Patient’s Story: I Was Diagnosed with Diabetes at 36—Weighing Less Than 50 kg at 1.75m
When I was diagnosed with diabetes at thirty-six, I stood 1.75 meters tall but weighed less than 50 kilograms. I may have looked “slender,” but in reality, I felt extremely weak.
Climbing two flights of stairs left me breathless. My hands and feet were always cold. I often felt drowsy after meals and woke frequently during the night. I kept hoping that someday, like other people, I could enjoy a meal with meat and actually gain weight—instead, I was either dehydrated or losing more weight.
Many assume diabetes only affects those who are overweight. But in China, “underweight diabetes” is becoming increasingly common. According to the Chinese Journal of Diabetes, nearly one-fourth of type 2 diabetes patients in China have a BMI below 23.
People like me simply can’t gain weight—we struggle to eat enough, absorb nutrients, and maintain metabolic balance.
I was a living example of “can’t gain weight.” When the doctor said my fasting blood glucose was 10.3 and my HbA1c was 9.1%, I was confused. The only word I understood was: high.
It was only later that I learned diabetes isn’t just about “too much sugar”—it’s an insulin problem. When your body becomes resistant to insulin, the sugar you consume isn’t used properly. Instead, it circulates in the blood, damaging blood vessels, nerves, and muscle tissue over time.
Back then, all I knew was to restrict my diet: cut carbs, avoid sugar, and even skip fruit. Within three months, I lost another 3.5 kilograms. My stomach shrank, my cheeks hollowed, and my pants kept slipping down without a belt.
It wasn’t until my follow-up visit that the doctor frowned at my weight and said, “You’re not managing your diabetes well—you’re malnourished.”
The Chinese Dietary Guidelines emphasize that dietary management for diabetics isn’t just about controlling sugar—it’s also about ensuring adequate nutrition, especially protein and healthy fats.
Yet, many people hear “diabetes” and immediately start extreme dieting, slashing carbs and cutting out all fats. The result isn’t better glucose control—it’s deteriorating health.
My doctor advised consuming at least 1.2 grams of protein per kilogram of body weight daily. For me, that meant around 60 grams of protein—equivalent to 150 grams of lean meat or five eggs.
At the time, I was even hesitant to eat one egg, fearing “high cholesterol.” But dietary cholesterol doesn’t automatically raise blood cholesterol—it depends more on liver metabolism than intake alone.
I overhauled my eating habits:
Breakfast changed from congee and pickles to eggs, whole-wheat bread, and soy milk.
Lunch always included protein, vegetables, and carbs.
Dinner included controlled portions of carbohydrates and fish.
I started tracking my protein intake and monitoring the glycemic index of my meals. It felt counterintuitive at first—almost like I was “breaking the rules” of diabetes. But after three months, I gained two kilograms, and my post-meal blood sugar became more stable.
That’s when I realized—blood sugar isn’t controlled by starving yourself. It’s supported by stable metabolism and proper nutrition. As noted in China Diabetes Medicine, reasonable nutritional intervention can significantly improve HbA1c levels and insulin sensitivity in underweight type 2 diabetes patients.
Exercise Matters Too
Running was too much for me—even walking made me breathless. The doctor suggested starting with resistance training: wall squats, resistance bands, light weights. Muscle is insulin’s “best friend”—the more muscle you have, the better insulin works.
I bought a pair of dumbbells. After six months, my body fat decreased, my weight increased, and I could see more muscle definition. Most importantly, my post-meal blood sugar dropped from 13 to 8.5, and my HbA1c fell from 9.1% to 7.2%.
It wasn’t about increasing medication—my body was finally able to help itself. What made the difference wasn’t one specific food, but a sustainable balance between energy intake and expenditure.
For diabetics, weight gain isn’t the enemy—unhealthy weight is. We shouldn’t gain fat around the abdomen, liver, or blood vessels. A lot of people think controlling blood sugar is all that matters.
But the real challenge is restoring the body to a healthy metabolic balance.
It hasn’t been entirely smooth. Once, after I caught a cold, I ate some chilled watermelon—and my blood sugar spiked to 16. The doctor scolded me severely.
But that incident taught me a valuable term: “sustainability of dietary behavior.”
Long-Term Consistency Is Key
During one check-up, my creatinine and urinary microalbumin levels were elevated. The doctor said it might be early kidney damage. I’d been drinking protein shakes and eating high-protein meals—but hadn’t drunk enough water, overloading my kidneys.
The lesson? When increasing protein intake, you must drink plenty of water—don’t “overwork” your kidneys. The Chinese Type 2 Diabetes Prevention and Treatment Guidelines highlight the importance of regular kidney monitoring for diabetics, especially those on long-term high-protein diets.
It’s not about eating more—it’s about eating right and eating smart.
In Conclusion
Today, my weight is stable at 58 kilograms, with a BMI of 21. My face has filled out, and no one asks me anymore if I’m sick. My blood sugar is under control, and my kidney function is normal. I’ve learned how to work with my body.
When people ask me what worked, I tell them:
Don’t be afraid to eat—just eat right.
Don’t exercise blindly—exercise wisely.
Don’t focus only on blood sugar—look at your overall metabolic health.
Diabetes isn’t a “starvation contest” or a “weight loss mission.” It’s an ongoing process of negotiating with your body and making peace with yourself.