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Avatar universal

Why are overweight people at higher risk?

I am not understanding why would the fact that a person is overweight put them at higher risk for diabetes.

Lets say we have 2 people A and B.

A:  150lbs muscle + 20lbs fat = 170lbs total
B:  150lbs muscle + 50lbs fat = 200lbs total

Lets say they both eat a meal with the same amount of carbs, the insulin response of the muscle cells is higher than that of the fat cells so they both absorb the same amout of glucose with their 150lbs of muscle each.

Now fat cells still help absorbing the glucose even though not as much as muscle.

So 'A' absorbs some more glucose with his 20lbs of fat, but 'B' should absorb even more with his 50lbs of fat?

So seems like the heavier person would actually absorb more glucose out of their bloodstream? Then why are they at higher risk?
29 Responses
231441 tn?1333896366
Some scientists say that fat should be considered as a separate organ, considering the impact it has on hormone systems in the body.

Putting it very simplistically ; Fat contributes towards insulin resistance.  Insulin resistance means that insulin levels need to be much higher than for a relatively slimmer person, in order for the sugars to be absorbed.

This is one of the reasons that overweight people with diabetes are recommended to lose weight.

For obese people, who are diabetic, and lose weight, their diabetes may be apparently reversed (though the tendency for diabetes is still there and it may return if they gained weight again)..

Avatar universal
Back in the 80s when I was DX as diabetic i WENT TO A TRAINING CLASS AT THE LOCAL HOSPITAL.  The MD showed a study that was done on 5,000 people. of people that gained weight without changing diet or activity level a full 90% of them developed diabetes in 5 years.  We define diabetes when BG crosses a line (used to be 250 then they decided that 200 was the line now they are saying 180 is the line).  The point is it is a made up line  the science says tat its the condition that puts on the weight and when the condition gets bad enough we call it diabetes.

20% of the diabetics are of normal body mass,  not all fat people get diabetes.

Its a correlation not causation.
4851940 tn?1515698193
Like diabetes86 says, not all fat people get diabetes.

Being fat not only puts you at risk of getting diabetes, but also from getting other illnesses, like heart disease and more strain on the bones causing damage to the weight bearing joints.

What you say is technically true, but when the pancreas does not produce enough insulin or too much insulin but your body has become resistant to it, the glucose stays attached to the red corpuscles and does not get pushed to the body cells that need the energy.

Our western diet exposes us to too much temptation with lots of foods that we overload our bodies.  Having said that even with no overload does not mean that you won't get diabetes, because it can be genetic.

For example if you have a parent or close family members who have diabetes, you will be more at risk at getting the illness.

Imagine the glucose as being the fuel in the engine of a car.  The fuel is useless until the engine is turned on.  The fuel won't be used properly or efficiently if you have blocked filters, or bad spark plugs.  Same for the body.  If the pancreas does not produce enough insulin then the energy is not pushed to the cells that need it.  If the pancreas produces enough insulin but your body doesn't utilise it properly its like the filters in the car are damaged.

Fat cells do not need glucose or energy.  Fat cells are made when there is too much energy that is not being burned off.  Your car full of fuel in the tank, but it won't be used until you turn the engine on.  Your body won't burn the fat or energy until you exercise.  Some energy is used to help the body function, but any excess of food that you eat or drinks full of calories, will be stored as fat.  To burn body fat, you need to move and exercise more or eat less food (fuel).

Hope that, in a simple way, can help you understand about it a bit more.
Avatar universal
Ok let me see if I get it in a non-scientific kind of way.

A person eats an unhealthy diet with lots of carbs, at the same time leading a sedintery lifestyle. For a while his body produces enough insulin to absorb all the glucose, but then his body doesn't utilize it so it gets stored as fat.

Then one day the body says: 'wait a minute we are not using all this glucose, so lets not respond to all this insulin that is coming our way' and starts building insulin resistance. And from that point on its pretty much a downwards spiral?

4851940 tn?1515698193
Yep, sort of.

In Type 2 diabetes, the pancreas either does not produce enough insulin or it produces the insulin, but your body has become insulin resistant.

When you have Type 2 diabetes, sometimes it does not end up as a "downwards spiral".  The reason to stop it spiralling down is by eating smaller portions, but with a few hours in between.  Not have large meals with desserts and puddings.  And also by exercising.  Exercise burns energy (what we call calories - eat too many calories (too much energy), it gets stored as fat.

