How common is lean Type 2 Diabetes in Young Adults?

Type 2 Teens and Young Adults
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Hi everyone, I’m new to this forum. I’m curious if anyone has any insights about having high blood sugar as a young adult while being lean. How common is it for it to be type 2 diabetes? Mody?

I’ve always had high blood sugar since I can remember. It was first discovered during my first annual health check up at around 19 years old. I’ve always been pretty lean and fit. I’m currently 5’4" , 105 pounds. I was only 93 pounds when I first found out about my fasting high blood sugar when I was 19. When I first got my annual check up when I was 19 my fasting blood sugar was around 109. Till this day, my average fasting blood sugar ranges from 101-130, usually around 110.

I’ve recently become very obsessive with my blood sugar since I just had a miscarriage, I’m not sure if having high blood sugar caused it but it’s making me feel like it’s a possibility. My a1c has always ranged around 5.7-6.5 and I’m actually really lean. During the time when my a1c was 6.5 I only weighed 90 pounds.

I’m currently 34 now, and my hba1c still hovers around 5.9-6.2 for the past year.

Is there a possibility it could be MODY? Mody 2? My mom and grandma (mom’s mom) didn’t get diagnosed until their mid 40’s though (during menopause), so it possibly isn’t? I’m at a loss and feel so frustrated, depressed, and hopeless.

Note: I was recently put on NPH insulin and it doesn’t seem to be helping at all. my a1c is still around 5.8-6.2… even increasing doses isn’t helping… as a matter of fact I think it’s making me even more hyperglycemic.

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I would say that it is highly unlikely that you are a T2. Much more likely a very slow progressing LADA. All I can tell you is what happened to me. I came down with T1 at age 62. Due to age, my diagnosis was T2. I became more and more ill as the months went by until I finally went to an endocrinologist who immediately prescribed insulin and explained how to use it. I started feeling better the very next day. That was 24 years ago. I think that you have been misdiagnosed for years and to now prescribe NPH proves that whoever your health “professional” is does not know much about T1 diabetes nor how to treat it. Find another doctor.

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Hi! Thank you so much for your response. I did have my insulin autoantibody, IA-2, GAD-65, & ZnT8 tested and they all came back negative, though.

The doctor put me on insulin because I’m trying to conceive. She said I can do other medications but because I’m trying to conceive she wouldn’t put me on it.

The insulin is really not lowering my blood sugar though. I’m not too sure if it’s MODY 2. It’s so expensive to get tested for MODY……

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I’m not saying you shouldn’t be on insulin. I am saying that any doctor who prescribes NPH today is way behind times. You should be prescribed a basal insulin and a bolus insulin. I’m not up on the various basals available today because I use only Novolog in my Tandem insulin pump. And there are also several bolus insulins available today besides Humalog and Novolog. Long-ago users of NPH will tell you how difficult an insulin it is. And anyone taking an adequate dose of insulin will have BG go down. You must have been told to take too little to show any effect. Also eating fewer carbohydrates such as anything with flour in it would be of benefit. It has also been found that quite a few T1s test negative for all those tests you were given. Find a doctor who specializes in diabetes.

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Oh I see! Got it. I believe my Endo told me she prescribed NPH insulins- particularly novolin n & novolog because it’s the safest type of insulin during pregnancy. They told me they wouldn’t put me on insulin yet if I wasn’t trying to get pregnant.

Ah, really? It doesn’t seem like my blood sugar has gotten any higher since 19 years old though? My fasting blood sugar and hba1c is still around the same range as 15 years ago… when I was 19. Around 5.7-6.5.

It really does depend on if I eat allot of carbs and sugary stuff though! I notice if I drink a lot of sweeten beverages during the previous 2-3 months prior to getting my hba1c drawn it goes to around 6-6.5, but if I cut down it ranges from 5.7-5.9.

Never goes lower than this… or higher :frowning: .

I will see if I can get another endo’s opinon, though. Thank you!

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I hope you are testing your glucose levels several times a day also… before eating and 2 hours after. A single test at arising in the morning is not adequate.

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I am using a continuous glucose monitor

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Glad to hear you have a CGM. Have you found a solution to put together your food and exercise logging so you can try to manage to get your time in tight range up? The BG targets for pregnancy are tight.

Diabetes happens regardless of body type. Sure, most common is fat around the middle caused by the breakdown in regulatory systems related to glucose control but its not a requirement.

On NPH versus a long acting insulin, that raised my eyebrows too but then I remembered searching for a good book about pregnancy for people with T1D for someone who was going to start IVF and struggling with the tight control required and found very little. Scratching my head I checked out what the ADA had to say and found even they were bemoaning the lack of science and good studies around diabetes and pregnancy. So I’m not surprised a doc prescribed NPH and offered safety platitudes because it is all they have experience with and hasn’t seen evidence to convince them to update their protocols.

