Dr. Louis Teichholz, chief of cardiology at Hackensack University Medical Center in New Jersey, says that even people with a normal body mass index (BMI), a standard obesity measure, can have surprising levels of visceral fat. Indeed, 45 percent of the women and 60 percent of the men scanned by Dr. Bell and his colleagues had normal BMI scores and excessive levels of internal fat.
The same risk factors for type 2 diabetes apply whether you are slim or heavy: a family history of diabetes, increased age, being in a high-risk ethnic group, poor diet, and lack of physical activity. A woman's risk increases if she's had gestational diabetes, has heart or blood vessel disease or has polycystic ovary syndrome. Unfortunately, many health care providers think "diabetes" only when they see a patient who fits the typical stereotype-obese and inactive-and therefore often neglect to check people of normal weight for pre-diabetes and diabetes. Dozens of people I've spoken with who had some of the classical symptoms of diabetes, yet were not overweight, were not initially tested for high blood sugar.
If you have any of the risk factors or any of the symptoms for type 2 diabetes, which include constant thirst, waking in the middle of the night to urinate, waking with a headache, fatigue, blood pressure of 140/90 or higher, a recurrent urinary tract infection, or neuropathy (burning or tingling sensations in your feet, hands, or limbs as a result of nerve damage), ask your doctor for a fasting plasma glucose (FPG) test and an oral glucose tolerance test (OGTT) to check for elevated blood sugar.