Endocrinology-Diabetes Questions Diabetes

Why am I not putting on weight?

I am a diabetic (5 years so far) and I have only been losing weight. Despite all my efforts to eat the right diet, I am not gaining weight. Why is this happening?

7 Answers

Weight loss in diabetes suggests that you lack insulin, which promotes growth. Your physician and a nutritionist should review your diet and ensure that you have adequate medication to control your blood glucose as you meet your caloric needs. Starvation is not needed to manage diabetes. Proper timing of balanced meals is the important feature of management.Check my article on CHRONONUTRITION in Diabetes Spectrum November 2018 issue.
My guess is that you are a type 1 who is not on enough insulin, so your body keeps destroying your fat stores and muscle for fuel to stay alive....
This is an important complaint which requires a good evaluation with history and physical. It may not be due to diabetes alone and could represent other serious diseases.  Please discuss with your primary and ask if referral is required.

Edward M. Condon, MD, FACE, ECNU
Very good question.

First, knowing the TYPE of diabetes is important. Type 1 diabetes is a lack of insulin and subsequent elevation in blood sugars. Type 2 diabetes is insulin resistance (can't use it) and subsequent elevation in blood sugars. Insulin is anabolic. This means it promotes the machinery of our cells to grow and divide. Hence, insulin deficiency (type 1 diabetics) are often quite thin in contrast to type 2 diabetics (make insulin) who are generally obese (or at least overweight).

Extremely elevated blood sugars, regardless of type, can put your body into a sense of starvation. Regardless of underlying type of diabetes, body perceives "low sugar" as "low energy" because it can't get into the cells for use. This prompts breakdown of muscle tissue and to a lesser extent fat tissue, causing weight loss.

For most people, good control is defined by a hemoglobin A1c < ~7% or avg sugar around 150 or less.

If you're on adequate therapy with good results, then I would take a quick look into thyroid and bowel habits. Make sure all else is well outside of the diabetes. There is no rule in medicine that states you can only have one disease process at a time.

A healthy body mass index (BMI) is 19-24.9 (unless Asian).

Doing a food/calorie log and taking it to your doctor can help guide you and provides tremendous insight into your day to day intake.

How well is your diabetes controlled? Are you checking your sugars?
With the small amount of information you sent, is impossible to say why this is happening. I would need to know things like your age, degree of diabetic control, meds you are taking, etc. including what type of diabetes you have. If you still have high blood sugars then you are not putting the carbohydrate into the cells but losing the calories in the urine. So get the blood sugars under control & see a dietician to get a good diety plan.
This could be related to high blood glucose or other problem unrelated to diabetes. You should visit a healthcare provider to discuss.