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.

Waist size

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 resistance and belly fat

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.

Other risk factors

According to the American Diabetes Association, one in three American adults has prediabetes. In addition to lifestyle, the following increases our risk for insulin resistance/prediabetes 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 prediabetes, we need to exercise and maintain a healthy weight.
  • Ethnicity. Prediabetes and type 2 diabetes are more common among African Americans, Hispanics/Latinos, American Indians, Asian Americans and Pacific Islanders.

Learn more about your risk and take a one-minute test at