How Being Overweight Might Put You at Risk for Diabetes

Most prediabetics carry excess weight, says Duke University's Beth Reardon. That fact alone is a major risk factor for diabetes. But especially worrisome is when you try to cut back on calories and still can't see the scale budge. Stubborn weight loss despite best efforts can be the result of mixed messages that our cells are receiving, Reardon says. "The cells are starving because the fuel they need (in the form of glucose) is not being absorbed at the insulin receptor site on the cell. In the face of a perceived fuel shortage, the body will hold tightly onto existing stores of energy -- fat," she says. What little is absorbed also goes straight into storage -- as more fat.

What helps: Incremental change. Don't think, "OMG, I have to lose 50 pounds; I can never do that." Instead, think small. Losing just 5 to 7 percent of body weight prevents or delays diabetes by 60 percent, according to the Diabetes Prevention Program (DPP), a major multicenter research study. People over age 60 see even greater benefits, according to the DPP. Five percent of body weight translates to just 10 pounds for a 200-pound person. A combination of lifestyle changes (especially changes in diet) and medication is often needed to address weight loss in these circumstances.

What It Might Mean if You Look More Like an Apple Than a Pear

Weight gain is weight gain, and all of it risks moving you down the path toward diabetes. But added pounds in one particular area -- the midsection -- are especially associated with insulin resistance and prediabetes.

Weight gain around the waist and abdomen (visceral fat) is considered more dangerous than extra padding in the thighs and rear. So-called "belly fat" is linked to a higher rate of high blood pressure, heart disease, stroke, and dangerous cholesterol levels -- all risk factors for diabetes. Having an apple-shaped middle has also been linked to Alzheimer's disease.

For men, the danger point is considered to be a waist circumference of 40 inches or more; for women, the dangerous measurement is a waist of 35 inches or more.

What helps: Diet, weight loss -- and exercise. The third leg of a diabetes-thwarting approach is moving. It's not true that sit-ups and other abdominal exercises will target belly fat. (Though they do build muscles.) Exercise plays a critical role because when you build muscle, you increase the number of enzymes that are able to metabolize glucose as a fuel source for those cells, nutrition expert Beth Reardon says. Aim for 30 to 60 minutes of moderate exercise (like a brisk walk) most days of the week.

How High Blood Pressure Might Put You at Risk for Diabetes

High blood pressure is linked to many different conditions. But prediabetes may be the cause when it appears in tandem with excess weight gain (especially around the middle), fatigue, and other negative numbers on a medical workup (abnormal cholesterol levels and high triglycerides). Many people with high blood pressure worry about their heart without recognizing that the presence of hypertension -- along with these other signs -- is a neon red sign for prediabetes.

The numbers to beware: blood pressure equal to or higher than 130/85, an HDL "good" cholesterol level below 40 mg/Dl for men and below 50 mg/Dl for women, and triglycerides of 150 mg/Dl.

Blood pressure elevates in part because of inflammation, a damaging cascade of events in the body that high insulin levels contribute to. "Blood becomes stickier and more viscous, and blood clotting factors increase, making it more difficult for the body to move the blood around," Duke University's Beth Reardon says. "Insulin also has an effect on the pliability of blood vessels, making them less elastic and therefore less able to respond to changes in pressure. This, in combination with blood that doesn't flow as easily, results in elevated blood pressure."

What helps: Losing weight slowly through dietary changes and increased exercise.

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