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Diabetes Res Clin Pract. 2018 Sep 20;146:34-40. doi: 10.1016/j.diabres.2018.09.011. [Epub ahead of print]

Ethnic differences in the prevalence of diabetes in underweight and normal weight individuals: The CARRS and NHANES studies.

Author information

1
Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, Room 7040 N Emory University, Atlanta, GA, USA. Electronic address: ugujral@emory.edu.
2
Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialties Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, IDF Centre of Education, Chennai, India. Electronic address: drmohans@diabetes.ind.in.
3
Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialties Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, IDF Centre of Education, Chennai, India.
4
Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialties Centre, WHO Collaborating Centre for Non-communicable Diseases, Prevention & Control, IDF Centre of Education, Chennai, India. Electronic address: dranjana@drmohans.com.
5
Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road NE, Room 7040 N Emory University, Atlanta, GA, USA; Nutrition and Health Sciences Program, Emory University, 1518 Clifton Road, Room 7000, Atlanta, GA, USA; Department of Medicine, School of Medicine, 201 Dowman Drive Emory University, Atlanta, GA, USA. Electronic address: knaraya@emory.edu.

Abstract

AIMS:

Type 2 diabetes in lean individuals has recently come to attention. We assessed type 2 diabetes prevalence and the associated risk factors in underweight and normal weight individuals in two ethnic populations.

METHODS:

We conducted cross-sectional analyses, using representative samples of 4930 Asian Indians from the CARRS-Chennai Study and 2868 Whites from the NHANES Survey. Diabetes was defined as use of glucose lowering medication, fasting glucose ≥126 mg/dl, or 2 h glucose ≥200 mg/dl. Body mass index (BMI) was classified using WHO standard criteria.

RESULTS:

Prevalence of type 2 diabetes by BMI varied by ethnicity and sex. In men, type 2 diabetes prevalence was 5.4% and 23.5% in underweight and normal weight Asian Indians and 0.0% and 6.1% in underweight and normal weight Whites. In women, the prevalence was 5.6% and 13.6% in underweight and normal weight Asian Indians and 2.3% and 2.8% in underweight and normal weight Whites. Adjustment for waist circumference, insulin resistance, and insulin secretion did not explain the increased prevalence in Asian Indians.

CONCLUSIONS:

These findings suggest significant ethnic differences in type 2 diabetes prevalence without overweight or obesity. Future studies should examine the pathophysiology of type 2 diabetes development in lean individuals.

KEYWORDS:

Asian Indian; Body mass index; Ethnicity; Normal weight; Type 2 diabetes; Underweight

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