Lean and fit, yet uncontrolled diabetes

Reviewed by Dr Asim MaldarNovember 11,2023 | 10:16 AM
Lean and fit, yet uncontrolled diabetes

Lean and fit, yet uncontrolled diabetes

High blood glucose level is a serious consequence of Diabetes Mellitus. If you have diabetes, your body is no longer capable of adequately maintaining your blood sugar levels. Diabetes is becoming more common, both in India and throughout the world. The most common kind of diabetes in the world is type 2, which is frequently linked to being overweight or obese.

Type 2 diabetes (T2D) develops when the body either stops producing enough insulin or loses sensitivity to its effects. When someone is overweight, insulin's function as a key to open the door for sugar to enter cells is compromised. However, being overweight is just one aspect of the bigger picture that might raise a person's chances of acquiring diabetes.

Diabetes can also occur in younger people who are normal weight or skinny, known as lean diabetes. These individuals may have a Body Mass Index (BMI) below 25 kg/m2, yet their levels of insulin resistance are more extensive. This condition is sometimes referred to as the "thin-fat phenotype" or "metabolically obese normal weight."

People with this condition may have an elevated amount of intra-abdominal and subcutaneous abdominal adipose tissue while still maintaining a normal weight or BMI. According to a recent study, lean type 2 diabetes patients may experience more complications due to impaired insulin secretion than obese T2D patients. This suggests that Type 2 diabetes in slim individuals should be treated differently from diabetes caused by obesity.

Role of Weight in Diabetes
Let's explore the fascinating connection between weight and the risk of type 1 and type 2 diabetes:
Type 1 Diabetes
Type 1 diabetes is an autoimmune condition. The beta cells in the pancreas that produce insulin are attacked by the immune system in individuals with type 1 diabetes. The pancreas is thus unable to make insulin. Insulin, a hormone, is responsible for transferring blood sugar into your cells. Sugar is used by your cells as fuel. Insufficient insulin causes blood sugar levels to rise. Type 1 diabetes is does not correlate with individual’s weight. The only recognised risk factor for type 1 diabetes is genetics or family history, with a few postulated environmental factors.

The majority of type 1 diabetics fall inside the "normal" BMI range. Using your BMI, your doctor can evaluate whether you are a healthy weight for your height. Based on your height and weight, a formula is used to determine body fat. The resultant BMI value reveals where you fall on a spectrum from underweight to obese. Generally, the range for a healthy BMI is between 18.5 to 24.9 kg/m2. Type 1 diabetes is often diagnosed in children or young adults. Despite rising paediatric obesity rates, evidence indicates that weight is not a major risk factor for this particular kind of diabetes.

Type 2 Diabetes
If you have type 2 diabetes, either your cells have ceased responding well to insulin, or your pancreas has stopped generating enough of it. More than 90% of diabetes cases are type 2 patients. One element that might contribute to the onset of type 2 diabetes is weight. However, weight is not the only consideration. Around 12.5% of adults with type 2 diabetes have BMIs that fall within the normal or healthy range.

About lean Diabetes
In comparison to the type 2 diabetes generally linked with obesity, lean diabetes is significantly less well understood. In metropolitan areas, lean diabetes may affect up to one out of every three individuals with a diabetes diagnosis. According to several studies, lean diabetes is more likely to develop in people who are poor or have low socioeconomic status, are malnourished as children, or are younger people.

Furthermore, this elevated risk can be influenced by hereditary factors. These people may exhibit symptoms without the other metabolic syndrome disorders, such as high blood pressure, an abnormal cholesterol profile (particularly elevated triglycerides), and a larger waist circumference, which is often associated with type 2 diabetes. Despite this, those with lean diabetes may be at a higher risk of developing conditions like fatty liver disease, often known as NAFLD or NASH, and cardiovascular events like heart attacks.

Causes of Diabetes in Lean People
Diabetes in thin people can have a variety of reasons, including:

●Sedentary lifestyle: Long durations of sitting might alter your metabolism and may result in insulin resistance, which is a risk factor for diabetes.
●Prediabetes: This disorder is brought on by having blood sugar levels that are higher than usual. If left unattended, it may progress to Type 2 diabetes.
●Stress and Tension: Our bodies release a hormone called cortisol when we are under stress, triggering our fight-or-flight response.
●Fatty liver disease: If you have the condition known as fatty liver disease, you run the risk of getting diabetes. Fatty liver disease comes in two forms, with alcohol abuse being the main factor behind one type, and the other type, known as non-alcoholic fatty liver disease (NAFLD), being brought on by an accumulation of fat in the liver.
●Diet: Your risk for diabetes is significantly influenced by your diet. Diets high in sugar and harmful fats may raise your chances of getting diabetes.

Treatment of Lean Diabetes
It is extremely important to identify people with lean diabetes since doing so may enable medical professionals to modify the recommended lifestyle and medication to address the unique problem of insulin resistance. Although weight loss is often recommended for people with diabetes, those who have lean diabetes may still benefit from exercise even if they do not lose weight. This is because exercise is known to improve insulin resistance. Particularly, resistance training will also help build muscle mass and enhance insulin sensitivity in the muscles. Additionally, there are specialised diabetic medications known as "insulin sensitizers" that may reduce insulin resistance and be especially helpful for those with lean diabetes.


There are steps you may take to lower your chance of developing diabetes or postpone the onset of diabetes if your family has a history of any kind of diabetes. These steps especially help prevent diabetes that develops in children or people who are thin or of normal weight.

●Whether you are lean or overweight, regular exercise is healthy. Aim for 150 minutes of exercise every week.
●Even if you are skinny, a diet high in junk food is not healthy. Your risk of developing diabetes may be increased by eating unhealthily and consuming foods with low nutritional content. Eat a diet rich in fruits, vegetables, and nuts. Consume more leafy green veggies in particular.
●People who consume between 0.5 and 3.5 drinks per day may have a 30% lower chance of developing diabetes than those who consume more than that.
●Your risk of developing diabetes almost returns to normal if you give up smoking. This enables your body to control your blood sugar levels more effectively.
●It's wise to get frequent checkups with your doctor if you have a family history of high cholesterol or high blood pressure. This can aid in the detection or potential prevention of problems like diabetes or heart disease.
●It's crucial to prioritise self-care and make sure you receive adequate rest. You can get the deep sleep your body requires by taking a quick afternoon nap or going to bed a few minutes early.

Diabetes Treatment at Hinduja Hospital
We, at Hinduja Hospital, are renowned as the top diabetic hospital in Mumbai, and our team of highly qualified physicians provides the best diabetes treatment based on the type of diabetes. Patients who seek treatment from our Department of Diabetes and Endocrinology have access to cutting-edge diagnostic tools and procedures to aid in the recovery of any type of diabetes, be it best Lean diabetes treatment in Mumbai or Type 2 Diabetes due to obesity. The depth of experience and breadth of knowledge that our hospital offers have been instrumental in our development as the leading diabetology hospital in India.

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