Ask an Expert: Can a young, healthy, active adult get diabetes?

Q: Can an active, 32-year-old Caucasian female who eats well and who does not suffer from obesity, high blood pressure or high cholesterol be diagnosed with diabetes or pre-diabetes? If so, how common is this?

Answer from Susanna Reiner, R.N., B.S.N., diabetes nurse educator, Providence Diabetes Education:

Yes — even though a healthy diet, weight and lifestyle greatly reduce the chances of developing diabetes, there is still a small chance that the woman you described could be diagnosed with pre-diabetes or diabetes due to risk factors beyond her control. It’s relatively uncommon, but it does happen.

Fortunately, her healthy lifestyle will be an asset to her. If the woman in question is diagnosed with pre-diabetes, then staying physically active, maintaining a low-stress lifestyle and following a well-balanced diet will help her prevent or delay the diagnosis of type 2 diabetes, according to the Diabetes Prevention Program. If she is diagnosed with diabetes, she’ll have a much better chance of preventing complications related to uncontrolled diabetes if she continues to follow her healthy habits.

What could cause diabetes in such a young, otherwise healthy adult?

Let’s first consider type 2 diabetes, which accounts for 90 to 95 percent of all cases of diabetes in the United States according to the National Diabetes Fact Sheet.

Some of the most common risk factors for type 2 diabetes don’t appear to apply to the woman you’ve described. These include the following:

  • Obesity, particularly around the waistline (associated with 90 percent of people who have type 2 diabetes, according to the World Health Organization)
  • Certain non-Caucasian ethnic backgrounds (African-Americans, Native Americans, Hispanic/Latino Americans, Asian Americans and Pacific Islanders are at particularly high risk)
  • High cholesterol
  • High blood pressure
  • Unhealthy lifestyle choices

However, other factors, such as these, could influence her risk:

  • A family history of type 2 diabetes (this is a very strong risk factor for developing type 2 diabetes)
  • A history of gestational diabetes (women who develop this pregnancy-related form of diabetes have a 20 to 50 percent chance of developing diabetes in the next five to 10 years)
  • Having a baby that weighed more than 9 pounds at birth
  • Heart or blood vessel disease
  • Polycystic ovary syndrome

Age is considered a risk factor, as well, since the incidence of type 2 diabetes increases with age. However, if a thin 32-year-old has few or no other risk factors, then I might consider the possibility of a different type of diabetes.

Type 1.5 diabetes — the adult form of type 1 diabetes

Type 1 diabetes, an autoimmune disease, is most often diagnosed in children, teens and young adults. However, there is a form of type 1 called type 1.5 diabetes that is diagnosed in adults over 25. This adult form is sometimes called “slow-onset type 1” or “latent autoimmune diabetes in adulthood” (LADA).

In LADA, the immune system attacks the beta cells in the pancreas, which are responsible for making insulin (a hormone that helps the body’s cells use sugar for energy). People with LADA usually produce their own insulin for several years until all the insulin-producing cells in the pancreas have been destroyed by the autoimmune response. This causes an insulin insufficiency (type 2, on the other hand, causes insulin resistance). People with LADA may have little or no insulin resistance, and often are relatively thin.

A test that measures the level of certain antibodies (ICA and GAD) that attack the beta cells in the pancreas can help determine whether a person has type 1.5 versus type 2 diabetes.

Anyone can get diabetes — so be aware of the signs

As you can see now, even someone who is thin and active and who has minimal risk factors still can develop the disease. That’s why it’s important for everyone to be able to recognize the warning signs of diabetes. Recognizing the signs can lead to a prompt medical evaluation. And an accurate diagnosis can ensure that you receive the right care to prevent serious complications.

Warning signs to look out for, regardless of the type of diabetes, include the following:

  • Increased thirst, dry mouth
  • Frequent urination
  • Blurred vision
  • Increased hunger
  • Slow-healing wounds
  • Dry skin
  • Nausea and vomiting
  • Unexplained weight loss
  • Shortness of breath
  • Breath that smells fruity

To evaluate your own risk for diabetes, take this quick test.

For more information:

January 2007