Most people think diabetes is a disease for the old and the junk-food feasting. Tom Hanks, Halle Berry, Nick Jonas, Vanessa Williams, and Jay Cutler would disagree—they've all been diagnosed with type 1 or type 2 diabetes.
Diabetes among the young and thin is more than a red-carpet phenomenon: Among thirtysomethings, rates of diabetes-related hospitalizations have doubled in the past decade, and 79 million adults age 20 and older are estimated to have prediabetes—that's up from 57 million in 2007.
What's more, according to Louis Philipson, M.D., Ph.D., director of the Kovler Diabetes Center at the University of Chicago, 15 percent of type 2 diabetics aren't even overweight. A Journal of the American Medical Association study shows that nearly one in four skinny people has prediabetes and is "metabolically obese." And to top it all off, men develop diabetes at a lower body-mass index than women do.
Basically, those numbers suck—especially for the young, thin guys out there who have long assumed they were in the clear. While the cause of type 1 diabetes, an autoimmune disease in which the body attacks insulin-secreting cells, is not known, genetics, skinny-fat syndrome, and stress all contribute to the development of type 2 diabetes in the young and thin, Philipson says.
First, while a family history of type 2 diabetes is a huge red flag (if one of your parents has it, your risk could be as high as one in three), your ethnic heritage can also play a role. African-Americans, Hispanic Americans, Asian Americans, and Pacific Islanders may actually have a leftover "thrifty gene" from their ancestors that enabled them to survive during "feast and famine" cycles—and which may now contribute to chronically high blood sugar. What's more, many non-Caucasians have a genetic tendency to be thin, Philipson says, meaning that, compared to Caucasians, they may have a lower fat threshold for increased type 2 diabetes risk.
While there's not much you can do about genetics, you can do something about your fat—even if you're thin. Skinny-fat syndrome, in which normal and even underweight people have excessive levels of visceral fat, is a major contributor to diabetes among the seemingly svelte. Visceral fat, which makes its home around your major internal organs, can damage your liver (which stores and produces sugar) and your pancreas (where insulin is made) and increase your body's resistance to insulin, he says. Plus, it also secretes stress hormones.
Stress—whether it comes from fat cells, your career, or an on-again-off-again relationship—seriously screws with the way your body processes sugar and insulin. Adrenaline increases the liver's release of sugar while decreasing the pancreas's insulin secretion. (Philipson explains it's nature's way of giving you extra energy when trying to outpace a wildebeest.) Plus, over time, cortisol increases insulin resistance and raises blood-sugar levels to up your odds of becoming a type 2 diabetic.
So no matter your pants size, this month (a.k.a. American Diabetes Month) take two minutes to access your type 2 risk with the [American Diabetes Association's risk calculator](check%20your%20risk%20by%20taking%20the%20American%20Diabetes%20Association's%20Diabetes%20Risk%20Calculator). If you score five or higher, consider setting a date with your doc to test your fasting blood glucose and A1c levels.
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