CLINICAL PROFILE OF LEAN NIDDM IN SOUTH-INDIA

The majority (> 80%) of patients with non insulin dependent diabetes m ellitus (NIDDM) present in Europe and America are obese. In developing countries like India, most NIDDM (> 60%) are non-obese and many are a ctually lean with a body mass index (BMI) of < 18.5 and are referred t o as 'lean NIDDM'. This paper compares the clinical profile of a cohor t of 347 lean NIDDM, with a group of 6274 NIDDM of ideal body weight ( IBW) and 3252 obese NIDDM attending a diabetes centre at Madras in Sou th India. The lean NIDDM who constituted 3.5% of all NIDDM patients se en at our centre, had more severe diabetes and an increased prevalence of retinopathy (both background and proliferative), nephropathy and n europathy. Although a larger percentage of the lean NIDDM patients wer e treated with insulin, 47% of the males and 53% of the females were s till on oral hypoglycaemic agents even after a mean duration of diabet es of 9.2 +/- 8.1 years. Studies of GAD antibodies, islet cell antibod ies (ICA) and fasting and stimulated C-peptide estimations done in a s mall subgroup of the lean NIDDM showed that they were distinct from ID DM patients. More studies are needed on metabolic, hormonal and immuno logical profile of lean NIDDM seen in developing countries like India. (C) 1997 Elsevier Science Ireland Ltd.