Why Are People Diabetic-shaped?

[zand]

I used to be pear shaped. Now I'm an apple. It isn't so easy to return to being a pear, my tummy just stays even when I lose weight.

 

[DCUKMod]

My size 6 body, and VF score of 3 usually has 'em fooled.

 

[AloeSvea]

One boffin (can't remember which one) mooted the idea that in the eras of feast/famine those who stored fats around the middle survived the lean times and those who may have stored it around the organs didn't survive. He possited the theory that storing fats around the waistline might in future prove to be the safest place for it.
He was musing at this point and I did wander about those people who seem to store fats in both areas which is why I am interested in finding out exactly which fats are shed first.

Not just a musing - but a bonafide in the field of evolutionary biology theory. (or is it biological evolution? I always get them confused .)

 

[hankjam]

and here I was thinking "going pear shaped" was a bad thing... should it be "apple shaped"?

 

[Guzzler]

It never occurred to me that there is a diabetic shape. Could it be used as a diagnostic tool I wonder.

I hope appearance alone is never used as a dictator of possible diagnosis although I am personally convinced that had I been heavier it would not have taken a random MOT to diagnose me with a HbA1c of 98. I think that had I been diagnosed earlier it may have stood me in better stead.

 

[Robinredbreast]

I used to be pear shaped. Now I'm an apple. It isn't so easy to return to being a pear, my tummy just stays even when I lose weight.

You sound a bit 'fruity' Zand

 

[Robinredbreast]

and here I was thinking "going pear shaped" was a bad thing... should it be "apple shaped"?

Going pear shaped, to me, means going down hill, sliding....................going apple shaped would be just going round and round I suppose lol and doesn't quite sound the same.

 

[Rachox]

My weight loss has gone from my chest, face, arms, legs and upper abdo, my lower abdo still has a tyre although I’m not sure how much is fat and how much is excess skin now? My visceral fat reading on hubby’s posh Tanita scales says 9-10, under12 is normal so something is happening inside aswell as outside. I’m sure my visceral fat must have been sky high at diagnosis. It’s only recently I dared used the Tanitas! So I was an Apple, now a pear

 

[hankjam]

After my weight loss the loose bits round in the lower tum were.... unsightly... and well hidden. Muscle loss from arm and legs made the whole thing look pretty "weedy"... morning exercises, walks and swimming are slowly replacing the definition.
Now a knobbly pole.... nothing you can do about knees....

 

[hankjam]

Going pear shaped, to me, means going down hill, sliding....................going apple shaped would be just going round and round I suppose lol and doesn't quite sound the same.

I should have used the term of a previous decade, which would post date pear shaped.... gone "Pete Tong".

 

[Jenny15]

I saw someone alluding to this on a different post and realised I don’t know the answer. Is it a cause or an effect? Or both. And how do you minimise it?

I have been asked dozens of times since teenagerhood whether I am pregnant. Because I look it, always, exercise or no exercise. I’m a short, stocky (always within BMI guidelines) or recently much less stocky (now, having lost 7 lbs on LCHF unintentionally) UK size 8 so am what might be termed ‘petite’ if I didn’t look heftier than that.

I always assumed I looked like my mum (short Chinese) with the build of my dad (the stocky bit) in a genetic mix that could have had a more impressive outcome. But my mum had type 1. So maybe she was diabetic shaped too and not what I thought was Asian shaped.

The diabetic nurse took one look at me and told me I was diabetic shape. After asking if I was pregnant...

Is it just me who this happens to? (Men, I’m assuming you don’t get this?)

I have been asked if I am pregnant a few times over my life. Now that I'm nearly 50 I hope it stops.

It's an extremely rude question to ask a stranger, an acquaintance or a patient. It's tantamount to saying "I think you look fat and I want to discuss that with you for some reason."

And if a nurse must ask a patient, he or she should phrase it differently. Like "is there a chance you could be pregnant" while not looking at your belly, in the way radiographers ask every woman before taking x-rays.

I started responding to people with "no, why do you ask?" They seemed to clam up at that point.

 

[Jenny15]

It is being used as a diagnostic tool at my surgery, as a sort of early warning sign for those of us who are apple shaped. Its a recent tick box for the DN - waist measurement as a sign of IR. Along with her new found enthusiasm for low-ish (around 130g a day) carbing being recommended by her. Its progress!!!!!

The waist to hips ratio has been around for a while as a screening indicator. I read somewhere that fat above the waist is more of a problem than below the waist. For many years most of my excess weight was the latter, then I started developing it above the waist, and my T2 diagnosis came a few years later.

I have always been pear shaped, it's a bone structure thing in my case and can't be changed. Apparently it means I would be expected to have an easier time giving birth, but I never wanted to test that hypothesis for myself.

