The Genetic Connection
Stephanie Yi didn't yo-yo diet and wasn't super stressed. Sure, she had that sweet tooth, but don't lots of fit women? After her prediabetes diagnosis, she called her father. He reminded her that his father had died from a heart attack related to diabetes when Stephanie was very young. She was likely the victim of yet another type 2 risk: genetic predisposition.
Scientists are still working out the specifics, but lean young people might be at a bigger risk of developing type 2 if one of their also-lean relatives was diagnosed, according to the Joslin Diabetes Center at Harvard Medical School. (If both her parents have type 2, a woman has a 50 percent chance of getting it herself; if both of her parents and a sibling have it, her risk increases fourfold.) Why? It's possible that normal-weight type 2 patients inherited a specific set of genes that affects the way their body handles even a bit of excess fat.
For example, some women can house ample junk in their trunk without serious health consequences—their pancreas functions as a genius locksmith that distributes insulin keys to open the doors that let cells store sugar. But other women, like Stephanie, might have a much lower threshold for excess food or fat. Certain DNA might hinder their pancreatic function; no matter how many keys are passed out, none work.
Sugar gets locked out of cells and floods the bloodstream, damaging organs like the liver and heart, says endocrinologist Nicola Abate, M.D., of the University of Texas.
While the only test for "type 2 DNA" involves a long, hard look at a family tree, researchers know that certain people might be at a higher risk. Asian Americans, for instance, are more likely than white Americans to develop type 2, even though just 9 percent of the former group are obese, compared with 32 percent of the latter, according to the National Diabetes Fact Sheet. It appears, says Abate, that Asian Americans are genetically predisposed to be extra sensitive to extra calories.
Stamping Out Prediabetes
Some doctors, such as leading diabetes expert Richard Bernstein, M.D., believe that many of the slim women diagnosed with type 2 don't actually have that disease. Rather, they could have an undiagnosed case of type 1.
"The definitions of type 1 and type 2 are too vague," he says. "Many adults show symptoms of both." After all, the signs—extreme thirst, blurred vision, high blood sugar—can be similar, according to the National Institutes of Health. So it's important to get tested for both types (the typical type 2 screen does not look for the autoantibodies that come with type 1). "Most doctors don't test for diabetes unless their patient is obese," says Abate. But they should; symptoms might not show up until the disease is well under way. Ask your doctor to check you every five years.
Your best bet, of course, is preventing type 2 symptoms altogether. Even if you have type 2–prone DNA, the disease is almost entirely preventable if you make smart lifestyle choices or catch prediabetes early. "While type 2 can never be reversed, prediabetes can," says Abate. The problem is that about 93 percent of prediabetics don't even know they're sick.
Besides being tested, a crucial antidiabetes move is to eat healthy foods—not just foods that seem healthy, says Bell. Women can up their TOFI risk by downing too much junk food in disguise—all too easy with sugar lurking in "health foods" such as low-fat salad dressings, breakfast cereals, and vitamin drinks. Such fare is often packed with high-fructose corn syrup, which the body converts into visceral fat. Eat as little added sugar as possible each day and stick with low-glycemic-index carbs and unprocessed foods like fruits, veggies, and whole grains.
Since cutting out her guilty pleasures, Stephanie has watched her blood sugar levels drop. She has also said good-bye to carb-heavy white bread and embraced exercise nearly every day of the week. (Studies show that just 30 minutes of brisk walking a day can cut people's odds of developing type 2 by 58 percent—even people who are already prediabetic—according to the NIH.) "I know my body better now," says Stephanie. "Making these small changes has made me healthier." The last time she checked, her blood sugar was close to normal.
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