A 32-year-old teacher, who appeared to maintain a healthy weight and followed what many would call a balanced diet, recently received a type 2 diabetes diagnosis. This case is not unique, as recent research reveals that individuals with normal or even underweight body mass can still develop the condition. The findings challenge traditional perceptions of diabetes risk, highlighting the complexity of metabolic health.
A study published in *Diabetologia* underscores that type 2 diabetes is increasingly prevalent among people with normal or low BMI. In several Asian and African communities, up to 66% of diabetes cases occur in individuals who are not overweight. Although being overweight remains a significant risk factor, the study shows that it is not the sole determinant. This trend suggests that other elements, such as genetic predispositions and metabolic responses, play critical roles in the disease’s development.
The research also emphasizes that fat distribution, particularly visceral fat—stored around the abdomen and internal organs—can contribute to insulin resistance and impaired glucose regulation, even in those with a healthy BMI. Imaging studies have identified that some “lean” individuals with type 2 diabetes exhibit fat patterns similar to overweight counterparts, including increased visceral fat and altered muscle or pancreatic fat composition.
Metabolic dysfunction can manifest in people with normal weight but abnormal health markers. Known as the “metabolically unhealthy normal weight” (MUNW) phenotype, this condition is characterized by insulin resistance, elevated blood sugar levels, and unfavorable lipid profiles. These factors, often overlooked due to the individual’s weight, significantly increase diabetes risk.
Modern diets, despite appearing healthy, may contain ultra-processed foods that contribute to metabolic issues. A study from *The Journal of the Academy of Nutrition and Dietetics* found that higher consumption of such foods correlates with poorer blood sugar control, as measured by elevated HbA1c levels. Even without excessive sugar intake, refined carbohydrates, additives, and unhealthy fats can disrupt metabolic balance.
The teacher’s experience exemplifies how dietary choices, such as frequent pastry consumption, can lead to blood sugar spikes. This case serves as a reminder that health metrics extend beyond visible indicators, requiring closer attention to lifestyle habits. As the story illustrates, hidden risks in diet, genetics, and body fat storage can quietly contribute to chronic conditions like diabetes.