title: Lean versus obese diabetes mellitus patients in the United States minority population.
abstract: OBJECTIVE
  To identify special characteristics in large group of lean diabetes minority patients in comparison to obese type 2 diabetes.
  
  
  METHODS
  1784 Lean (BMI <25) diabetes patients were identified and compared with 8630 obese (BMI ≥30) patients. Patients with Type 1 Diabetes (N=523) were excluded. Patient data, including demographics, psychosocial factors, insulin use, and complications was analyzed.
  
  
  RESULTS
  In lean compared to obese, there was male predominance (62% vs 48%, p<0.001), higher prevalence of insulin use (49% vs 44%, p=0.001), lower TG/HDL (2.28 vs 3.4, p<0.001), and higher prevalence of alcoholism (5.7% vs 2.4%, p<0.001) and pancreatitis (3.6% vs 0.9%, p<0.001). In both groups, African Americans and Latinos were the prevalent ethnicities (38%, 34% vs. 53%,31%). When comparing patients within the lean group who were on insulin (49%) to those on oral medications, there were more males (65% vs. 59%, p<0.001), earlier age of onset (40±14 vs. 47±12, p<0.001), lower BMI (22.1±2 vs. 22.6±1.7, p<0.001) and lower TG/HDL (2.18 vs. 2.42, p=0.021).
  
  
  CONCLUSIONS
  A subset of diabetes patients in the United States minority population are lean and may have rapid beta cell failure. The etiology is not clear and acquired factors, genetics, and autoimmunity may be contributory.
authors.affiliation: Division of Endocrinology, John H. Stroger, Jr Hospital of Cook County and Rush University Medical Center.
authors.forename: Nathaniel J
authors.initials: NJ
authors.lastname: Coleman
authors.affiliation: Division of Endocrinology, John H. Stroger, Jr Hospital of Cook County and Rush University Medical Center.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Miernik
authors.affiliation: Section of Endocrinology, University of Chicago.
authors.forename: Louis
authors.initials: L
authors.lastname: Philipson
authors.affiliation: Division of Endocrinology, John H. Stroger, Jr Hospital of Cook County and Rush University Medical Center. Electronic address: lfogelfe@cchil.org.
authors.forename: Leon
authors.initials: L
authors.lastname: Fogelfeld
mesh_terms: D001741:Black or African American; D017668:Age of Onset; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D015992:Body Mass Index; D002641:Chicago / Q000453:epidemiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D054525:Minority Health / Q000208:ethnology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D010195:Pancreatitis / Q000150:complications* / Q000208:ethnology / Q000209:etiology; D015995:Prevalence; D012737:Sex Factors; D014504:Urban Health / Q000208:ethnology
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Diabetes in minorities; Lean diabetes; Pancreatitis