Search Trends: Diabetes

A trend I’ve recently noticed in the search terms (WordPress’s handy table of phrases Google says people searched on to get to my site):  fat people who don’t have diabetes.

Specific examples:

why not all obese people get diabetes
do all overweight people get diabetes
i’m obese; will i get diabetes?
why obese people get diabetes
how many obese people have diabetes
how to fat people get diabetes
do all overweight people have diabetes 2
what percentage of obese people get diab
do all overweight people develop diabete

Since there is evidently some confusion out there, I’m going to make it nice and clear in this corner of the net:

No, not all fat people have diabetes.

From the American Diabetes Association – which is not exactly the most fat-accepting group in the world:

Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

Why not?  Other major risk factors for diabetes are genetics, race, and age — even sleep patterns have been implicated.   But weight is seen as being something people can control, and weight gain has traditionally been a precursor to type 2 diabetes, so “control your weight” has been the drumbeat of the public health sector.

By the way, research shows that regular exercise alone decreases diabetes risk.  It’s often lumped in with “lose weight”, but in fact, exercise improves your health whether you lose weight or not.

More:

One might even surmise from this that weight gain alone doesn’t cause diabetes, or that diabetes isn’t completely avoidable….

19 thoughts on “Search Trends: Diabetes

  1. You can also get diabetes from medication. I am at risk for steroid-induced diabetes because I take corticosteroids (prednisone in my case) for an adrenal disorder. My old doctor never bothered to tell me that, although my current endocrinologist sent me for glucose tolerance testing as soon as I signed up with him. I had steroid-induced insulin resistance, but not diabetes. Regular exercise, as you note, keeps diabetes at bay, so I do that. My most recent glucose test shows no insulin problems at all–probably due to the fact that we have been slowly reducing my steroid dosage. I’m still fat though.

  2. You know, it really is irresponsible of you. Being so, blindingly, LOGICAL and punching massive holes in peoples irrational belief systems. How would you feel if you believed the sky was paisly and someone came along with the rediculous suggestion that it might be blue?

    [feeling kinda sarcastic today. I’d go for a walk but, of course, it’s raining.]

  3. weight gain has traditionally been a precursor to type 2 diabetes

    That’s not exactly right – well, it’s correct literally, but it’s a little misleading. Insulin resistance typically causes gradual weight gain over time, and (since it causes chronic hyperinsulinemia) makes weight loss very difficult physiologically. Type 2 Diabetes is just what we call insulin resistance when it gets severe enough. So the progression is

    insulin resistance -> progression -> type 2 diabetes
    gradual weight gain -> more gradual weight gain

    – but the insulin resistance is causing the weight gain, not the other way around.

    (Exercising and reducing carb intake – specifically, reducing the kind of eating that spikes your blood glucose – seemingly can slow or reverse the progression of insulin resistance, so there’s something that you can potentially do. And doing these things often results in slight weight loss [typically around 5-10% of body weight], which confuses the issue and causes some lazy doctors to prescribe “weight loss” to their patients with no attention to healthy eating and exercise. Bah.)

    Bottom line is, failing to “diet” does not give you type 2 diabetes. It’s an endocrine condition. It’s genetic. You inherit it. You don’t get it by being overweight, obese, or deathfat.

    • And the fact that this is 4 paragraphs instead of one part of a sentence is why I didn’t get into it (I do appreciate you pointing it out, though, since the additional detail is helpful for those who aren’t still wrestling with “how can people be fat and not have diabetes???” ;) Especially since diabetes used to have a higher threshold, which meant insulin resistance had more time to work before people would get diagnosed with diabetes.

      confuses the issue and causes some lazy doctors to prescribe “weight loss” to their patients with no attention to healthy eating and exercise. Bah

      And the ADA, and the NIH…there are a LOT of references out that state “weight loss help[s] the body respond better to insulin” or “Weight loss can improve the body’s ability to recognize and use insulin appropriately.” Never mind that exercise alone has been demonstrated to improve insulin resistance.

      • Sorry – I didn’t mean to get all lectur-ey on you! (This stuff just sets me off.)

        Cassi, I agree there are a lot of ways to gain weight, and IR is only one possible factor of many. I didn’t mean to say otherwise. And diabetic insulin resistance is not all that well understood. Still, we do know some of the mechanisms by which it works, and the inhibition of lipolysis in the presence of insulin (meaning you can’t lose fat while your insulin levels are high), plus the basic action of insulin resistance itself, do seem pretty well established as (some) mechanisms of weight gain.

        • Right, they’re definitely connected. I completely agree on that. I just have a knee jerk reaction to anything that even smacks of correlation/causation confusion, because it’s so badly abused by fat haters. Actually by lots of people, but fat haters are some of the worst. Frankly, I think that occasionally getting all lecture-y is a good thing, because I think all of us keeping in touch with how very complex all this stuff really is, is a key to stopping the “just lose weight and life will be roses!” crapola. (Though I certainly understand that the OP can’t go into that sort of depth in every single blog post or else she’d have no time for, you know, life ;)

    • – but the insulin resistance is causing the weight gain, not the other way around.

