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January 29, 2001

Weight and Weight Loss

Question from Jakarta, Indonesia:

I have type 2 diabetes, diagnosed about a year ago and controlled with diet and exercise. My HbA1c last time was 5.2% (from 6.5% ), and I had urine ketones, perhaps because I was scared and ate so little. My weight dropped itself even though I didn't want it to. I am 165 cm tall and weigh 55 kilograms, and I feel underweight at the moment. Everybody says I'm very thin. I would like to ask all of you how to gain weight. I know how to eat moderately and appropriately without starving to maintain good control. However, I need any advice as how I should maintain my diet and eating without raising my blood sugars in order to gain weight. I drink skim / non-fat aspartame milk. I heard that people who want to gain weight should eat more good fat. I would like to try drinking cow's milk. I know it contains lots of fat, calories, and lactose/sugar. Is it good since we should avoid sugar?


I am hoping you might have a diabetes center nearby since your questions can probably be better answered by them. I will assume you do not have access to such a center, and so I would recommend that you eat as you have been, but just add a small amount more to each meal or snack. I do not know what skim/non-fat aspartame milk is, but it seems like it must be a soy-based milk. If you can get low fat cow’s milk and it sets okay with your stomach, you could add that to your diet. You will probably need to start with small amounts of that if you have not had cow’s milk before. There is some milk sugar in milk, but again, in small amounts, it should be fine. Adding some fats to your diet is a good way to add more calories, but I hope you can check with a nearby dietitian so you are adding good fat (unsaturated ones) so your risk of heart disease is not increased.

Additional comments from Betty Brackenridge, diabetes dietitian:

I think it is also important to point out that starving blood sugars into control cannot be followed as a permanent treatment approach to whatever form of diabetes you have. You need to be able to eat a nutritionally complete diet with adequate calories to maintain a healthier weight. Medicines need to be added to your treatment to allow that level of normal food intake. Because you are so thin, the medicine of choice may well be insulin. Your body simply starves without adequate insulin, making it impossible to gain back the weight you have lost.


[Editor’s comment: It’s unclear from the question how the writer was diagnosed with type 2 diabetes. It also seems possible that the writer might have Late-onset Autoimmune Diabetes of Adulthood (LADA). However, our advice applies in either case.