Even in the 21st century, a tape measure may be quite telling. The past few years have seen the emergence of useful and powerful electronic devices equipped with sophisticated sensors that check our heart rate, blood pressure, steps, etc. These tools help us keep our health in check. The tape measure is not as widely used but it can reveal a lot. Research shows that waistline measurement is a good indicator of diabetes risk and is generally more accurate than body mass index (BMI) readings. This is because belly fat deposited around the waist invades the spaces between our organs, causing insulin resistance. Insulin resistance causes pre-diabetes and diabetes. According to the National Institutes of Health, a waist size greater than 35 inches for women or greater than 40 inches for men increases your risk for diabetes. To correctly measure your waist, stand and place a tape measure around your middle, just above your hipbones. The tape measure will usually pass within an inch or so of your belly button. Measure your waist just after you breathe out. Insulin, a hormone made by the pancreas, moves glucose or sugar generated from the food we eat out of the bloodstream and into the body’s cells, where it is either burned for immediate energy or stored for later use. Insulin resistance occurs because of problems with the cells preventing sugar from entering. This causes the pancreas to produce more and more insulin to solve the problem. Our blood sugar may gradually stay higher than normal. Scientists believe that belly fat increases insulin resistance because of its proximity to the portal vein, which carries blood from the intestinal area to the liver. Substances released by belly fat (visceral fat), including free fatty acids, enter the portal vein and are transported to the liver. Studies show that waistline measurements are directly linked with higher levels of total cholesterol and LDL (bad) cholesterol, lower levels of HDL (good) cholesterol, and insulin resistance/diabetes risk. Studies also demonstrate that healthy fat tissue acts as an active “organ,” releasing a variety of bioactive proteins into our blood circulation. One of these important proteins is adiponectin. Adiponectin increases fat breakdown to release energy, which lowers the number of free fatty acids in the blood and improves our cells’ response to insulin. However, excessive storage of fat, especially around the organs, reduces the amounts of adiponectin produced, increasing our risk for insulin resistance and other health problems. According to the American Diabetes Association, 1 in 3 American adults has pre-diabetes. In addition to lifestyle, the following increases our risk for insulin resistance/pre-diabetes and diabetes. Age: While we can’t stop the aging process, steps can be taken to reduce risk by staying active, eating a healthy diet, maintaining a healthy weight and keeping blood pressure under control. Family History: If a parent, sister or brother has been diagnosed with type 2 diabetes, there is higher risk for family members. To prevent or delay pre-diabetes, we need to exercise and maintain a healthy weight. Ethnicity: Pre-diabetes and type 2 diabetes are more common among African Americans, Hispanics/Latinos, American Indians, Asian Americans and Pacific Islanders. Alert Day: The American Diabetes Association wants people to find out if they are at risk for diabetes. An annual date has been set so people will set aside time in their schedule to find out. On the fourth Tuesday in March, take the Diabetes Risk Test to see if you are at risk for type 2 diabetes. You can take the risk test online or download a paper version of the test from the American Diabetes Association website. Type 2 diabetes occurs when the body doesn’t make enough insulin or the body becomes unable to utilize the insulin it makes. Insulin is important because it is essentially the key that unlocks cells to allow the glucose or sugar to go inside. If the glucose cannot get inside the cell, it builds up in the blood and can cause damage. Anyone who is over the age of 45, under active and overweight should consider themselves at risk for diabetes. You may also be at risk if you have high triglycerides, high cholesterol, you have an immediate family member with diabetes, you had gestational diabetes or you delivered a baby that weighed more than nine pounds. Some symptoms of diabetes include frequent urination, blurred vision, excessive thirst, fatigue or an increased appetite. But do not wait until you have one of these symptoms to see a doctor. It is estimated that there are almost six million people in the United States who have diabetes and don’t know it. That is because people with type 2 diabetes often don’t experience any of these symptoms. Unfortunately, diabetes is often not diagnosed until a person develops one of the serious complications from it which includes heart disease, stroke, kidney disease, eye damage or nerve damage. The good news about type 2 diabetes is that it is very controllable. Once you are diagnosed you can learn about what you need to do to make sure blood sugar levels stay within an acceptable range. You can do that through medications, proper nutrition and exercise. An early diagnosis of type 2 diabetes can make a big difference in your health. Take the risk test to see if it’s time to follow up with your doctor. Published in Daily Times, June 14th 2018.