Clinical Features, Biochemical Profile, and Response to Standard Treatment in Lean, Normal-Weight, and Overweight/Obese Indian Type 2 Diabetes Patients

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The Review of Diabetics Studies,2021,17,2,68-74.
Published:October 2021
Type:Original Article
Author(s) affiliations:

Ahmad Faraz1, Hamid Ashraf2, and Jamal Ahmad3

1Assistant Professor, Department of Physiology, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, India.

2Assistant Professor, Rajiv Gandhi Centre for Diabetes and Endocrinology, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, India.

3Former Professor of Endocrinology & Dean Faculty of Medicine, Ex-Director, Rajiv Gandhi Centre for Diabetes & Endocrinology, Aligarh Muslim University, Aligarh Diabetes & Endocrinology Super-Speciality Centre, Aligarh, India.


BACKGROUND: Much evidence is available on the relationship between type 2 diabetes mellitus (T2D) and obesity, but less on T2D in lean individuals. AIM: This study was conducted in 12,069 T2D patients from northern India to find out which clinical and biochemical features are related to lean, normal weight, and overweight/obese T2D patients. METHODS: The study was conducted at two endocrine clinics in northern India as a retrospective cross-sectional study. The records of all patients who attended these clinics from January 2018 to December 2019 were screened. After screening 13,400 patients, 12,069 were labelled as type 2 diabetes mellitus according to the criteria of the American Diabetes Association, 2020, and were included in the study. The patients were subdivided into the three groups by their body mass index (BMI): lean (BMI < 18), normal weight (BMI = 18-22.9), overweight/obese (BMI ≥ 23). The study evaluated how the three subgroups responded to standard diabetes management, including antidiabetic medication and lifestyle interventions. RESULTS: Of a total of 12,069 patients 327 (2.7%) were lean, 1,841 (15.2%) of normal weight, and 9,906 (82.1%) overweight/obese. Lean patients were younger, but had more severe episodes of hyperglycemia. All three subgroups experienced significant improvements in glycemic control during follow-up; HbA1c values were significantly lowered in the overweight/obese group during follow-up compared with baseline. CONCLUSIONS: While overweight/obese patients could benefit from the improvements in glycemic control achieved by lowering HbA1c, lean and normal-weight patients had more severe and difficult-to-control hyperglycemia.