Lean diabetes is an emerging entity in the era of obesity. Despite the well-known relationship between high body weight and diabetes, this condition can also occur among the lean (BMI<25). If you’re not sure what your body mass index (BMI) is, use this BMI calculator.
A 2014 American study found that out of 18,000 patients with Type 2 Diabetes in the US, 13% had a normal body weight with a BMI of 17-25 while another study reported that >60% Indian patients with non insulin dependent diabetes had a BMI of < 18.5. Worryingly, a recent study found that diabetes increased significantly among lean adults with a BMI of <25 kg/m2 from 4.5% in 2015 to 5.3% in 2020, representing a 17.8% increased risk for diabetes in 2020 among non-overweight people.
Therefore, contrary to popular belief, people of all shapes, sizes, and weights can develop diabetes. Unfortunately, compared to diabetes that occurs in overweight people, little is known about lean diabetes.
Let’s take a deep dive:
Why do thin people get diabetes?
Genetics
Your genes can play a significant role in determining your risk for type 2 diabetes, regardless of your weight. If your family has a history of diabetes, you may be at a heightened risk even if you’re thin.
Presence of visceral fat
Another reason you can get diabetes is due to insulin resistance, a condition characterized by the body’s inability to use insulin efficiently to regulate blood sugar levels. This may occur in those who appear thin but have “skinny fat,” meaning that while you appear skinny on the outside, you actually have significant hidden fat that contributes to insulin resistance.
There are two types of fat in the body: fat stored under the skin (subcutaneous) and visceral fat, which is located around internal organs. Even if you appear lean, you may have excessive visceral fat, which contributes more to insulin resistance than subcutaneous fat.
Lack of muscle (sarcopenia)
Lack of muscle can increase your risk of diabetes because muscles play a key role in regulating blood sugar levels. When muscles are inactive or lack sufficient strength, they are less effective at utilizing glucose from the bloodstream. This can lead to higher blood sugar levels and potentially contribute to insulin resistance, a key factor in the development of type 2 diabetes.
Having less muscle mass can also result in a lower overall metabolic rate, which may also impact your body’s ability to regulate blood sugar effectively. Therefore, maintaining muscle mass through regular physical activity and strength training is important for reducing the risk of diabetes.
Dietary factors
A healthy diet plays a crucial role in preventing diabetes. Even if you’re thin, it doesn’t mean you can eat everything and anything without worry. Consuming a balanced diet with the right mix of good carbohydrates, proteins, and fats is essential.
Focus on incorporating whole foods like vegetables and lean proteins while limiting processed carbohydrates and added sugars. Eating a diet rich in fiber, especially sourced from vegetables, can also help regulate blood sugar levels.
How are lean diabetics different from overweight diabetics?
While both lean and overweight individuals can develop type 2 diabetes, some specific characteristics set us apart.
Sadly, lean diabetics among minority populations have been found to be at higher risk of rapid beta cell failure, which leads to insulin-dependence among minority populations. This indicates that their body’s ability to produce insulin might decline faster than in overweight diabetics. Whether this finding can be generalized to the rest of us is not known.
The risk factors for diabetes might be different for lean and overweight individuals. In lean diabetics, genetic predisposition, an unhealthy diet, and a sedentary lifestyle might contribute more to your condition.
On the other hand, overweight diabetics often face risk factors such as obesity and metabolic syndrome.
The approach to managing diabetes differs between lean and overweight people. For lean diabetics, treatment often focuses on multiple metabolic defects. This may require a combination therapy that addresses both insulin secretory dysfunction and insulin resistance.
Meanwhile, overweight diabetics benefit more from weight management strategies and lifestyle interventions that help reduce insulin resistance.
Unfortunately, due to generalization (and dare I say discrimination) lean diabetics may face challenges in diagnosis and awareness. Many people assume that only overweight individuals can develop diabetes, which can lead to a delay in diagnosis or misperception of our health status. Regardless of your weight, be aware that you’re at risk of diabetes.
