Why Thin People Get Diabetes

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If you think only overweight men need to worry about diabetes, wake up. One in five normal-weight adults now has prediabetes, up 8 percent from 1994, finds new research from the University of Florida. Among adults over age 45 with BMIs under 25, one in three has high blood sugar, a double-digit jump in two decades. Left untreated, up to 30 percent of people with prediabetes will develop full-blown type 2 within five years.

Why the sharp rise in this condition? The abundance of nutrient-void, sugar-packed processed foods is likely having some effect. However, “our increasingly sedentary lifestyles are playing a huge role,” says lead researcher Arch Mainous. “Many people now sit in front of a computer all day and get only minimal, if any, leisure-time exercise. They think that as long as their BMI is under 25, they’re healthy. But the scale gives a false sense of health.”

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According to Mainous, skimping on exercise is so metabolically harmful because it leads to a higher proportion of body fat than lean muscle mass. He says people with very little lean muscle tend to have low grip strength — and past research has linked low grip strength to heightened risk of prediabetes and diabetes. The easiest way to tell whether you’re potentially in trouble? “Just look in the mirror,” Mainous says. “If you look too soft, you are too soft.”

When it comes to high blood sugar, surprisingly, total-body lean muscle mass matters more than even waist circumference, which is often blamed for metabolic health issues. “Many think metabolic syndrome is all about abdominal obesity,” Mainous says. “But we looked at waist circumference in our study, and it did not go up. Incidence of prediabetes did, so I don’t think abdominal obesity is the key.”

Mainous believes doctors are missing prediabetes every day because current federal guidelines recommend screening only obese 40- to 70-year-olds. “We know that identifying and treating prediabetes is an effective, cost-efficient way of slowing the progression to diabetes,” he says. “Yet there are probably 6 to 7 million people whose diagnoses will be missed because the perception is they are healthy.”

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But that doesn’t mean running to your doctor and demanding a screening is the answer, Mainous insists. It’ll take more large human trials to prompt a change in the federal guidelines, which means most insurance companies will continue not covering blood sugar testing. Rather, if you’re thin but squishy, your best solution is exercise. “If you’re already at a healthy weight, then calorie restriction probably isn’t the answer, either,” Mainous says. “Ramping up exercise is step one in preventing diabetes.”

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