      While I too strongly suspect the above as a likely scenario, unless there’s been some serious progress in the field that I’m unaware of (certainly possible, though I do follow fairly closely), this hasn’t been proved either. We don’t fully understand all the variables in all the metabolic pathways that lead to either weight gain or diabetes, so all we really have is a bunch of correlations that are not absolute evidence of causation in either direction.

      If the above were true, then correcting people’s insulin resistance (which as stated can often be done with diet changes rather than caloric restriction) would mean they would stop gaining weight, but that doesn’t always happen, because lots of things can combine in lots of ways to cause weight gain. Some type 2 diabetics might have been fat even if they never had any insulin resistance. Others aren’t fat at all. Correlation is NOT causation.

  4. You know, I took the test, and it told me I could be pre-diabetic.

    I know it did this solely based on my weight, (I’m BMI 45) because I have no family history, no history of blood sugar problems, and I’m active.

    I recently had my blood sugar checked, and it’s perfect. Not even in pre-diabetic territory.

    The ADA might say that 70% of all overweight people will never get diabetes, but their test says that so long as you’re overweight, you’re pre-diabetic. Not very consistent.

  5. I have a MAJOR genetic predisposition towards diabetes.

    My fasting blood sugars are regularly low.

    I’m fatter than my diabetic relatives. (I also eat a tenth as much processed food and exercise about five times as often. Ain’t automagically making me skinny, mind).

    • I’m kinda split.

      Mom’s side of the family: Every relative I know of has diabetes: Mom’s mom, both her sisters, all their kids.

      Dad’s side of the family: Nobody has diabetes.

      I grew up being told by both my mother and my doctors that if I didn’t lose weight I absolutely would get diabetes. It’s one of the reasons I dieted so much. In my early 20s one doctor read an article on how genetic inheritance matters more than weight, rechecked my family history, and told me that statistically speaking my weight didn’t actually change my chances. That was part of why I decided to stop dieting temporarily—and had my weight stabilize for the first time in my life.

      So, yeah, I get the genetic predisposition thing. But I’m older and fatter than my cousins were when they were diagnosed, and my fasting blood sugars are fine.

      (Preventing diabetes has become one of my reasons for exercising, too.)

  6. In certain communities the risk of diabetes is higher, because it’s passed on as a survival trait amongst peoples who hunted large game. For Australian aboriginal people, for example, who lived in harsh surroundings with regular food shortages, diabetes is much more common (because having diabetes made them more likely to survive, and because it’s genetic).

    I think that if you don’t have a family history of diabetes you don’t need to panic, no matter what you do or what you weigh. I think it’s roughly 6-8% of the population at risk anyway so, you know, unless it’s already in your family history the likelihood is very, very low. You’re in more danger of getting run over, which is something you can’t do anything about, so get on with your life.

  7. On my mother’s side of the family, there is diabetes, both Type II and hypoglycemia. My mother gets bouts of hypo, as do I when I go too long without eating. Normally, our blood sugar rarely goes over 100. My fasting blood sugar is always good.

    But still, the risk is there to develop Type II, and because of genetics, I don’t think it would matter what I weigh. However, I think that the amount of exercise I do does fend off getting it quicker.

    Because diabetes can affect anyone regardless of weight, age, race/ethnicity etc, we really need to stop thinking of it as strictly a fat persons’ disease.

  8. My grandfather was diagnosed with type 2 diabetes recently – he’s 86. Now, he’s been taking a statin for quite some time and there is now evidence which suggests, that like corticosteroids, taking statins can cause diabetes as they decrease your insulin sensitivity. Given that nobody else ever in our family history has ever had type 2 diabetes, and they’ve all lived very long healthy lives, it’s making me wonder.

    It also seems a little worrisome, as many type 2 diabetics are automatically prescribed statins as preventive therapy even if they have good or only slightly high levels. I’ve never really seen compelling evidence that statins do any good long-term for anyone except older men who have already had a heart attack. My grandfather has never had a heart attack, he just had a couple of higher cholesterol results about ten years ago. From what I hear, his doctor is an ass, but there really isn’t any alternative in his small town!

  9. Statins are some of the most dangerous & useless drugs to have been foisted off on us. Even the damn commercials admit in the disclaimer that ‘lowering cholesterol has not been shown to decrease risk of stroke or heart attack’ & in many other countries they do not screen cholesterol levels. It is strongly indicated by a lot of medical research that cholesterol is irrelevant to health for most people & that only those with a history of familial hypercholesterolemia have any real issues with cholesterol & they need a lot more help than statins can give them. The research also suggests that statins, while having many negative & sometimes deadly side effects, MAY be helpful to perhaps 10% of men & are useless to women. However, we will not see any of that publicly acknowledged by the $500 billion a year pharmaceutical industry. They are not pushing statins because they care so much about people’s health, but because they care so much about their profits. Over 30 years ago, a CEO of one of the major companies told his board that it wasn’t enough to sell drugs to sick people, they had to try to reach healthy people too & unfortunately they do better at it all the time, by exaggerating the importance of ‘numbers’ & by selling the idea that, regardless of who you are or how old you are, you are supposed to aim for the ‘numbers’ of a fit 20-year-old.

  10. Pingback: March Round-Up « Living ~400lbs

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