New research suggests that the risk of type 2 diabetes among obese individuals is determined by where and how your body stores fat and not the total amount of fat you have.
The study by researchers at UT Southwestern Medical Center in Dallas found that obese people with excess visceral fat (abdominal fat that surrounds the body’s internal organs) were more likely to develop type 2 diabetes. However, the risk was not higher for those with excess abdominal subcutaneous fat (fat underneath the skin).
“Among obese individuals, it is not necessarily how much fat a person has, but rather where the fat is located on a person that leads to diabetes,” senior author, Dr James de Lemos, professor of internal medicine at UT Southwester, said.
The observational study, published in the Journal of the American Medical Associatio, is one of the largest of its kind to assess a multi-ethnic population of obese people in the US.
Using extensive imaging techniques, the research team identified 6,000 obese individuals who were at a greater risk of diabetes years before the disease appeared.
After testing the participants for body composition and biomarkers, such as insulin resistance and blood sugar levels, they found that body mass index, HDL (good) cholesterol, and body-fat percentage did not impact type 2 diabetes risk, but the level of visceral or belly fat did.
“Diabetes was linked to fat around the organs, not subcutaneous fat, not total body fat, and not body mass index,” Dr de Lemos said.
“Understanding the biological differences between visceral fat and subcutaneous fat may help doctors to more effectively battle the obesity epidemic occurring in the United States.”
He added: “The risk for diabetes varies widely among different obese individuals, and this study suggests that by predicting who will get diabetes, it may be possible to target intensive lifestyle, medical, and surgical therapies for those at a higher risk.”

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