Thanks for asking this very important but seldomly addressed question. Most classic descriptions of type 2 diabetes are true for about 80-85% of the people.  A minority of individuals with type 2 diabetes are actually not overweight.  For example, many Asian people with type 2 diabetes are what would be considered normal weight.  We believe the "thin type 2's" have a slightly different disease process than the majority of people who are overweight with type 2 diabetes.

 

There are reasons to believe that individuals who are thin with type 2 diabetes may have more problems with producing enough insulin rather than with using insulin efficiently (insulin resistance). This is not to say that normal weight, non-obese individuals with type 2 diabetes do not have insulin resistance.  In fact, our study shows that they do. In other words, both issues of insulin production and insulin resistance exist even in the thin individuals with type 2 diabetes, but the relative contribution to the disease probably tilts more to insulin production as the predominant issue.

 

Of note, a high A1C, as in your case, could lead to lower body weight because much of your glucose (calories) escapes the body in the urine. Keeping your A1C to less than 7% is best for your health. In your case, targeting insulin resistance by exercising rather than weight loss may be of specific benefit to you.