摘要
Much has been published on the characteristics of type 2 diabetes mellitus and its association with the epidemic of obesity.But relatively little is known about the incidence of lean diabetes,progression of disease and fate of the patients with low-normal body mass index(< 25).Studies in developing countries have shown that the clinical characteristics of these patients include history of childhood malnutrition,poor socioeconomic status,relatively early age of onset and absence of ketosis on withdrawal of insulin.In the United States,recent studies showed that the lean,normal weight diabetes is not rare especially among minority populations.They showed that these patients are mainly males,have higher prevalence of insulin use indicating rapid beta cell failure.They might have increased total,cardiovascular and non cardiovascular mortality when compared to obese diabetic patients.In this review,the epidemiologic and clinical features of lean diabetes are presented.The potential causal mechanisms of this emerging diabetes type that may include genetic,autoimmune,acquired and behavioral factors are discussed.The need for studies to further elucidate the causation as well as specific prevention and treatment of lean diabetes is emphasized.
Much has been published on the characteristics oftype 2 diabetes mellitus and its association with theepidemic of obesity. But relatively little is knownabout the incidence of lean diabetes, progression ofdisease and fate of the patients with low-normal bodymass index （〈 25）. Studies in developing countrieshave shown that the clinical characteristics of thesepatients include history of childhood malnutrition, poorsocioeconomic status, relatively early age of onsetand absence of ketosis on withdrawal of insulin. In theUnited States, recent studies showed that the lean,normal weight diabetes is not rare especially amongminority populations. They showed that these patientsare mainly males, have higher prevalence of insulinuse indicating rapid beta cell failure. They might haveincreased total, cardiovascular and non cardiovascularmortality when compared to obese diabetic patients.In this review, the epidemiologic and clinical featuresof lean diabetes are presented. The potential causalmechanisms of this emerging diabetes type that mayinclude genetic, autoimmune, acquired and behavioralfactors are discussed. The need for studies to furtherelucidate the causation as well as specific preventionand treatment of lean diabetes is emphasized.
