Systematic review and meta-analysis of the prevalence and clinical profile of lean type 2 diabetes mellitus in Africa

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-08-05 DOI:10.1016/j.diabres.2025.112406

Nankunda Oreb , Katuramu Richard , Bwayo Denis , Ahmed Waheed

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Abstract

Introduction

Lean Type 2 diabetes mellitus (T2DM), defined as individuals with body mass index (BMI) < 25 kg/m², presents distinct clinical and biochemical characteristics across populations, particularly in Africa. This review assessed the prevalence and clinical-biochemical profiles of lean T2DM in Africa, aiming to improve understanding and management strategies.

Methods

This systematic review and meta-analysis involved 11 observational studies on lean T2DM in African adults. Specific BMI definitions [<25 Kg/m²] and clinical parameters were assessed, while non-observational studies were excluded. Data was analysed using STATA 18.

Results

The pooled prevalence of lean T2DM in African populations was 38.5 % (95 % CI: 26.8 %-50.9 %, I2 = 96.71 %, p < 0.001]). Clinical characteristics reveal a mean age of 48.35 years and a pooled mean BMI of 25.45 kg/m². Metabolic assessments indicated raised HbA1c levels with a pooled median 9.34 % [95 %CI: 8.60–10.08 %, I2 = 97.44 %, p < 0.001]). Insulin resistance was low, as indicated by HOMA2-IR levels.

Conclusions

This review revealed a high prevalence of lean T2DM in Africa and identified unique clinical and biochemical characteristics. The findings suggest a potential need for more tailored approaches in assessing this phenotype, which remains underrepresented in current guidelines. Larger, well-designed studies are needed to strengthen the evidence base and inform effective treatment strategies.

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非洲瘦型2型糖尿病患病率和临床概况的系统回顾和荟萃分析

2型糖尿病（T2DM），定义为个体的身体质量指数（BMI） <；25公斤/平方米，在人群中表现出明显的临床和生化特征，特别是在非洲。本综述评估了非洲瘦型2型糖尿病的患病率和临床生化特征，旨在提高认识和管理策略。方法本系统综述和荟萃分析涉及11项非洲成年人瘦型2型糖尿病的观察性研究。评估了特定的BMI定义[25 Kg/m2]和临床参数，排除了非观察性研究。使用STATA 18分析数据。结果非洲人群中瘦型T2DM的总患病率为38.5% (95% CI: 26.8% - 50.9%, I2 = 96.71%, p <；0.001])。临床特征显示平均年龄48.35岁，合并平均BMI为25.45 kg/m2。代谢评估显示HbA1c水平升高，中位值为9.34% [95% CI: 8.60 - 10.08%, I2 = 97.44%, p <；0.001])。胰岛素抵抗低，如HOMA2-IR水平所示。结论：本综述揭示了瘦型2型糖尿病在非洲的高患病率，并确定了独特的临床和生化特征。研究结果表明，在评估这种表型时，可能需要更有针对性的方法，目前的指导方针中仍未充分体现这一点。需要更大规模、设计良好的研究来加强证据基础，并为有效的治疗策略提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.