Low BMI but prediabetic

I’ve been recently working with a client who decided to get a CGM (unknown to me), he was concerned about some post-prandial numbers (slightly above 180) but I reassured him it’s not extremely uncommon and if he wanted to get accurate tests he should see his doctor.

Low and behold his HbA1c came back at 6.1% with total cholesterol at 200 and LDL at 122. I was very surprised.

He’s in his early 30’s with a very low BMI (18-19). In general, he undereats but his diet is poor (perhaps one take out meal per day). His bodyfat level would be probably in the high teens if I was to estimate and muscle mass is relatively low.

I’m not a doctor but this seemed strange to me. The client wanted to gain muscle and put on weight, however, it appears one of the best interventions to get someone out of a prediabetic state is to drop approx 5% of bodyweight. It doesn’t seem appropriate here.

Would there be a suggestion of re-testing? I understand LDL could be high independent of BW due to excess saturated fats.

Unfortunately tough to give specific recommendations here without knowing more about this patient, their medical/family history, and a variety of other parameters that would require a consultation.

They should work with their physician (or, if there is suspicion for an unusual/less common cause of insulin resistance, a consultation with an endocrinologist may be useful).

How can I refer him to barbell medicine for a consultation, I cannot find that within the services. If that is something you still offer.

Email support at barbellmedicine.com

Is it just a DM on IG? I couldn’t find anywhere on your YT channel to send a DM or get an email address.

support@barbellmedicine.com is the email.