Can prediabetes cause weight gain?

October 21, 2012 8:16 PM

Can prediabetes cause weight gain?

I'm in the normal weight range. My doctor believes I'm prediabetic because I have had elevated fasting sugars as well as episodes of hypoglycemia.

I used to be very thin. Even though I'm still a normal weight according to the charts doctors use, in the past few years I gained about 15 pounds and had a lot harder time managing my weight.

Now I'm sort of normal to high normal weight. Could the prediabetes have caused my weight gain? If so, what is the mechanism for the weight gain?

posted by davisnot to health & fitness (8 answers total)

How high is your fasting blood sugar? what's your hba1c?

I have had prediabetes for years, and I indeed gained a substantial amount of weight and had a very hard time losing it. The mechanism, I think, is that your messed-up carbohydrate metabolism causes you to have less energy and more hunger after eating, rather than the other way around. Even very small amounts of extra snacking or reduced activity can cause weight gain over time; fifteen pounds over three years could be caused by an extra slice of bread once a week, or by ten fewer minutes of walking around per day.

Increasing my activity and running a sharp calorie deficit was impossible until I gave up simple carbohydrates virtually entirely. I have to eat basically just meat & vegetables and exercise an hour a day in order to keep my appetite under control; I am much hungrier on days I don't exercise than I am on days when I do. It will probably be this way for the rest of my life.
posted by KathrynT at 8:33 PM on October 21, 2012 [3 favorites]

Thanks for your take on this. My fasting sugars are just over 100 (102-105) on some days. Other days they are normal or high normal (e.g. 96). My A1c I believe has been around 6 (5.9-6.2).
posted by davisnot at 8:55 PM on October 21, 2012

My understanding is that the pre-diabetes doesn't cause your weight gain. (Nor does weight gain cause pre-diabetes for that matter.) Instead, both the pre-diabetes and weight gain are both a result of your bodies ability/ inability to metabolize the food that you consume, and more specifically, the carbohydrates that you consume.

I've found that Gary Taubes' book "Good Calories, Bad Calories" has the most comprehensive, well-researched breakdown of the science behind how and why our bodies process foods in the way that it does. He explains the underlying commonalities of metabolic syndrome, pre-diabetes, diabetes and insulin sensitivity and how they are all related to our metabolic and hormonal processes.

It's a bit of a dens, science-y read, so if you're looking for something more concise, his follow up book "Why We Get Fat: And What To Do About It" is also good.
posted by platinum at 9:00 PM on October 21, 2012 [2 favorites]

As I understand it, elevated fasting sugars can indicate insulin resistance. One of the symptoms of insulin resistance is that it's easier to put on weight and harder to lose it, because the excess insulin stops your body from converting your fat stores to energy when you need it.

Did your doctor refer you to an endocrinologist? They could tell you more.
posted by Georgina at 9:58 PM on October 21, 2012

People do not usually get referred to endocrinologists for pre-diabetes - there aren't enough endocrinologists in the world to see all the pre-diabetics out there (besides which their care does not require any special treatment or diagnostics that cannot be managed by a primary care physician), it is an extremely common problem in the modern world.

To the OP, have you considered that age decreases your metabolic rate and that people tend to gain weight over time? Read the article for information on the mechanism.
posted by treehorn+bunny at 10:32 PM on October 21, 2012

Insulin both influences your blood sugar level and your tendency to lay down fat reserves. So a faulty insulin system can lead to both symptoms - high blood sugar and wright gain. As a nasty twist it can also lead to increased appetite, making everything worse.

I was in a similar position to you, except I went into full type 2 diabetes. I had carefully followed many weight loss plans over the previous years with no success, with hindsight this was all down to a faulty Insulin system.

My problem had a broken response response to carbohydrates, especially anything "refined" or starchy. Even a small amount of bread, potato, rice, pasta, sugar (Etc) would send me into a fat depositing mode. So replacing fatty foods with pasta or rice (the kind of move many low-fat diets encourage) made everything worse, not better.

After becoming "officially" diabetic I decided to go for the nuclear option and adopted a strict "low/no carb" approach. Replace all starchy/grainy foods with green veg. So I have bolognese on a bed of cabbage. Etc. Etc.

Do not add fats or meat in place of carbs (ie not a naive atkins diet), add green or leafy veg.

I've been doing this for a year. I've got healthy/normal blood sugar readings at all times. I can have the occasional treat (cake at a party etc) and don't see spikes. I've lost 60lbs in weight without changing anything about my lifestyle other than my carbohydrate intake.

I am no longer technically diabetic (technically because it is a chronic condition and you can never really be diagnosed, just have it under control). I take no medication. To give you an idea of the movement, my fasting readings have gone from being very spikey in the range of 180 to 220 to being very constant with a 30 day average of 80.

This was an anecdote, not medical advice. Your mileage will vary. Seek advice from your medical carers before changing anything in your life. :)
posted by samworm at 12:42 AM on October 22, 2012 [4 favorites]

It seems more likely that the weight gain caused the pre-diabetes. Obesity researcher Stephan Guyenet has written several detailed, well-cited articles on insulin resistance, which is associated with elevated glucose levels: check out Fat Tissue Insulin Sensitivity and Obesity, and his six-part series on What Causes Insulin Resistance (latter parts).

Of note is the fact that insulin sensitivity of fat tissue declines as the size of fat cells increases, and when fat cells get smaller (via caloric restriction leading to weight loss), insulin sensitivity in fat tissue increases, and both the blood glucose and insulin response to an oral glucose load improves considerably. Exercise also increases insulin sensitivity. Additionally, insulin resistance is not predictive of future weight gain, and in some cases it even predicts lower future weight gain.

I'd also note that -- trying to state this diplomatically -- Gary Taubes is not a scientist, and his theories are not accepted by the scientific establishment. This is, however, not to say that a low-carbohydrate dieting strategy would not be helpful to you.
posted by ludwig_van at 8:19 AM on October 22, 2012

I have almost the same exact diagnosis as you. One thing that you should also have checked is to see if your cholesterol levels are within normal ranges. There's some evidence that Type 2 diabetes (or the precursor conditions to type 2 diabetes) and heart disease are related.

Losing 30 lbs (combination of changing to a diet that involves protien and only difficult to digest carbs -- aka vegetables for carbs, proteins are fish, and meat) and exercise has "fixed" my body. I feel better and no longer suffer from GERD and the horrible daytime drowsiness that I have been experiencing for the past few years.
posted by SpecialK at 8:30 AM on October 22, 2012