As type 2 diabetes becomes more prevalent, people are becoming more aware of the risk factors for developing type 2 diabetes. And, most people are aware that being overweight puts you at a higher risk.
But what if you’re not overweight? Can you get type 2 diabetes without being overweight?
The short answer is yes.
Approximately 12.5 percent of adults with type 2 diabetes have BMIs in the normal range.
In our culture, we often get hyper focused on weight as an overall indicator of health, or health risk. But, it’s not the only indicator or risk factor. Given that approximately 85% of people who develop type 2 diabetes are overweight or obese, it certainly is an important risk factor. But, it’s not the only one.
If we get too focused on weight, we’re missing the whole picture.
Table of Contents
The Risk Factors for Type 2 Diabetes
There are a number of risk factors for type 2 diabetes. You can basically split them into two categories; those you can control, and those you cannot.
You can’t control your:
- Birth gender
- Family history
But, you do have some control over your:
- Level of Physical Activity
- Blood sugar
- Blood pressure
- HDL Level (low HDL increases risk)
As you can see, weight is only one of these risk factors, and each of these are independent risk factors. So even if you’re not overweight, but you get poor sleep, or are sedentary, your risk for type 2 diabetes still goes up.
You also don’t need to be overweight to have low HDL, high triglycerides, or elevated blood sugar. Having any of these can increase your risk.
Get to Know Your Numbers
If you’re concerned about getting type 2 diabetes, it’s important to know your numbers and understand what they mean. So, if your risk is increased with blood pressure, you should be familiar with what your blood pressure is. You should know if your HDL is in or out of range.
But, most importantly, you need to get familiar with your blood sugar numbers.
Why is Your Blood Sugar So Important?
The primary test indicator that’s used for diagnosing type 2 diabetes is your blood sugar. This test is also used to detect prediabetes, and if you can detect prediabetes, you can then prevent or slow the progression to type 2 diabetes.
If your blood sugar numbers are reaching into the prediabetes range, it should serve as a warning light… you’re in the danger zone.
So, what do you need to know? There are two tests that are most often used for measuring blood glucose.
- Fasting Blood Glucose Test
- A1C Test
The fasting blood glucose test is taken after about 8 hours of fasting, that way it’s not elevated due to a recent meal. Normally, it should be less than 100 mg/dL. If it’s rising up between 100-125 mg/dL, it’s in the prediabetes range and indicates some possible insulin resistance. At this point there’s an increased risk of progressing to type 2 diabetes, unless nutrition and lifestyle changes are made.
The A1C test is a measure of your average blood sugar for a 3 month timeframe. Normally, it should be below 5.7%. Prediabetes is indicated by a measurement of 5.7-6.4%, and above that indicates diabetes.
In summary, if these numbers are elevated, it indicates that your body is not able to adequitly manage and regulate blood sugar.
Coming Back to Weight
So, the original question was “can you get type 2 diabetes without being overweight?”. And as I’ve explained, yes, you can get type 2 diabetes without being overweight.
But there’s another important aspect of weight that should be explained. Rather than focusing on being weight classification, it’s also important to look at where fat is accumulated in the body.
You see, we typically classify weight according to BMI.
If your BMI is:
- 18.5 to 24.9, you’re considered to be normal weight
- 25 to 29.9, you’re considered to overweight
- 30 or more, you’re considered to be obese
However, BMI is a simple calculation that only takes into account your total weight and your height. It does not take into consideration how much of that weight is fat or muscle.
BMI also does not take into consideration where the fat is dispersed on your body. And, that’s actually really important.
Why Waist Size Matters
Waist size is an indicator of belly fat, or what’s often referred to as visceral fat. This is the fat that accumulates around your organs, and is much worse than fat that is evenly dispersed throughout the body.
Having too much belly fat interfere with metabolism, increases inflammation, and has been linked to insulin resistance, heart disease, stroke and cancer.
So, as you can see, belly fat is the worst kind. And, I know what you’re thinking. Isn’t it possible to have a normal weight BMI, but to still have belly fat?
Yeah, even if you’re of normal weight, you can still have belly fat. To get a better idea of your belly fat, you can do a quick measurement as follows:
- Measure around your waist in inches, going over the belly button
- Measure around your hips in inches
- Divide your waist measurement by your hips measurement to get your waist to hip ratio
- A waist to hip ration of 0.8 or higher, you have a higher risk for type 2 diabetes.
The waist to hip ratio is especially helpful for those with a BMI between 18.5 – 29.9.
Can A Dietitian Help Prevent Diabetes?
If you’re looking for help with prediabetes and preventing diabetes, evidence suggests that working with a dietitian can help. Learn how a dietitian can help with prediabetes.