If you eat a lot and sit at the computer or watch the telly all the time (couch potato), you gain weight because you are eating too much energy, but that energy is not being used, so gets stored as fat.  Being very overweight is not good if you want to stay healthy and well.  Some thin people get diabetes.  And it may be that their pancreas is not working properly (which no one knows why) or it may be  hereditary - if any of your parents or family members have diabetes, our risk is that much higher of getting it if you do not look after your health and weight.

Sometimes the pancreas stops working altogether and doesn't produce any insulin.  This is called Type I diabetes.  It can happen at any age, but usually in young children.  People with Type I diabetes have to have an injection of insulin.  Insulin is the hormone that is produced by the pancreas to help get the glucose to the cells in the body, without insulin the glucose sits in the blood which causes a glucose overload.
Avatar universal
I meant its a downwards spiral if nothing is done.

So can one do even more than just stopping it spiraling down? Can pancreas function and/or insulin resistance ever be restored to normal through lifestyle changes, exercise etc?
4851940 tn?1515698193
Only if you have glucose intolerance or Type 2 diabetes that is not too advanced.
4851940 tn?1515698193
Are you overweight and have been told recently that you have glucose intolerance or Type 2 diabetes?

Avatar universal
No, I am 48 yrs old and well inside my weight range for my height and I am an ex-marathon runner, I still exercise for at least and hour daily, 6 times a week.

Had a fasting BG test done recently because of some eyesight changes and it came back at 107, A1C was 5.3 I think.

Dr, said the eyesight changes were not due to BG and not to worry as long as I stay slim, and keep doing what I am doing, but I am concerned.

I am used to eating a lot of carbs for my training, so now I am cutting all the extra snacks, sweets, etc. Also trying to add back some high intensity sprints to my running routine since I read it increases insulin sensitivity.

Thing is I never had a BG test done before so I don't know whats normal for me.
231441 tn?1333896366

to develop diabetes, you need the unhealthy lifestyle and genetic predisposition or environmental trigger.

I think your Dr is right that you don't need to worry too much at an A1c of 5.3.  However, it is definitely something to be monitoring to see if it progresses over time.  Of course you should be keeping up activity levels, and maintaining weight.  

Cutting carbs is really important to preventing progression of diabetes / controlling it if it does develop.  After all - what is diabetes - it is a defect in how the body handles carbs.

Low carb, moderate protein, high healthy fats.  There is currently a lot of research about ketogenic diets and endurance training.  Tim Noakes used to be a big advocate of carbs / carbo loading, but now has done a 180 degree turn and is very much advocating low carb, high fat diets for athletes.  You can certainly research this and should find it interesting.

4851940 tn?1515698193
You are fine.  If you continue to the exercises like you have been, you don't need to worry about your foods and carbs.  The body needs carbs for energy.   The types of carbs to watch are the simple carbs like cakes, sweets.  But as you are burning up the energy, your body needs it.

If your lifestyle changed, then you would need to cut out or cut down on the simple carbs.  Although fruit contains fructose (sugar in fruit), when you eat the whole fruit the energy is broken down differently because of the fibre.  
So the type of carbs to eat would be the slow release energy carbs, like porridge, wholemeal bread and so on.

With the fats, there are good fats and bad fats.  It is the trans fats that you have to watch.  Oil in fish, nuts, avocado, olive is the healthy oil.
Coconut oil is healthy and has antibacterial and antifungal properties, can be eaten off the spoon, used in cooking, used on the skin, in the scalp, get make up off, used in baking.  It is the only oil that does not change its composition when heated up.  Unfortunately it is a saturated fat like butter.

The reason your eye sight and your blood sugar was checked is that with high sugar levels in the body, this can damage nerves, cause peripheral retinopathy which is damage to the small blood vessels inside the eye, cause circulation problems.  

Not everyone gets symptoms of diabetes and damage can happen way before you even notice any symptoms.

Glad that you are fine.

Avatar universal

Thanks for all the info.

I am still wondering if there is still anything I can do to get my fasting glucose and a1c levels into a completely normal range?

From what I am reading on this forum. Low 80s for fasting glucose and a1c < 5.0 is the non-diabetic range.

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231441 tn?1333896366
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