A myth about diabetes

You might be surprised to learn that skinny people also get Type 2 Diabetes Mellitus (T2DM). Very often they are overlooked as type 2 diabetes has been historically viewed as a disease of overindulgence coupled with inactivity. This too, is another Diabetes myth! Remember that one in three type 2 diabetics go undiagnosed. It’s possible that a significant number of these people are lean. They don’t suspect they might have T2DM because they believe that “only overweight people get diabetes”.

High Blood Sugar is the killer

High blood sugar for anyone is a killer. Over time it results in many of the complications associated with diabetes – nerve damage, retinal changes, and early signs of kidney deterioration. This is why it’s just as important for lean people to maintain healthy blood sugar as it is for the overweight and obese.

What causes high blood sugar and T2DM in lean people?

Not surprisingly, the causes of T2DM in lean people are similar to the causes of T2DM in those that are obese and are as follows:

• Genetics There is an inherited defect that means people with this defect are not able to burn glucose or fatty acids efficiently, causing lipotoxicity and an accumulation of fat inside muscle cells. You may be lean, but if your cells aren’t working as they should due to a genetic defect, you will develop insulin resistance and high blood sugar

• Fatty liver Studies of lean, Asian Indian men have found that they have a 3-4 fold higher incidence of insulin resistance than caucasian men. They also have a much higher prevalence of non-alcoholic fatty liver disease (NAFLD) and liver insulin resistance. It has also been proposed that fatty liver is a cause of insulin resistance and type 2 diabetes. This is a problem that affects almost 1 in 3 people in developed nations too

• Inflammation Chronic, low-grade inflammation is an important mechanism in decreasing insulin signaling and causing insulin resistance in muscle, liver and fat cells. It has also been shown to precede the development of diabetes

• Autoimmunity It was thought that type 1 diabetes (insulin-dependent diabetes) which develops in childhood, was caused by autoimmune destruction of the beta cells of the pancreas, leading to decreased insulin production. Type 2 diabetes was thought to be caused by insulin resistance of the liver, muscle and fat cells. It is now known that type 1 diabetes, can also develop later on in life. This form is referred to as latent autoimmune diabetes (LADA) or type 1.5 diabetes. Type 1 diabetes in adults is frequently misdiagnosed as T2DM, in fact 1 in 4 lean people with T2DM may actually be suffering from T1DM (autoimmune diabetes), requiring a different treatment altogether

• Stress When stressed, the body produces higher levels of the hormone cortisol whose most important role is to raise blood sugar in order to help us deal with the threat. However, this mechanism was only designed for short bursts of stress. Our bodies aren’t prepared to deal with the effects of chronic stress, which include chronically elevated levels of cortisol. Cortisol is capable of raising blood sugar to unhealthy levels, which means that you can be lean, eat a perfect diet, and still have high blood sugar and thus (T2DM) if you suffer from chronic stress

Stay tuned more to come...

Check out the Diabesity story so far and catch up on each instalment below

See also Part 1 of our series The Modern Day Health Epidemic that you should know about See also Part 2 of our series Diabesity: Myths that kep you sick See also Part 3 of our series Diabesity and Inflammation See also Part 4 of our series Diabesity: How come I’ve got Type 2 Diabetes? I’m not fat!!!