Type 2 diabetes mellitus in lean Egyptian patients

Abstract

Background The prevalence of diabetes has increased exponentially over the past decade. Much has been published on its characteristics and its association with the obesity, but relatively little is known about the incidence of lean type 2 diabetes and its pathophysiology. Aim The aim was to determine the role of insulin resistance and β-cell dysfunction in disease pathophysiology in lean type 2 diabetic patients. Patients and methods The authors evaluated parameters including BMI, fasting blood glucose, fasting insulin, homeostatic model assessment for insulin resistance, and homeostatic model assessment for β-cell function percentage. This study was carried out on 300 adult patients who were classified into four groups: group I (lean type 2 diabetic patients with BMI ≤27 kg/m2), group II (obese type 2 diabetic patients with BMI >27), group III (lean controls), and group IV (obese controls). Results When comparing group I with group II, there was a statistically significant difference regarding the sex, where males (64%) were more in group I. Regarding homeostatic model assessment for insulin resistance, in group I, it was 2.00±0.79, whereas in group II, it was 4.97±1.22, with statistically significant difference (P=0.00), and regarding homeostatic model assessment for β-cell function percentage, in group I, it was 33.76±19.89, whereas in group II, it was 56.45±17.69, with statistically significant difference (P=0.00). Conclusion This study showed that lean type 2 diabetes was common in male sex and characterized by low level of insulin resistance and was associated with markedly reduced β-cell function in contrary to what occurred in obese type 2 diabetes with marked insulin resistance.