Lean diabetes mellitus: An emerging entity in the era of obesity

Figure 1 Pathogenetic model of development of lean type 2 diabetes. In the obese individuals the diabetes develops once the beta cell cannot cope with the insulin resistance conferred by the growing obesity. In the lean diabetes the early failure of the beta cells results in development of diabetes at much lower insulin resistance. It might be speculated that in individual with similar beta cell dysfunction but lower insulin resistance (lower weight) diabetes might not develop. NGT: Normal glucose tolerance; IGT: Impaired glucose tolerance; T2DM: Type 2 diabetes; Modified from Weyer et al. J Clin Invest 1999; 104: 787–794.