Thin and Type 2 Diabetic: A Dangerous Combination

Thin and Type 2 Diabetic: A Dangerous Combination

By CareerSmart® Learning Contributor, as published by Healthcare Hot Spot

Type 2 diabetes mellitus is typically believed to affect only the obese population, and with good reason, there is a multitude of research on the link between obesity and type 2 diabetes.  And the subjects in type 2 diabetes research are generally obese.  The common advice from physicians to people who are obese (BMI greater than 25) and pre-diabetic or diagnosed with type 2 diabetes is to lose 10% of their body weight through diet and exercise.  But what does a physician advise to a patient who doesn’t have body weight to lose?

Some studies refer to it as “lean diabetes,” while some articles use the term “skinny fat” to describe the phenomenon.  Approximately 26 million people in the United States have diabetes and another 9 million are pre-diabetic, of those, it is estimated that approximately 13% are of normal body weight (George, Jacob, & Fogelfield, 2015). 

Research is showing that there are several different trends in lean diabetes.  Some lean diabetics fall into a category of experiencing childhood malnutrition and low socioeconomic status because one study found that even a brief period of pediatric malnutrition could greatly increase the likelihood of lean diabetes.  However, this category does not account for all of the lean diabetics (George, Jacob, & Fogelfield, 2015). 

Another finding is that some lean diabetics don’t carry fat in the adipose layer below the skin; instead they often have visceral fat – fat surrounding their organs (Subramanian, 2011).  Two factors can increase visceral fat, dieting (where muscle mass is lost) and stress.  So for many lean diabetics, even though their weight may not be an issue, their fat content is an issue.  Interestingly, this means that the advice given to diabetics who are obese still holds true for those who are of normal body weight – exercise and follow a diabetic diet.  While weight loss might not be the goal for lean diabetics, losing fat, particularly visceral fat, and daily exercise time to burn excess glucose remain excellent strategies to prevent and treat type 2 diabetes (Subramanian, 2011).

You may also be interested in:

George, A.M., Jacob, A. G., Fogelfield, L.  (2015).  Lean diabetes mellitus: An emerging entity in the era of obesity.  World Journal of Diabetes; 6(4): 613-620.  doi:  10.4239/wjd.v6.i4.613

Subramanian, S.  (2011).  Type 2 Diabetes in Women: Young, Slim, and Diabetic.  Women’s Health.  Retrieved from

October 21, 2020

3 responses on "Thin and Type 2 Diabetic: A Dangerous Combination"

  1. To me, this says that “lean” people get type 2 diabetes for the same reasons as “larger” people – fat content, genetics, and childhood malnutrition. Treatment includes medication, exercise, and balanced nutrition. Over 90% of “diets” fail within 3-4 years, returning to the same or higher weight than before the diet.

    Maybe studies should consider the disease overall instead of separating subjects by BMI, since BMI is inaccurate and insufficient. This separation perpetuates weight stigma. It conflates correlation with causation.

  2. I am 8 years diagnosed @ age 35 how long can live with diabetic now I am 43

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