person, except for the diabetes, is very disturbing to me. It is putting us in a class system, that doesn’t exist. Would you mind explaining more of your thoughts? thanks, Travis.

Travis, no need to explain, I guess I should have read the dlife post before I posted. here. Your friend John is probably more the exception to what the public seems to think a diabetic looks like, yet, there are millions of us, so we can’t hardly be expected to be all fat and non-exercisers. I’m glad you met him…and Big Foot!

I was diagnosed as a type 2 over a decade ago when i was 26 and could run a 5k (3.1 miles) at a pace good enough to qualify for my high school varsity cross country team and was training for my first triathlon.

Too often, the “thin, athletic” person who has just been diagnosed with Type 2 diabetes actually has slowly progressive Type 1 diabetes (sometimes called LADA or latent autoimmune diabetes in adults) and has been misdiagnosed strictly based on age not etiology. I have seen this again and again, and it is incredibly common here on TuDiabetes. Antibody testing (GADA, ICA, IA-2) is the gold standard test for Type 1 diabetes, and a c-peptide test is also useful. All that said, there are some thin, athletic people who do have Type 2. It’s just very important for one’s health to get a correct diagnosis.

So far John has been type 2 for six years. Any idea how long it takes for a type 2 mis-diagnosis to be realized?

If a person actually has slowly progressive Type 1, he/she can go a number of years (six is a lot, but it is possible) without exogenous insulin. If I were that person, I would simply get antibody testing and c-peptide testing to get a definitive answer, since even small amounts of exogenous insulin are protective of the remaining beta cells if the person actually has Type 1.

I was 30 when I was diagnosed with T2 at 5’6", weighing approximately 140lbs and exercising 3-4 times/week. I don’t think I’m as rare as big foot… I had good control with diet and exercise for about a year and now I’m on Metformin. I sincerely hope I don’t have a misdiagnosis, but will probably ask for the antibody testing the next time I head to the Dr.

You know, there is a huge misconception about type 2 diabetes. That somehow you get diabetes by poor eating choices, being a couch potato and getting fat. That is just so sad and is really hurtful. In truth, diabetes (t1 and t2) can strike anyone. In t2, you become insulin resistant and your body produces high levels of insulin. Guess what high levels of insulin do? It causes you to pack on weight and even by some argument gives you hunger cravings further causing problems. But the time most t2s are diagnosed, they have probably spend a decade sick with elevated blood sugars and elevated insulin. They go to their family doctor, who looks at them and starts the vicious attack. You got fat, and that gave your diabetes.

I call that bullsh*t.

People get diabetes for reasons that even the best doctors can’t yet explain. It strikes everyone, but certain populations worse. Don’t make the mistake of thinking that being overweight “causes” diabetes, that is an error in logic. And to understand that you have to look at all the overweight people who will never have diabetes and see all the people with diabetes who were never overweight and were never helped by losing weight. It pisses me off to always be told to lose weight, like being underweight will help me and even more it breaks my heart to have overweight type 2 diabetics be constantly harrassed that their weight “gave” them diabetes. In most circumstances, it is the other way around, diabetes causes weight gain.

Rant off.

How about this. Have you had your adrenal function checked? Adrenals are responsible for stress hormones, esp cortisol, which along with insulin and thyroid hormones T3 & T4 are the major regulators of metabolism & energy use/production. Cortisol can interfere with insulin’s activity as well as thyroid hormones (get that checked too, if you haven’t already–and don’t let them just check TSH, have them check free T3 and free T4). Weight gain can stem from underperforming adrenals, underperforming thyroid, and insulin resistance that develops DESPITE a healthy diet & exercise regimen because of the interference of stress hormones. it’s certainly worth a look… though I would suggest you go to a functional medicine practitioner (see the Institute of Functional Medicine’s web site) rather than a standard endocrinologist because the latter still think that adrenal insufficiency is a load of hooey (it’s an accepted diagnosis in Europe, and there’s a great, recent NEJM article about it that makes it pretty clear that cutting edge endos understand that you don’t have to have Cushing’s disease to have an underperforming pair of glands). I’d also suggest getting your vitamin D status checked and if it’s below 32, start taking supplemental D3 because being low can contribute to a whole host of related problems.

