Getting Overweight Doesn't Guarantee You Will Become Diabetic

Does diabetes run in your family? Have you put on a few too many pounds? Are you worried you might become diabetic, too?

Even when people have a genetic tendency toward type 2 diabetes and become overweight, however, diabetes is not necessarily inevitable. Vigorous daily exercise maintains circulation. If increased circulatory health keeps the blood flowing, the fat cells that use insulin to “catch” circulating glucose and turn it into fat can keep blood sugar levels normal. Alternatively, expanded muscle mass, also from exercise, enables muscle cells to use more glucose and also keep bloodstream glucose levels low.

But when overweight people with a hereditary tendency toward diabetes become inactive, diabetes results. Even while cells all over the body are losing their ability to respond to insulin, fat cells undergo changes that make them accumulate fat more readily and release them more slowly, compounding poor circulation caused by lack of exercise. As fat cells become “stuffed” with triglycerides, even if sugar reaches them, they cannot process it. Gaining weight becomes easier. The muscle cells are forced to do more and more of the work of keeping blood sugar levels normal, even while their own insulin resistance eventually forces them to use fats and their own proteins for fuel.

The metabolic disruption caused by diabetes affects every cell of the body, but especially the eyes and nervous system. Unlike other tissues, the eyes, the brain, and the nerves do not have to rely on insulin transporters as their only way to receive glucose fuel. When blood sugars are high, glucose pours into these tissues faster than the tissues can use it, and toxic waste products build up. For this reason, especially in type 2 diabetes, the first obvious symptoms are usually psychological. Excess sugar “revs up” the brain so that many untreated type 2 diabetics appear slightly manic, with racing thoughts, racing speech, and a “go-go mind with a so-so body.” Having too little energy for too much to do is a good time to see a doctor to make sure you do not have diabetes.