Weight is not the only risk factor for diabetes – 3 other factors

It turns out you can’t avoid diabetes with a low BMI.

In a large study involving nearly 45,000 participants, researchers attempted to determine the factors that lead to the progression of prediabetes to diabetes – and weight is just one aspect.

They found that factors such as age, gender and fasting blood sugar, or the amount of sugar in the blood, also play an important role.

“The study highlights that the prevalence of diabetes is increasing worldwide and that we must emphasize the importance of prevention, regardless of medical history, as we see that the risk is increased in all types of patients, including patients with low BMI. » Dr. Danielle Brooks, an endocrinologist at North Shore University Hospital who was not involved in the study, told the Post.

In the study, published Thursday in the journal JAMA Network Open, the average age of participants was 43.7 years, with an average BMI of 28.9, which is considered overweight.

Their fasting plasma glucose levels ranged from normal (70 to 100 mg/dL) to impaired (100 to 125 mg/dL), placing the latter group in the prediabetes zone, where blood glucose is elevated but not yet in range. diabetic.

Over a median follow-up of 6.8 years, 8.6% of participants developed diabetes – and the researchers estimated that figure would be 12.8% within 10 years.

One particularly striking finding was that any FPG level outside the narrow range of 80 to 94 mg/dL — even if it was still considered normal — was linked to an increased risk of developing diabetes.

Abnormal BMI categories, including those considered underweight, were also associated with increased risk.

“The authors posit that there was an increased risk for this section of individuals due to a potential state of malnutrition as an increased individual risk factor for insulin resistance and development of diabetes, which we do not “We don’t usually think so,” Brooks added.

Researchers also found that men were more likely than women to develop diabetes, while older age was also linked to higher risk.

Notably, the study revealed a significant additive relationship between key variables, notably between FPG levels and BMI.

For example, a woman aged 55 to 59 with a BMI of 18.5 to 24.9 and an FPG level of 95 to 99 mg/dL had a 7% chance of developing diabetes within 10 years.

But if his BMI increased from 30 to 34.9, his risk almost doubled to 13%. If his FPG level also reached 205 to 209 mg/dL, his risk increased to 28%.

One limitation of the study was that more than 87% of participants were Caucasian, leaving questions about how race and ethnicity might interact with other factors to increase or decrease the risk of developing diabetes.

“We know that there are increased risks of developing diabetes in patients of particular ethnicities,” Brooks said. “I think additional research is absolutely needed in this area to further individualize patient care and prevention of the development of diabetes.

What you can do now

As the United States grapples with an obesity epidemic, the number of people with diabetes continues to rise. According to the CDC, nearly 98 million Americans have prediabetes and more than 38 million have type 2 diabetes.

Brooks says the study highlights the need for doctors to be acutely aware of the increased risk of diabetes in every patient, not just those who are overweight or have a history of the disease.

“We need to be extremely aware of this trend in our health,” she said.

The researchers believe the findings could help guide doctors and patients in implementing pharmacological and lifestyle interventions for those most at risk, with the ultimate goal of reducing future morbidity and mortality due to illness.

In 2022, 101,209 Americans died from diabetes, which was the eighth leading cause of death.

Currently, metformin is the main option for delaying or preventing type 2 diabetes through medication. But new research shows that new-generation weight-loss drugs, like tirzepatide, could also reduce the risk of developing the disease in people who are overweight or obese.

If you’re not ready to use the medicine cabinet yet, there are still many daily steps you can take to reduce your risk of diabetes.

“Leading a healthy lifestyle in terms of overall recommended exercise per week is one of the foundations of diabetes prevention,” said Brooks, who recommended aiming for 150 minutes of exercise per week.

Managing your food choices is just as crucial, especially at a time when 60% of the average American diet is ultra-processed foods, like sugary cereals, frozen pizza, and chips.

Brooks advises focusing on a low-carb, high-protein diet to maintain a healthy weight over time and help prevent diabetes.