Although they are not overweight, they have terrible eating habits. I went to the supermarket with one of them and watched as she loaded her cart with pancake mix, syrup, diet soda and several boxes of processed frozen dinners that were advertised as healthy but contained huge amounts of sodium.

Her concession to the fact that she has diabetes was buying light syrup and some bananas. She did not have a single vegetable other than what was included in her frozen meals. She also leads a sedentary life.

She is constantly complaining about her “bad genes.” When I suggested that her diabetes might be due to her eating and exercise habits, she explained that she is not obese and therefore did not cause herself to become diabetic.

I don’t know what her doctor has told her regarding lifestyle, but in general it does seem to me that type 2 diabetes is looked upon as your fault if you are heavy but beyond your control and the result of “bad genes” if you are thin. I think this is a dangerous mentality and also quite untrue.

DEAR READER: Absolutely. Type 2 is the most common form of diabetes. It is commonly associated with being overweight, but this does not mean that simply being overweight will cause you to develop diabetes. Rather, excess weight is simply a risk factor. Other risk factors include a family history, leading a sedentary life, age, ethnicity and more. Diabetes may be associated with other health conditions, such as high blood pressure and abnormal cholesterol levels.

Type 2 diabetes is caused when cells become resistant to insulin and the pancreas is unable to make enough insulin to overcome the resistance. When this occurs, the cells no longer take in sugar, causing it to build up in the bloodstream. The exact reason why this happens is unknown.

Symptoms can include increased thirst, extreme hunger, slow-healing sores, frequent urination, unexplained weight loss, fatigue, frequent infections and blurred vision.

Complications can arise from untreated or poorly managed diabetes. Short-term complications need to be addressed immediately because, if left untreated, they can lead to seizures and/or coma. Short-term issues include hyperglycemia (high blood sugar), hypoglycemia (low blood sugar) and increased ketones (potentially toxic acids) in the urine.

Long-term complications develop gradually. If the diabetes is left untreated or poorly treated, these can become permanent or life-threatening. Long-term issues include cardiovascular disease, bone and joint problems, skin and mouth conditions, and nerve, eye or kidney damage.

Type 2 diabetes is often preventable if proper steps are taken to manage risk factors. It is important to maintain a healthful diet and exercise routine. Remember to include plenty of fruits, vegetables and whole grains while reducing your intake of animal products and sweets. Simply substituting sugar-free products for normally sugar-laden treats is not helpful. Any excessive intake of simple or complex sugars (carbohydrates) can result in high blood-sugar levels. A registered dietician is an excellent resource in developing a meal plan.

Exercise can lower blood sugar and decrease insulin resistance. For those with diabetes, aerobic exercise is the most beneficial and should be included most days of the week for at least 30 minutes per day.

In those who develop the condition regardless of lifestyle changes, treatment is available. These include medication to stimulate the pancreas to produce more insulin, inhibit the production and release of glucose causing cells to need less insulin to transport sugar, block the action of enzymes that break down carbohydrates, or make tissues more sensitive to insulin and insulin injections.

As you can see, simply being overweight isn’t enough to cause diabetes. While your friends may be thin, they likely have risk factors for developing diabetes and have, thus far, failed to make the necessary changes. They are accountable for their health, and blaming “bad genes” is just an excuse. They must change their lifestyles and not rely only on medication to solve this problem.

People who are overweight can benefit greatly from losing weight, and in some cases, that may be all that is necessary to improve or even reverse type 2 diabetes (or high cholesterol or high blood pressure). Those with normal weights still need to be accountable and make changes.

To provide related information, I am sending you a copy of my Health Report “Living with Diabetes.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.