Abstract
Abstract Background Lean type 2 diabetes (LT2D) is a prevalent manifestation of type 2 diabetes (T2D). However, it has been an understudied subgroup of T2D. Aim To compare characteristics and outcomes of patients with LT2D with that of typical presenting T2D. Methods A retrospective review of electronic health records was performed between 2013 and 2020. The study included 254 patients with LT2D and 429 patients with typical T2D located in the South Bay of Southern California. LT2D and typical T2D were defined as having a body mass index (BMI) of 18.5 to 24.9 kg/m2 and 25 to 29.9 kg/m2, respectively. Patient-level variables included age, sex, race, ethnicity, educational level, area of deprivation index (ADI), microvascular and macrovascular comorbidities, alcohol use, tobacco use, and diabetes family history. Labs and vital signs obtained included hemoglobin A1c (HbA1c), glomerular filtration rate (GFR), creatinine, albumin, and blood pressure. Student's t-test and Chi-square tests/Fisher's exact tests were performed with SAS version 9.4 to compare differences between the LT2D and typical T2D groups. Results Between the diabetes subgroups, there were several statistically significant differences identified. The LT2D population was older, with a mean age of 78.2 years compared with 74.6 years in the typical T2D (p < 0. 001). The LT2D group had a higher percentage of Asians at 40.6% and fewer Caucasians at 35. 0%, while the typical T2D consisted of 22.4% Asians and 46.4% Caucasians (p=0. 0007). Diastolic blood pressure was lower in the LT2D group at 71.6 compared to 73.9 in the typical T2D group (p=0. 0053). There were no differences in sex, HbA1c, systolic blood pressure, hypertension, dyslipidemia, chronic kidney disease, cardiovascular events, peripheral vascular disease, combined microvascular complications, combined macrovascular complications, substance use, education level, ADI, GFR, creatinine, albumin, or number of relatives with diabetes. Conclusion We identified several key differences between the LT2D and typical T2D cohort, including age, race, and diastolic blood pressure. Further investigation and large studies are warranted to explore the risk factors and long term outcomes of patients presenting with LT2D. Knowing what the key differences are may help identify appropriate diabetes medical treatments and lifestyle interventions for this particular target population rather than using T2D treatments that are used for a more general population of patients. Presentation: No date and time listed
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