Here’s the ADA info on diabetes and pregnancy. https://diabetesjournals.org/care/article/48/Supplement_1/S306/157565/15-Management-of-Diabetes-in-Pregnancy-Standards which may give you some insight on where your doctor is coming from.

You don’t say you’ve been diagnosed with diabetes, I’m just using the term to represent the body’s “different” glucose control… Docs have a hard time with people that don’t fit their labels and you don’t sound like you fit. I’ve heard it’s important to find a doc you trust and follow their plan, NPH or otherwise, for a couple years. The plan may not work for you and you may need to make the decision to try a different doc with a different plan. Hope this turns into a joyful experience for you soon.

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And here’s good info on MODY

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Hello! I’ve been trying to change my diet to really low carbs, but I’d fall off the train once in a while and have a cookie or a doughnut, :(. I also workout 6 days a week for about an hour each day.

Now that you’ve mentioned it, all my doctors including 2 endocrinologists and 3 GP never officially diagnosed me with type 2, they just pretty much said my glucose runs a bit high and I’m most likely insulin resistant. So I assumed they think or are diagnosing me with type 2. They’re probably not too sure what to diagnose me with either?

I’m not sure why exogenous insulin isn’t working for me…. A dose would work for maybe a day or two and then stop working and go back to where the levels were when I’m not using exogenous insulin. Then, I would drop the dosage a little bit and my blood sugar would get a bit better… then after a while it goes back to how it was before again & I would increase the dosage a bit and the same thing happens again. It’s like a cycle, not too sure what is going on. My endocrinologist told me to just keep increasing my dose, but I’m really scared to be injecting too much insulin.

I wonder if MODY 2 has issues with exogenous insulin working as effectively as well?

Additionally, thank you so much for providing the gestational diabetes and MODY 3 information. I really appreciate it.

I actually had my endocrinologist order a MODY genetic panel. She was the one who suggested it. It’s now pending insurance approval. Hopefully it gets approved….

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I never would have guessed that they put you on insulin for a 6.2.

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If you can, talk to other docs if you’re unsure of your diagnosis, but keep monitoring. Perhaps insulin - which can cause weight gain as well as low BG - isn’t the best choice for you. Hard even for docs to know.

Yes, there can be a lifestyle component for T2D., but never forget genetics. And recent research shows T2D appears to have an autoimmunity component as well as genetic.

My dad, his dad and i were/are type 1. His mom, brothers and sisters AND my 16 cousins had/have type 2, all diagnosed when teenagers, all active, tall & lean. So that genetic force is strong in my family! My husband is type 2, but with lifestyle changes could get off insulin. Our daughter is pre-diabetic, but with lifestyle changes, might avert the full-blown diabetes decree.

No matter which type you have, or why you have it, you now will want to explore what treatments work best for you, because both types wreak havoc with your insides - from brain to circulatory systems to skin.

The best suggestion i can give you is to ask questions, as you are doing. Ask docs, fellow diabetics, sites like TU, their experiences and results, and see what works best for you.

For me, insulin isn’t a choice. Gotta have it. But i don’t want too much, because there are long-term side effects. So for me, the gym or something aerobic is critical. That also allows me to eat non-fibre carbs from time to time. But that’s me.

With this disease, everyone’s mileage varies.

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Thank you for your insight !

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Speading out my carbs really helped me, along with accurate carb counts (measuring most everything with carbs). Small meals, many snacks.

Sounds like your Docs and Endo may be thinking prediabetes even if they’re not saying so.

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Belief in “prediabetes” is like belief in being “a little pregnant” or “a little dead.”

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Yeah, I personally hate the term, if people diagnosed as prediabetic would take it seriously and do what is necessary, they might be able to live well, drug and exogenous insulin free for life. But everyone I know with that diagnosis just shrugs their shoulders, “It’s not bad,” continuing as before.

Unless it is later determined to be LADA/LADY T1DM - prediabetes is early T2DM. The earlier one gets diet and exercise on board, the slower the progression. In fact it may not progress ever.

I was not diagnosed as prediabetic, it was full on with a fBG of 400mg/dl+ and HbA1c of 14.5%. This means that for several years my Beta cells have been working overtime to combat my cells resistance to insulin.

I am amazed that I got 10 years of near to normal BGs with diet and exercise before the 1st progression requiring oral drugs. This has continued until now that I am on an oral plus a pump. And yes, I still eat correctly and exercise.

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