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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2015; 6(4): 613-620
Published online May 15, 2015. doi: 10.4239/wjd.v6.i4.613
Published online May 15, 2015. doi: 10.4239/wjd.v6.i4.613
Lean diabetes mellitus: An emerging entity in the era of obesity
Amrutha Mary George, Amith George Jacob, Leon Fogelfeld, Division of Endocrinology, John H Stroger Hospital of Cook County, Chicago, IL 60612, United States
Author contributions: George AM, Jacob AG and Fogelfeld L contributed to this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Leon Fogelfeld, MD, Head Division of Endocrinology, John H Stroger Hospital of Cook County, Professor of Medicine, Rush University Medical Center, Division of Endocrinology, John H Stroger Hospital of Cook County, 1901 W Harrison Street, W.Polk (room 811), Chicago, IL 60612, United States. lfogelfe@cchil.org
Telephone: +1-312-8640539 Fax: +1-312-8649734
Received: August 29, 2014
Peer-review started: August 29, 2014
First decision: October 14, 2014
Revised: November 18, 2014
Accepted: February 4, 2015
Article in press: February 9, 2015
Published online: May 15, 2015
Peer-review started: August 29, 2014
First decision: October 14, 2014
Revised: November 18, 2014
Accepted: February 4, 2015
Article in press: February 9, 2015
Published online: May 15, 2015
Core Tip
Core tip: Little is known about lean diabetes (patients with low-normal body mass index). Studies in developing countries have shown that these patients have history of childhood malnutrition, poor socioeconomic status and early age of onset with absence of ketosis. In the United States, recent studies showed that the lean, normal weight diabetes is not rare especially among minorities. These patients are mainly males and 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. The potential causal mechanisms of this diabetes type may include genetic, acquired and behavioral factors.