When patients are first diagnosed with diabetes, I’m often asked “Why do I have a sugar problem? I’m at a healthy weight and only eat brown rice and tofu; how is this possible? Isn’t diabetes a disease for overweight people?”
What most patients don’t realize is that there are 2 types of diabetes and a number of non-modifiable risk factors for developing the disease (i.e. age, family history, genetics, etc.).
Type 1 diabetes is where the body does not produce insulin. It is the less common form (only accounting for approximately 5% of all diagnosed cases of diabetes) and is usually developed before the patient turns 40 – often in early adulthood or teenage years. There is no known way to prevent type 1 diabetes, and patients can be normal or even underweight when diagnosed. Weight has no direct correlation with this disease.
Type 2, on the other hand, is where the body does not produce enough insulin for proper function, or the cells in the body do not react to insulin (insulin resistance). According to the CDC, type 2 diabetes accounts for about 90 – 95% of all diagnosed cases of diabetes. It is associated with older age, obesity, family history of diabetes or gestational diabetes, impaired glucose metabolism, physical inactivity and race/ethnicity.
With overweight and obesity rates on the rise in the U.S., the incidence of type 2 diabetes is increasing dramatically. Excess weight gain will certainly increase your risk of developing this disease – especially if you carry extra weight around your waist line. If you go to the American Diabetes Association Web site, you can do the risk test to see your chances of getting diabetes.
As mentioned above, your race/ethnicity also factors into your risk of developing type 2 diabetes. For example, if you are Asian, your healthy weight range is different than someone who is Caucasian. A healthy weight for an Asian patient is less than 23 on the body mass index (BMI) scale as opposed to 25 on the BMI scale for a Caucasian patient. A healthy waist line for an Asian patient is less than 31 inches for women and 35 inches for men as opposed to 35 inches for women and 40 inches for men among Caucasians (Joslin Diabetes Center & Joslin Clinic). So, as little as a five pound weight gain could put an Asian patient at risk for insulin resistance!
African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications as well.
So, while we can’t change our non-modifiable risk factors such as ethnicity/race, age, genetics, and family history, we can change modifiable risk factors such as our eating habits and increasing our daily physical activity to help prevent this chronic disease. Remember that portion control is key for controlling your weight – too many healthy foods can actually make you gain weight!
If you’d like some more pointers for reducing your risk level for developing type 2 diabetes, I encourage you to schedule an appointment with me!
-Posted by Haesun Hwang MS, RD, CDE