Department of Physiology, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
Rajiv Gandhi Centre for Diabetes and Endocrinology, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
Rev Diabet Stud. 2021 Nov 1;17(2):68-74. doi: 10.1900/RDS.2021.17.68.
Much evidence is available on the relationship between type 2 diabetes mellitus (T2D) and obesity, but less on T2D in lean individuals. 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. 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. 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. 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.
有大量证据表明 2 型糖尿病（T2D）与肥胖之间存在关联，但关于消瘦个体中的 T2D 的证据较少。本研究在印度北部的 12069 名 T2D 患者中进行，旨在找出与消瘦、正常体重和超重/肥胖 T2D 患者相关的临床和生化特征。该研究在印度北部的两家内分泌诊所进行，采用回顾性横断面研究设计。筛选了 2018 年 1 月至 2019 年 12 月期间在这些诊所就诊的所有患者的记录。在筛选了 13400 名患者后，根据美国糖尿病协会 2020 年的标准，将 12069 名患者标记为 2 型糖尿病，并纳入研究。根据患者的体重指数（BMI）将患者分为三组：消瘦（BMI<18）、正常体重（BMI=18-22.9）、超重/肥胖（BMI≥23）。该研究评估了三组亚组对标准糖尿病管理的反应，包括降糖药物和生活方式干预。在总共 12069 名患者中，327 名（2.7%）为消瘦，1841 名（15.2%）为正常体重，9906 名（82.1%）为超重/肥胖。消瘦患者更年轻，但高血糖发作更严重。所有三组在随访期间血糖控制均显著改善；与基线相比，超重/肥胖组在随访期间的糖化血红蛋白（HbA1c）值显著降低。尽管超重/肥胖患者可以从降低 HbA1c 以改善血糖控制中获益，但消瘦和正常体重患者的高血糖更严重且难以控制。
