An Atypical Form of Diabetes Among Individuals With Low BMI
Methods: State-of-the-artmetabolic studies were used to characterize Indian individuals with ”Low BMI Diabetes”( LD) in whom all known forms of diabetes were excluded by immunogenetic analysis. They were compared with demographically-matched groups: type 1 diabetes (T1D), type 2 diabetes (T2D), and non-diabeticsInsulin secretion was assessed by C-peptide deconvolution. Hepatic and peripheral insulin sensitivity were analyzed using stepped hyperinsulinemic-euglycemic pancreatic clamp studies. Hepatic and myocellular lipid contents were assessed by 1H-nuclear-magnetic-resonance-spectroscopy.
Results: The total insulin secretory response was lower in the LD group when compared to the lean non-diabetic group and the T1D group. Endogenous glucose production (EGP) was significantly lower in the LD group than the T2D group (0.50±0.1 vs. 0.84±0.1 mg/kg.min, p<0.05). Glucose uptake was significantly higher in the LD group when compared to T2D (10.1±0.7 vs. 4.2±0.5 mg/kg.min, p<0.001). Visceral adipose tissue (VAT) and hepatocellular lipids (HCL) were significantly lower in LD than in T2D.
Conclusions: These studies are the first to demonstrate that low BMI individuals with diabetes in LMICs have a unique metabolic profile suggesting that this is a distinct entity that warrants further investigation.