Diabetologie und Stoffwechsel 2017; 12(S 01): S1-S84
DOI: 10.1055/s-0037-1601721
Poster: *Poster + Kurzpräsentation
Versorgungsforschung
Georg Thieme Verlag KG Stuttgart · New York

Lean diabetes: A joint analysis of the German DIVE and DPV registries

B Hartmann
1   Klinikum Ludwigshafen, Ludwigshafen, Germany
,
F Groß
2   Praxis Dr. Groß, Murnau, Germany
,
P Bramlage
3   Institut für Pharmakologie und Präventive Medizin, Mahlow, Germany
,
S Lanzinger
4   Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm, Ulm, Germany
5   Deutsches Zentrum für Diabetesforschung e.V., München-Neuherberg, Germany
,
T Danne
6   Kinderkrankenhaus 'Auf der Bult', Diabeteszentrum für Kinder und Jugendliche, Hannover, Germany
,
S Wagner
7   DONAUISAR Klinikum, Deggendorf, Germany
,
D Krakow
8   Diabeteszentrum Forchheim, Forchheim, Germany
,
A Zimmermann
9   Praxis Dr. Zimmermann, Diabeteszentrum Bad Aibling, Bad Aibling, Germany
,
C Malcharzik
10   Diabetes Kröpcke, Hannover, Germany
,
R Holl
4   Institut für Epidemiologie und medizinische Biometrie, ZIBMT, Universität Ulm, Ulm, Germany
5   Deutsches Zentrum für Diabetesforschung e.V., München-Neuherberg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
05 May 2017 (online)

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Aims:

To assess differences in characteristics, treatment and outcomes of lean people with diabetes (LD) clinically classified as type 2 diabetes mellitus (T2DM) compared to overweight and obese.

Materials and methods:

Combined data from the German DIVE (Diabetes Versorgungs-Evaluation) and DPV (Diabetes-Patienten-Verlaufsdokumentation) databases were analyzed for characteristics, comorbidities and outcomes of people clinically classified as T2DM with body mass index (BMI) < 25 kg/m2 in comparison to subgroups with BMI ≥25 – 30 kg/m2 and ≥30 kg/m2. People with type 1 diabetes (T1DM), positive autoantibodies and wasting diseases were excluded as far as possible.

Results:

A total of 37,870 people were included in the analysis. Of these, 3,191 (8.4%) had a BMI < 25 kg/m2. LD had less CV risk factors but showed more nicotine (41.6% vs. 38.1% and 33.4%; P < 0.001) and alcohol consumption (12.0%, 10.3% and 6.6%; P < 0.001) compared to the other subgroups. Significant more LD were treated with insulin in comparison to the other subgroups (short acting insulin 33.1% vs. 28.4% and 28.0%; P < 0.001; long acting insulin 31.3% vs. 28.9% and 29.3%; P = 0.043). Adjusted regression models showed a 2.50 times higher risk of hypoglycemia and a higher mortality (odds ratio (CI) 2.52 (1.54; 4.13)) in LD compared to the BMI subgroup ≥30 kg/m2.

Conclusion:

LD differ from overweight and obese people with T2DM. Under real life conditions it remains a challenge to rule out whether LD are a distinct subgroup of T2DM or should be classified as T1DM, LADA, other diabetes types or T2DM with wasting diseases because of similarities in their clinical presentation.