I am a 57 year old male diagnosed with type 2 diabetes about two years ago. I had all the classic symptoms including weight loss. I was never overweight and exercised regularly. I have never gained the weight back that was lost (165 pounds; now 145). How can I can gain weight while maintaining good blood sugar control on a low carb diet?

If you are maintaining good blood sugar control, but have not spontaneously gained back the lost weight, there are a couple of possibilities. To replace lost tissue, you need to be taking in extra calories above your maintenance needs and you also need to have enough insulin available to lay down new tissue. (Besides its glucose control function, insulin is needed for tissue growth.) Perhaps in an effort to control your blood sugars, you are restricting your food intake to a level that doesn’t provide extra calories for weight gain. If your blood sugars rise when you eat more generously, consider whether this might be the case. It might also indicate that your body insulin supplies are quite low. This can happen in type�2 diabetes, but since you are not overweight, it is also worth considering whether you might actually have type�1 or Late-onset Autoimmune Diabetes of Adulthood (LADA) diabetes, caught early while you were still producing some insulin. Your doctor can determine this through antibody testing. If, indeed, you are simply quite short of insulin, regaining to your normal weight should follow pretty rapidly in the wake of starting insulin.

BB