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Obesity Research
Obesity Research
iConcept Press

Chapter 6

Obesity Research

Lean Type 2 Diabetes Mellitus

by Reetu Keisam, Manash Pratim Baruah and Ranabir Salam

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Type 2 diabetes mellitus is the most prevalent form of diabetes seen worldwide. Obesity has always been thought to be a risk factor for diabetes and maximum numbers of diabetics are obese; however, various studies in India have reported a prevalence of low body weight/lean (Body mass index, BMI<19 kg/m2) type 2 diabetes mellitus ranging from 1.6% to 26%. In US a subset of diabetes patients among minority population such as African Americans and Latinos are lean with BMI < 25 kg/m2. The clinical and biochemical profile of these patients are different from classic type 2 diabetes mellitus. An increased prevalence of retinopathy, nephropathy and neuropathy is seen in them compared to non-lean type 2 diabetics. Although a large percentage of the lean T2DM patients require insulin for glycemic control, around 50% of them may still respond to oral hypoglycemic agents even after a mean duration of diabetes of 10 years. The mean age of lean T2DM patients (45±10 years) is about two decades higher than that of the Type 1 diabetes patients. These patients are neither related clinically or patho-physiologically to latent autoimmune diabetes of adults (LADA). Studies of GAD (glutamic acid decarboxylase) antibodies, islet cell antibodies (ICA) and fasting and stimulated C-peptide estimations showed that they were distinct from type 1 diabetic patients. Homeostatic model assessments suggest that they are typical cases of type 2 diabetes and the low body weight does not reflect poor beta cell function or loss of body weight due to long-standing uncontrolled diabetes.

Author Details

Reetu Keisam
Department of Physiology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, India
Manash Pratim Baruah
Division of Endocrinology, Excel Centre, Guwahati, India
Ranabir Salam
Department of Medicine, Regional Institute of medical Sciences, Imphal, India


Reetu Keisam, Manash Pratim Baruah and Ranabir Salam. Lean Type 2 Diabetes Mellitus. In Obesity Research. ISBN:978-1-922227-67-6. iConcept Press. 2016.