Most people think type 2 diabetes is a health condition that affects only people who are overweight or obese. It’s true that being overweight or obese is one of the strongest risk factors for this disease, but type 2 diabetes is affecting people at an earlier age these days and not all of its victims are overweight. In fact, according to the National Institutes of Health, about one out of six people with type 2 diabetes has an ideal body weight or under.
Type 2 Diabetes and Body Weight
Why the increase in type 2 among normal weight women? In some cases, genetics are to blame. If close family members have the disease, you’re at higher risk. Some experts point to stress as the culprit. There’s no doubt we live in a fast-paced society where stress is an issue. Chronic stress elevates cortisol levels. This has a negative impact on blood sugar levels and increases visceral abdominal fat, another risk factor for type 2 diabetes.
Skimping on sleep is another factor that increases the risk of type 2 diabetes. Interestingly, both too little sleep (less than 5-6 hours a night) and too much sleep (greater than 8 hours) are linked with a greater risk. Cortisol plays a role here too. Too little sleep, especially over several nights, elevates cortisol levels, causing transient elevations in blood sugars and metabolic changes that may contribute to type 2 diabetes risk.
The Epidemic of Skinny-Fat
Some people think they’re at low risk for diabetes when they look at the scale and see they’re ideal body weight, but a standard scale doesn’t tell the full story. It can’t distinguish between fat and muscle. Even if you’re 5 feet, 7 inches and 135 pounds or less, if you have a body fat percentage of 40, you’re at greater risk for type 2 than someone without a body fat percentage of 20 or 25.
Just as telling is waist circumference. Waist circumference is a rough indicator of how much visceral body fat you carry deep in your abdominal cavity. Higher levels of visceral body fat are a known risk factor for type 2 diabetes, regardless of weight. In fact, waist circumference appears to be a better indicator of type 2 diabetes risk than body mass index, or BMI. Women who have a waist circumference of 35 inches or greater are at particularly high risk for type 2, independently of BMI or body weight.
What Does This Mean?
Type 2 diabetes is on the rise among younger people and it’s not just a threat to people who are overweight. In fact, recent research showed that overweight and obese people who have type 2 diabetes actually live longer than thinner people with the disease. They call this the “obesity paradox” and it’s not clear why this is the case.
What can you do to lower your risk? Make physical fitness a priority. People who are physically fit are less likely to have large waistlines and dangerous levels of visceral body fat and are likely to have a lower body fat percentage, regardless of weight. Exercise also improves insulin sensitivity so there’s less stress on the pancreas to produce more. Resistance training is just as important as aerobic exercise since it increases lean body mass.
It also means that no woman regardless of body weight should assume they’re immune to this disease. Know your waist circumference and your body fat percentage – and make fitness a priority – both aerobic and resistance training.
WebMD. “Obesity Paradox: Thin Not in for Type 2 Diabetes?”
Sleep Medicine [2009, 10(8):919-924]
Science Daily. “Diabetes Risk: Waist Circumference Gives Better Prediction than BMI”
National Diabetes Information Clearinghouse