Diabetes is a condition that is caused by high blood sugar. If you have diabetes, your body is no longer able to regulate your blood sugar levels effectively.
It’s a common myth that only overweight individuals will develop diabetes, both type 1 and type 2. While it’s true that weight can be one factor that increases a person’s risk for developing diabetes, it’s just one piece of a larger picture.
People of all shapes and sizes — and yes, weights — can develop diabetes. Many factors other than weight can have an equally strong influence on your risk for developing the condition, including:
- genetics
- family history
- a sedentary lifestyle
- poor eating habits
Let’s review the role weight can play in the risk for type 1 and type 2 diabetes, as well as the many non-weight-related factors that can affect your risk.
Type 1
Type 1 diabetes is an autoimmune disease. In people who have type 1 diabetes, the body’s immune system attacks the beta cells that make insulin in the pancreas. The pancreas can then no longer produce insulin.
Insulin is a hormone that moves sugar from your bloodstream into cells. Your cells use this sugar as energy. Without adequate insulin, sugar builds up in your blood.
Weight is not a risk factor for type 1 diabetes. The only known risk factor for type 1 diabetes is family history, or your genetics.
Most people with type 1 diabetes are in the “normal” range for body mass index (BMI). BMI is a way for doctors to determine if you’re a healthy weight for your height.
It uses a formula to estimate your body fat based on your height and weight. The resulting BMI number indicates where you are on a scale of underweight to obese. A healthy BMI is between 18.5 and 24.9.
Type 1 diabetes is commonly diagnosed in children. However, despite increasing rates of childhood obesity, research suggests weight is not a significant risk factor for this type of diabetes.
One study found that the rising cases of type 2 diabetes were related to increases in childhood obesity, but not type 1.
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Type 2
If you have type 2 diabetes, your pancreas has stopped producing enough insulin, your cells have become resistant to the insulin, or both. More than 90 percent of diabetes cases are type 2 diabetes.
Weight is one factor that can contribute to the development of type 2 diabetes. An estimated 87.5 percent of U.S. adults with type 2 diabetes are overweight.
However, weight is not the only factor. About 12.5 percent of U.S. adults with type 2 diabetes have BMIs that are in the healthy or normal range.
People who might be considered thin or skinny can develop type 2 diabetes. A variety of factors may contribute:
Genetics
Your family history, or your genetics, is one of the leading risk factors for type 2 diabetes. If you have a parent with type 2 diabetes, your lifetime risk is 40 percent. If both parents have the condition, your risk is 70 percent.
10.3390/genes6010087
Fat distribution
Research shows people with type 2 diabetes who are of normal weight have more visceral fat. This is a type of fat that surrounds the abdominal organs.
It releases hormones that affect glucose and interfere with fat metabolism. Visceral fat can make the metabolic profile of a person of normal weight look like the profile of a person who is overweight, even if they appear thin.
You can determine if you carry this type of weight in your belly. First, measure your waist in inches, then measure your hips. Divide your waist measurement by your hips measurement to get your waist-to-hip ratio.
Waist-to-hip ratio
If your result is 0.8 or higher, it means you have more visceral fat. This could increase your risk for type 2 diabetes.
High cholesterol
High cholesterol can affect anyone. Your genetics, not your weight, largely determine your cholesterol issues.
One study found that almost a quarter of Americans who are not overweight have an unhealthy metabolic risk factor. This includes high cholesterol levels or high blood pressure.
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Gestational diabetes
Gestational diabetes is a type of diabetes that women develop while they are pregnant. They did not have diabetes prior to the pregnancy, but may have had prediabetes and not known it.
This form of diabetes is often thought of as an early form of type 2 diabetes. It occurs in 2 to 10 percent of pregnancies.
Most cases of gestational diabetes resolve once the pregnancy is over. However, women who had the condition during a pregnancy have a 10-fold higher risk of developing type 2 diabetes in the 10 years following their pregnancy, compared with women who did not have gestational diabetes.
10.1371/journal.pone.0179647
About half of all women who develop diabetes during pregnancy will later develop type 2 diabetes.
