Women Who Are Trim, Young,...And Diabetic?

The Editors of WOMEN'S HEALTH

Stephanie Yi, 29, had a body most women would kill for. She never had to work hard to maintain her long-limbed, flat-bellied frame-weekend hikes near her northern California home and lots of spinach salads did the trick. She could easily afford to indulge her sweet tooth with the occasional buttery, sugary snack. At 5'7" and 120 pounds, she had, she figured, hit the good-genes jackpot. (Genes play a mixed role in determining your body shape. Are You Destined to Inherit Your Mother's Body Type?)

But everything changed two years ago, when a crippling fatigue left Stephanie sidelined from college classes. Listless, she dragged herself to a doctor, who suspected a thyroid imbalance. A blood test and a few days later, she received the alarming results: Her thyroid was fine; her blood sugar levels were not. She was prediabetic and on the cusp of developing type 2.

Stephanie was stunned. Of course, she'd heard diabetes was a health crisis. (At last count, 26 million Americans had the disease-according to the Centers for Disease Control and Prevention. Among them: these Top Celebrities Who Have Diabetes.) But weren't type 2 diabetics fat, sedentary, and on junk-food-and-soda diets? Stephanie hadn't been to a drive-through in ages; she didn't touch meat. Yet, somehow, she'd gotten an illness most slim women dodge.

A Growing Threat
The CDC estimates that one in nine adults has diabetes and, if current trends continue, one in three will be diabetic by the year 2050. For decades, typical type 2 patients were close to what Stephanie pictured: heavy and inactive. They were also older, often receiving a diagnosis in middle age or beyond. But while such type 2 cases continue to skyrocket, there has been a disturbing increase in a much younger set.

The number of diabetes-related hospitalizations among people in their thirties has doubled in the past decade, with women 1.3 times more likely to be admitted than men. Perhaps even more troubling is the enormous number of people age 20 or older with prediabetes: 65 million, up from 57 million in 2007. Every decade of life requires a specific focus. Here, the Best Foods, Workouts, and Medical Checks for Your 20s, 30s, and 40s

Suddenly, a condition that can take half a lifetime to develop has become a young person's problem. Even more surprising, about 15 percent of people with type 2 diabetes aren't overweight, according to the National Institutes of Health. They're not feasting on ice cream and cheeseburgers. But their average-weight bodies are hiding a dark secret.

Skinny-Fat and Stressed Out
Molecular imaging expert Jimmy Bell, M.D., studies a condition he calls TOFI-thin outside, fat inside. Nearly undetectable from a person's appearance, TOFI happens when fat that would normally build up under your skin (hello, thunder thighs!) gloms onto your abdominal organs instead. This visceral fat is way worse than any muffin-top chub-it can cause inflammatory substances to affect your liver and pancreas, and lower your insulin sensitivity, putting you at risk for type 2. "With TOFI, you might look slim," says Bell, "but your insides are behaving as if you are obese."

A big skinny-fat risk factor? Neglecting exercise and regulating weight through food choices alone, a behavior plenty of young women in our diet-obsessed, desk-strapped culture are prone to. Turns out, breaking a sweat is key in lowering blood sugar, because even moderate exercise causes muscles to suck up glucose at 20 times the normal rate (regular workouts are also the only way to shed visceral fat). Try this Do-Anywhere Total-Body Workout.

That's a fact Corinne Waigand, 30, wishes she had known. In college, she regularly skipped breakfast and pounded Mountain Dew in lieu of lunch to keep her wired for class. After school, she'd indulge all of her cravings-cookies, cake, pasta, chips-before sometimes heading out to parties with friends. She rarely exercised, though she did go on the occasional low-sugar kick; one year, she gave up soda for Lent and dropped 10 pounds (she gained it all back). At 5'10" and 165 pounds, she was never overweight, let alone obese, but her behavior caused huge troughs and peaks in her insulin production.

Corinne was diagnosed with type 2 diabetes two years ago. Like Stephanie, she was shocked. "I didn't fit the physical description of someone with type 2," she says. "Sure, I had some bad eating habits, but it never showed on my body."

Many young women also unwittingly engage in a second big TOFI and diabetes risk: yo-yo dieting. "Each time you lose weight through dieting, you also lose muscle," explains Betul Hatipoglu, M.D., an endocrinologist at the Cleveland Clinic. "And each time you regain that weight, you gain only fat." In other words, yo-yo dieters lose the muscle mass that would help them burn visceral fat and control blood sugar-a type 2 double whammy.

Layered on top of these risks is another familiar culprit: daily stress. When your mind is taxed, your body produces the stress hormone cortisol to give you a jolt of energy. Problem is, cortisol also temporarily elevates blood sugar-a diabetes danger if you're tense all the time. Plus, scientists have found that too much cortisol can also mess with fat storage and lead to a spike in visceral blubber among stressed-out, normal-weight women. That's right-chronic stress contributes to making you skinny-fat.

Continue Reading this Article on Type 2 Diabetes on Women's Health

--By Sushma Subramanian

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