Last updated: Mar 02, 2016
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You probably think you know what someone with type 2 diabetes looks like—older, obese and sedentary. But thin women are at risk, too: In fact, about 15 percent of type 2 diabetics are at a normal weight (meaning they have a BMI under 25). "If you saw them in the grocery store, you'd swear these people didn't have problems," says Rochelle Naylor, MD, an endocrinologist at the University of Chicago Kovler Diabetes Center.


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What's going on
Why would a slim person get diabetes? The likely explanation: "thin-fat syndrome" (aka skinny-fat), in which you're thin but your body-fat percentage is high. Look at your shape: If you're thicker through your torso or have a high waist-to-hip ratio, that's a clue you may be carrying a lot of visceral fat, the dangerous kind that surrounds your internal organs. "Fat cells don't just sit there. They actively secrete hormones that can worsen insulin resistance and lead to diabetes," says Sethu K. Reddy, MD, chief of the adult diabetes section at Harvard Medical School's Joslin Diabetes Center.

You may also be more susceptible if you have a strong family history, had gestational diabetes (or your mother had it when she was pregnant with you), don't exercise or have polycystic ovary syndrome.

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What you can do
"Even normal-weight people may have room to lose a bit of weight," says Dr. Naylor. (Think 5 or so pounds.) Exercise and diet are key, no matter what happens on the scale. Do cardio and strength training, both of which can improve insulin sensitivity. Aim for 30 minutes a day, five days a week. Steer clear of processed, simple carbs; fill up on fiber-rich foods like whole grains and vegetables instead.

However, if you're already working out and eating a relatively healthy diet but still have high blood sugar, you may need to take meds. "Some people think it's the last resort and try to avoid it," says Dr. Naylor. "But the most important thing is managing your blood sugar levels."

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7 Warning Signs

If you notice even one of these symptoms of diabetes, it's worth bringing it up to your doc and asking for a blood test (usually the A1C) to check your blood sugar levels.

•Waking up often during the night to pee

•Feeling unusually thirsty

•Unexplained weight loss or gain

•Frequent yeast infections

•Blurry vision

•Tingling in the hands and feet

•Cuts that don't heal well or infections that are difficult to get rid of

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