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Excess blood sugar causes damage to the entire vasculature, so if you have diabetes, you’re more likely to have heart disease or a stroke. High blood sugar also causes dangerous nerve damage by injuring the walls of the capillaries that bring blood and nutrients to your nerves. This is called peripheral artery disease, and it is especially common in the legs and feet, which is why you may have heard of people suffering from diabetes needing foot or leg amputations. When this happens in the eyes, it causes blindness. If that’s not bad enough, diabetes can damage your kidneys’ filtering system, resulting in kidney disease. And finally, the higher your blood sugar, the greater your risk for Alzheimer’s disease, to the point that some researchers call Alzheimer’s “type 3 diabetes.” So you’ve got to keep your blood sugar levels stable, no matter what.

You may think you’re off the hook if you are not overweight, but you can be thin and still be prediabetic (or even fully diabetic). Those problematic macrophages are most likely to trigger inflammation in adipose tissue, aka fat. So the more excess fat you’re carrying, the higher your chance of becoming insulin resistant and developing type 2 diabetes. But the same thing can happen if you are not overweight but have excess visceral fat, which is the type of fat that’s packed around your internal organs instead of underneath the skin. This “skinny fat” is even more dangerous than fat you can see.

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