I was told recently by someone who’d know that they’re finding antibodies more & more often in a subset of T2s, and they’re starting to think that T1 and T2 aren’t as unrelated as everyone has always thought - that there’s a spectrum between the two that means we really have three types - autoimmune, metabolic, and MIXED auto/meta diabetes.

This is one reason why I wish dumb-■■■ TV docs like Oz would refrain from telling everyone that diabetes can be cured if you just eat & exercise right. No amount of macrobiotic living & thrice-daily jogs will switch off the autoantibodies!

Sounds like he could be a LADA based on his weight at time of diagnosis. Thanks for the post.

hm, yeah - that could be your trouble, esp. if all they’re testing is your TSH and not looking at the T4/T3 levels. You can take all the T4 in the world and have a nice low TSH, but if you’re not converting that T4 to T3, you’ll still have symptoms of hypothyroidism (one of which is consistent weight gain). You’re on T4 supplements, Synthroid or another form of levothyroxine, right? Or did they put you on combination T4/T3? if the latter you have a thoughtful endo, most think that all you need is the T4. So a free T4/T3 would be a good check to make sure you’re converting T4 to T3 adequately. BUT, another thing to consider is whether your dietary intake of selenium is adequate? Selenium is a principal element in the enzymes that play the biggest role in T4 to T3 conversion, and if you don’t get it in your food or take a good multivitamin that contains it, you can’t make the enzyme, and thus can’t do the conversion of T4 to T3, and that could be part of your trouble. I honestly don’t know that most docs would think to test for this (I work w/a clinical nutritionist & have thyroid troubles of my own, that’s how I know all this stuff). Simplest cure for selenium deficiency is eating mushrooms, so I try to throw some into my dinners/breakfasts a couple times a week :slight_smile: but if you don’t want to go that route, find a multivitamin that includes it. Not the stuff you find in the grocery store–those things just go right through you because they don’t use bioavailable ingredients. Go high end–more expensive, but you at least get what you pay for. Just be careful and research the manufacturer, make sure they follow NSF GMP standards, because if they don’t, God only knows whether what’s on the label is what’s in the bottle. There was a case in FL recently where a manufacturer had 200 times the selenium in the product as it claimed on the label, and a couple of people were poisoned by it! There are just too many fly-by-night operations that crowd out the companies who actually RESEARCH their products and have reasonable quality controls. Irritating, and occasionally dangerous, but people should also check out what they’re buying & using to make sure the company is trustworthy.

I haven’t read your article…I will do so on my plane ride tomorrow.
I have to ask…what is healthy? People have their own version of health and what is active whether its right or wrong. My father thought poultry was its own food group… How many people eat 4 food groups8glasses of water everyday and follow a meal plan if you are non diabetic and not an athlete?

There are lots of folks who are skinny with a nice figure but could be in bad health. this person in your article may be a “true” Type 2 diabetic meaning they don’t follow all script as most doctors do to make a determination. He might be more prone to enviromental factors.

Again I ask what is the healthy.

Some medications can cause Type 2… And I think the meds he was taking provoked this… (I believed they said he had a Cholesterol problem) I don’t think that after 6 years of actually having control, with just diet and exercise, that he is likely to be LADA… LADAs will struggle with the control, and be put on meds that further don’t work… and so on. He would’ve lost some control in those 6 years, or a lot of it.

Hey Travis,

I’m, 6’ and 148 lbs. I have been jogging for 12+ years now and never eat junk food (fast food). I have always taken good care of my health, never smoked, drank too much etc…

If I stay away from carbs my BG numbers are good if I eat a piece of white bread they jump…

Some say I could be LADA, not sure as I probably wont get tested until (if ) my numbers start changing…

But, as far as being health and having D, I think i fall into that category…


Here is a “new and improved” definition of Healthy: One who is physically active (non-couch potato), and eats a balanced diet (no junk food).

Hi Paul:

I agree.