Setting Diabetes Right Even With Normal Weight

Normal Body Weight Outside But Fat-loaded Inside

Weight loss has always been the mantra for treating type 2 diabetes and this treatment protocol has worked magically. But what about people in normal weight ranges? Firstly, are they victimized by diabetes and secondly, if the answer is yes, would we suggest the same weight loss treatment method for such people to achieve diabetes remission or control? Let’s unravel the mystery.

Obesity/overweight does increase the risk of type 2 diabetes (T2D) but 5-15% (the numbers are still climbing) of individuals with T2D are in the normal weight ranges. Researchers feel that rather than blaming obesity for the cause of T2D it is, in fact, because the individual is too heavy for his/her body irrespective of the BMI number. Every person has a ‘personal fat threshold’ above which the chances of developing T2D increases.

While there have been various contemplations about the cause of T2D in normal people, an ongoing research program called Reversal of Type 2 Diabetes upon Normalization of Energy Intake in the Non-obese (ReTUNE) trial is looking into whether weight loss in normal weight people can help with diabetes remission.

In this study, the normal-weight participants were given a low-calorie diet (800 calories/day) for two weeks after which they were supported with maintaining the weight. The same procedure was conducted thrice and the results were amazing:

• An 11.9% weight reduction on an average
• Fat around the liver reduced from 4.4% to 1.4%
• Fat in the pancreas fell from 5.1% to 4.5%
• Triglyceride levels fell from 1.6mmol/L to 1.00mmol/L
• Diabetes remission happened in 67% of participants

The results undeniably show that excess fat has a debilitating role in controlling the occurrence and remission of diabetes. Fat accumulation around the liver prevents normal insulin functioning while in the pancreas, it stops insulin production by beta cells both of which pave way for T2D.

A JAMA study showed that slightly obese/overweight people with reasonable weight sizes (in turn, reasonable belly fat) had better diagnosis compared to normal weight individuals suffering from bigger waists and at a greater risk of death.

Besides body fat and waistline, another important factor triggering T2D is muscle mass. Muscles help in burning sugar and hence, higher the muscle mass lesser the quantity of sugar that’s converted to fat. Let’s get this straight—a BMI of 30 and above needs immediate action irrespective of waistline but when the BMI range is between 18.5 and 29.9, waist size plays a key role in elevating the risk of diabetes. Increased waist size means increased belly fat (visceral fat) and this in turn means increased risk of T2D.

The height of a person has an impact on waist size. The maximum waist size permissible for a person is the number got when we divide the height by 2. For example, the maximum waist size permitted for a 5 feet (60 inches) tall person is 30 inches. Generally, women should have a waist size below 32 inches and men 35 inches or below.

It is clearly understood that the cause behind T2D in normal weight people is beta-cell dysfunction or fat deposition around the liver and pancreas due to which insulin secretion becomes a problem. Some effective ways to control or put diabetes into remission in such individuals include:

• Building muscle mass or maintaining available muscle mass by performing strength training exercises. Try lifting weights, doing exercises on muscle-resisting machines, and performing resistance exercises at least twice a week or even better, every alternate day
• Follow a healthy diet by getting in touch with a dietitian/nutritionist to formulate meal plans based on body health conditions and requirements
• Look at the whole picture—there is more to health than weight. Try to maintain overall body health
• Stay hydrated
• Reduce stress with meditation and yoga
• Sleep adequately. Aim for at least 7-8 hours of sleep daily
• Choose a physical activity that’s sustainable. It could be anything such as walking, jogging, cycling, swimming, tennis, or likewise but never settle for anything less than 150 minutes of activity per week.

Even if the BMI is less than 25, if the individual suffers from T2D, weight training becomes indispensable for controlling the disease. While the ReTUNE research has shown positive effects regarding weight loss in normal weight people and controlling diabetes, more details and better understanding about the development of this disease could help in preventing further occurrence of the condition.

A Bigger Waistline is a Bigger Health Threat