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Most people associate type 2 diabetes with obesity gorging on fatty foods and doing little or no exercise.

This was confirmed last week by the news that obese people put on a strict 600 calorie a day diet were able to reverse the condition.

But while there is no denying being significantly overweight is a key risk factor, one in five with the condition is not obese, with many leading healthy lifestyles.

The problem is that the stereotype of the type 2 diabetes sufferer means that as many as one million people may be going undiagnosed simply because they do not believe they are in a high risk group.

Experts warn that invisible internal fat around vital organs could be placing this group at risk.

Type 2 diabetes is one of the greatest health care challenges facing Britain.

The cost to the NHS of treating the 2.5million people diagnosed with the condition is 3.5billion a year.

And this is set to balloon, with the number of those affected predicted to double over the next ten years.

Just this week, a new report revealed more than 350 million people worldwide have the condition.

Many of those will be people such as Lorraine Fearn, who is anything but the typical type 2 sufferer.

She is not obese (at 5ft 4in, she weighs 10st 9lb), she leads an active lifestyle she walks for half an hour four times a week and is a keen gardener and has a healthy diet of fish, vegetables and cereals.

Yet for the past five years, the 64 year old retired factory worker from Yeovil, Somerset, has had to take daily tablets to control her blood sugar levels following her diagnosis with type 2 diabetes.

Her late mother, who weighed just 7st, was diagnosed at the same age as Lorraine and her mothers brother also suffered, despite being over 6ft and very slim.

In fact, it seems a disease associated with being seriously overweight has blighted her family for generations, despite their low risk profile.

My grandmother also had it and Im sure her father did as well, because when I was young he went blind and had a leg amputated, says Lorraine, referring to two of the more serious complications of poorly managed diabetes.

There is a perception that type 2 diabetes is all about obesity. But not all of us are fat.

Ten per cent of diabetes cases are due to type 1, a different condition that has nothing to do with lifestyle and is thought to be brought on by a malfunctioning immune system, usually in childhood.

Type 2 accounts for the remaining 90 per cent.

According to the charity Diabetes UK, at the current rate of increase, the numbers affected in Britain will rise to fourmillion by 2025.

However, experts say a major cause for concern is that people do not realise their symptoms such as increased thirst, frequent urination or fatigue are due to hidden diabetes.

The cost to the NHS of treating the 2.5 million people diagnosed with Type 2 diabetes is 3.5 billion a year

In both types of diabetes, the body loses its ability to make use of glucose, a type of sugar that is released when we eat food, which is then turned into a source of energy for the muscles.

To get into the muscles, glucose needs insulin, a hormone produced by the pancreas. Insulin acts a bit like a key that unlocks the door into muscle cells, so that glucose can be taken on as fuel.

Type 2 diabetes is caused when excess fat interferes with the mechanism of the lock. The pancreas senses the insulin it is producing is not being used effectively and tries to compensate by making even more of the hormone.

This can go undetected for years until the pancreas becomes exhausted and can no longer produce enough, or any, insulin.

As glucose levels rise, circulation starts to suffer and blood vessels can be irreparably damaged. Left untreated, type 2 diabetes can raise the risk of heart attacks, blindness and amputation.

But some experts fear aiming diabetes warnings only at those who are overweight has fooled many into thinking they are not at risk.

When doctors assess a patients risk, they test for impaired glucose tolerance a sign that blood sugar levels are higher than normal and measure their body mass index (BMI).

This is a calculation that takes account of their weight compared to their height. According to Diabetes UK, anyone with a BMI score of 30 (officially obese) is classed as at risk and in need of lifestyle changes, such as a healthy diet and more exercise. An example would be a man who is 5ft 10in and weighs 15st.
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