Many people think of type 2 diabetes as being a disease of the overweight and obese. While it is true that being overweight or obese is a risk factor, it is not only overweight people at risk for type 2 diabetes.
Type 2 diabetes
Type 2 diabetes, formerly known as adult-onset diabetes, is a chronic condition that affects the way your body processes sugar (glucose). Around 15 to 20% of type 2 diabetes cases occur in people of normal weight. A normal weight individual is someone with a BMI of less than 25 (you can calculate your BMI here).
Metabolically unhealthy normal weight individuals
A person of normal weight can still be ‘metabolically unhealthy’. ‘Metabolic’ refers to all of the biochemical processes that occur in the human body to maintain life. When a normal weight person is ‘metabolically unhealthy’, they may look healthy from the outside, but inside they suffer from metabolic disturbances such as high blood pressure, high triglyceride and LDL cholesterol levels, low HDL cholesterol levels, high levels of insulin in the blood, and insulin resistance. Metabolic syndrome occurs when a person has a combination of metabolic factors that increase their risk of developing type 2 diabetes, cardiovascular disease, and other health problems.
Risk factors for type 2 diabetes in normal weight people
There have been many studies examining type 2 diabetes in normal weight individuals with metabolic syndrome. However, a new study found that metabolic syndrome was only present in one quarter of normal weight people with type 2 diabetes. Therefore, researchers identified both metabolic and non-metabolic risk factors for type 2 diabetes in normal weight people. They found that normal weight individuals who developed type 2 diabetes were characterized by many of the following risk factors:
- More likely to be male
- Former smokers
- Less physically active than normal weight people without diabetes
- Larger waist circumference (30″ average in women; 34.5″ average in men)
- Higher HbA1c (a gauge of average blood glucose levels over the previous 8 to 12 weeks)
- Increased triglycerides
- Lower HDL-cholesterol levels
While the normal weight people with type 2 diabetes displayed many of the above characteristics, generally their numbers were all within normal range, just at the higher end of normal than those without type 2 diabetes. Therefore, it might not be enough to stay within normal range. Instead, we should be striving to stay at the lower or middle end of ‘normal’ in all of these categories.
The bottom line
What can we take away from this study? While there is nothing we can do about gender or being a former smoker, the remaining characteristics identified by the study can be affected by our lifestyle choices.
By being more physically active and eating a healthy diet rich in fruits, vegetables, low-fat or fat-free dairy products, whole grains, fish, poultry, beans, seeds, and nuts, and limiting sodium, red meat, sweets, and sugar-sweetened drinks, we can have a positive effect on every one of the remaining characteristics identified by the study as risk factors for type 2 diabetes in normal weight people.
Just remember – type 2 diabetes is not just a disease of the overweight or obese. You can be normal weight and at risk. But if you get plenty of exercise and eat a healthy diet, your risk can be significantly reduced.
Eckel, N., Mühlenbruch, K., Meidtner, K., Boeing, H., Stefan, N., and Schulze, M. B. “Characterization of Metabolically Unhealthy Normal-weight Individuals: Risk Factors and Their Associations with Type 2 Diabetes.” Metabolism 64.8 (2015): 862-71. Web.