 

[first14808]

So question for someone better at interpreting scans than I.. The images on the wiki TOFI page also seem to show a considerably reduced lung volume?

 

[Rachox]

So question for someone better at interpreting scans than I.. The images on the wiki TOFI page also seem to show a considerably reduced lung volume?

I agree, and I think the visceral fat must push up on the lungs. I certainly used to get breathless going up stairs before I lost weight, I don’t now. A similar feeling to when heavily pregnant and your lung capacity is reduced.

 

[Jenny15]

I agree, and I think the visceral fat must push up on the lungs. I certainly used to get breathless going up stairs before I lost weight, I don’t now. A similar feeling to when heavily pregnant and your lung capacity is reduced.

Very true. It's even worse when supine (lying on one's back) trying to sleep. Sleep apnoea can occur in slim people but it mostly occurs in obese people, because of excess fat deposits in the neck and torso. When we inhale, the diaphragm is meant to move freely downwards, that's why the abdomen rises, not (mostly) the chest. Excess abdominal weight makes the muscles work harder, and there comes a point where they can't work hard enough to assist breathing.

Most people experiencing untreated sleep apnoea gravitate towards lying on their front or side in order to breathe better. During my sleep study in a sleep lab, they keep coming in to wake me up so I would roll onto my back so they could get proper readings from the sensors. It was very annoying, lol. I found it easier to get to sleep on my side or front. Now that I use CPAP therapy, I can fall asleep on my back, because the therapy will keep my airway open. Just a little bit of positive airway pressure was enough to lighten the load on my torso muscles to support normal breathing.

 

[Rachox]

During my sleep study in a sleep lab, they keep coming in to wake me up so I would roll onto my back so they could get proper readings from the sensors. It was very annoying

I can’t believe they thought it necessary to keep waking you during a sleep study! For a year or so we had sleep study patients on the ward I worked on, we just connected up all the monitoring equipment, said goodnight and returned in the morning to remove the monitors, the idea being to study how they normally sleep!

 

[first14808]

Interesting. I know pre-diagnosis, one of my concerns was I'd get really out of breath. I had some spirometry tests and was apparently 'excellent', although they were resting rather than exertion tests. And since losing weight, that problem's gone away and I can exercise more. And it makes sense if visceral fat was reducing lung volume. Apnoea was also fun when I was in HDU because I kept setting the alarm off. When I trained, I was taught to use my diaphragm for breathing, which was a novel experience but means I don't breathe 'normally'. Combined with a low resting pulse, my sleep got disrupted by the alarms going off

 

[Jaylee]

I agree, and I think the visceral fat must push up on the lungs. I certainly used to get breathless going up stairs before I lost weight, I don’t now. A similar feeling to when heavily pregnant and your lung capacity is reduced.

OK? This is getting interesting.. My dad was T2. ("was" as in, unfortunately no longer with us.) The guy was slim (like me) & active for his age. He also sang Opera.. I could still knock one out! I sing too. But heavy metal.
Now i'm currently "refreshing" with a diagram of the human body.. & what i (cough,) know about singing. (Though i did start off sounding like a choir boy. Having lessons in my yoof.)

Could visceral fat actually be restricting the diaphragm?

Tagging in @Contralto From memory a bit of a "singist" too?

 

[Jenny15]

Interesting. I know pre-diagnosis, one of my concerns was I'd get really out of breath. I had some spirometry tests and was apparently 'excellent', although they were resting rather than exertion tests. And since losing weight, that problem's gone away and I can exercise more. And it makes sense if visceral fat was reducing lung volume. Apnoea was also fun when I was in HDU because I kept setting the alarm off. When I trained, I was taught to use my diaphragm for breathing, which was a novel experience but means I don't breathe 'normally'. Combined with a low resting pulse, my sleep got disrupted by the alarms going off

Spirometry assesses things like asthma and doesn't help much with assessing other respiratory issues. Training how to breathe is great for daytime, but does nothing to help while asleep. I know you didn't mean literally that apnoea is ever fun, but as OSA is a distressing and potentially life threatening condition you might want to keep that in mind.

 

[Jenny15]

I can’t believe they thought it necessary to keep waking you during a sleep study! For a year or so we had sleep study patients on the ward I worked on, we just connected up all the monitoring equipment, said goodnight and returned in the morning to remove the monitors, the idea being to study how they normally sleep!

It was necessary given the type of sleep study they were doing (there are several types). The gold standard is to have the person video recorded during the whole night, and to have a qualified sleep tech on site in case something goes wrong, such as the person dropping below an SpO2 of 75%, which occasionally happens. Scary level, right? I never went below 82, thankfully. My longest event was 32 seconds... not good.

The kind of testing you administered would be excellent for the early stages of investigations but in some people they would need to repeat it with the kind of study I had.