Giving birth to a baby greater than 9 pounds
Women with gestational diabetes are more likely to have babies that are very large, weighing nine pounds or more. Not only can this make delivery more difficult, but gestational diabetes can also later develop into type 2 diabetes.
Sedentary lifestyle
Movement is vital for good health. Not moving can have a serious effect on your health. People with sedentary lifestyles, regardless of their weight, have nearly twice the risk of developing type 2 diabetes than people who are active.
Poor eating habits
A poor diet isn’t exclusive to people who are overweight. People of normal weight may eat a diet that puts them at risk for type 2 diabetes.
According to one study, a diet high in sugar increases your risk of diabetes, even after accounting for body weight, exercise, and total calorie intake.
10.1371/journal.pone.0057873
Sugar is found in sweet foods, but many other foods as well, such as processed snacks and salad dressings. Even canned soups can be sneaky sources of sugar.
Smoking
Smoking increases your risk for a number of health conditions, including diabetes. One study found that people who smoke 20 or more cigarettes every day have twice the risk of diabetes than people who do not smoke, regardless of weight.
People with diabetes, especially individuals who are overweight, are often the subject of stigma and harmful myths.
This can create barriers to getting proper healthcare. It can also prevent people who might have diabetes but are at a “normal” weight from getting a diagnosis. They may believe, falsely, that only people who are overweight or obese can develop this condition.
Other myths can interfere with proper care. For example, one common myth says diabetes is the result of eating too much sugar. While a sugar-rich diet can be one part of an unhealthy diet that increases your risk for diabetes, it’s not the main culprit.
Likewise, not every person who develops diabetes is overweight or obese. In particular, people with type 1 diabetes often have a healthy weight. Some may even be below weight because rapid weight loss is a common symptom of the condition.
Another common but harmful myth is that people who have diabetes bring the condition upon themselves. This is also false. Diabetes runs in families. A family history of the condition is one of the strongest risk factors.
Understanding diabetes, why it occurs, and who is really at risk can help you understand the persistent myths and rumors that can prevent people with the condition from getting proper care.
It may even help you — or a child, spouse, or other loved one — find proper treatment in the future.
If you have one or more risk factors for type 2 diabetes, you can take steps to reduce your chances for developing the condition. Here some steps to get you started:
- Get moving. Regular movement is healthy, whether you are overweight or not. Aim to get 150 minutes of exercise each week.
- Eat a smarter diet. A junk food diet isn’t OK, even if you’re thin. Unhealthy foods and foods with little nutritional value can increase your risk for diabetes. Aim to eat a diet that’s rich in fruits, vegetables, and nuts. In particular, try to eat more leafy green vegetables. Research shows these vegetables can lower your risk for diabetes by 14 percent.
Carter P, et al. (2010). Fruit and vegetable intake and incidence of type 2 diabetes mellitus: Systematic review and meta-analysis. ncbi.nlm.nih.gov/pmc/articles/PMC2924474/ - Drink in moderation. People who drink moderate amounts of alcohol — between 0.5 and 3.5 drinks every day — may have a 30 percent lower risk of diabetes compared to people who drink heavily.
Koppes LL, et al. (2005). Moderate alcohol consumption lowers the risk of type 2 diabetes: A meta-analysis of prospective observational studies. https://www.ncbi.nlm.nih.gov/pubmed/15735217 - Check your metabolic numbers regularly. If you have a family history of high cholesterol or high blood pressure, it’s a good idea to check these numbers with your doctor regularly. This can help you catch or possibly prevent issues like diabetes or heart disease.
- Quit smoking. If you stop smoking, it nearly brings your risk for diabetes back to normal. This allows your body to better manage your blood sugar levels.
Diabetes can occur in people of all shapes and sizes. Weight is a risk factor for type 2 diabetes, but it’s only one piece of a puzzle when it comes to risk factors.
Other risk factors for diabetes include:
- a sedentary lifestyle
- gestational diabetes
- high cholesterol
- greater abdominal fat
- smoking
- family history
If you’re concerned you might have diabetes, or if you have one or more risk factors, make an appointment to talk with your doctor.