Q: My HbA1c was 7% last month which is a good control of blood sugar. But I have not been able to gain adequate weight. Even before I was diagnosed to have NIDDM and high triglycerides. Presently I am allowed only 1800 Kcal and also cannot include high quality protein due to albuminuria, hence my weight gain measures still are not successful. Please advise.

A:1. Is the HbA1c 7% because of very good control, or very bad control? If your sugars swing a lot, your average might be quite good, even though control is not. In other words are you doing home BG monitoring at different times of the day on a regular basis? High triglycerides are also suggestive of poor control. 2. Caloric requirements are based on several factors, and if you are underweight, you will have to increase calorie intake. There is no hard and fast rule of only 1800 calories. Caloric restriction should not be used to avoid insulin therapy. 3. Having albuminuria does not mean you cannot take high quality protein, just that you should avoid excess protein. (In any case, excess protein does not cause weight gain, but weight loss.) 4. Has your thyroid function been tested? If not, please get a T4 and TSH test done. Also, are you taking low dose aspirin and controlling lipids adequately?