PMID- 28827839
OWN - NLM
STAT- MEDLINE
DCOM- 20171013
LR  - 20231112
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 8
DP  - 2017
TI  - Lean diabetes in middle-aged adults: A joint analysis of the German DIVE and DPV 
      registries.
PG  - e0183235
LID - 10.1371/journal.pone.0183235 [doi]
LID - e0183235
AB  - AIMS: To assess differences in demographics, treatment and outcome of lean (LD) 
      compared to overweight and obese people with diabetes clinically classified as 
      type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: We combined data from the 
      German DIVE (Diabetes Versorgungs-Evaluation) and DPV 
      (Diabetes-Patienten-Verlaufsdokumentation) databases to produce a large cohort of 
      people with T2DM. The characteristics of people with Body Mass Index (BMI) <25 
      kg/m2, >/=25-30 kg/m2 and >/=30 kg/m2 aged 30 to 50 years were compared, including 
      demographics, cardiovascular (CV) risk factors, comorbidities and outcomes. 
      RESULTS: A total of 37,870 people were included in the analysis, 3,191 of these 
      (8.4%) had a BMI < 25 kg/m2. LD reported more nicotine (41.6% of 2,070 vs. 38.1% 
      of 6,070 and 33.4% of 16,823; P<0.001)and alcohol consumption (12.0% of 1,282, 
      10.3% of 3,594 and 6.6% of 9,418; P<0.001)compared to overweight and obese 
      people. More LD were treated with insulin in comparison to the other subgroups 
      (short acting insulin 33.1% of 3,191 vs. 28.4% of 9,234 and 28.0% of 25,445; P 
      <0.001; long acting insulin 31.3% of 3,191 vs. 28.9% of 9,234 and 29.3% of 
      25,445; P = 0.043). Regression models adjusted for age, gender and diabetes 
      duration showed a 2.50 times higher odds ratio (OR) for hypoglycemia and a 2.52 
      higher OR for mortality in LD compared to the BMI subgroup >/=30 kg/m2. 
      CONCLUSIONS: LD is associated with an increased risk of hypoglycaemia and death. 
      Patients are characterized by male gender, lifestyle habits as smoking and 
      alcohol consumption while cardiovascular comorbidities are less important. In 
      comparison to patients of the other weight groups they are treated with insulin 
      more often and considerably less with metformin.
FAU - Hartmann, Bettina
AU  - Hartmann B
AUID- ORCID: 0000-0001-7910-7668
AD  - Department of Gastroenterology and Diabetology, Klinikum Ludwigshafen, 
      Ludwigshafen, Germany.
FAU - Lanzinger, Stefanie
AU  - Lanzinger S
AD  - Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, 
      Germany.
AD  - German Center for Diabetes Research (DZD), Neuherberg, Germany.
FAU - Bramlage, Peter
AU  - Bramlage P
AD  - Institute for Pharmacology and Preventive Medicine, Mahlow, Germany.
FAU - Gross, Felix
AU  - Gross F
AD  - Praxis Dr. Gross, Murnau, Germany.
FAU - Danne, Thomas
AU  - Danne T
AD  - Diabeteszentrum fur Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, 
      Hannover, Germany.
FAU - Wagner, Siegfried
AU  - Wagner S
AD  - Department of Internal Medicine II, DONAUISAR Klinikum, Deggendorf, Germany.
FAU - Krakow, Dietmar
AU  - Krakow D
AD  - Diabeteszentrum Forchheim, Forchheim, Germany.
FAU - Zimmermann, Artur
AU  - Zimmermann A
AD  - Praxis Dr. Zimmermann- Diabeteszentrum Bad Aibling, Bad Aibling, Germany.
FAU - Malcharzik, Christian
AU  - Malcharzik C
AD  - Diabetes Kropcke, Hannover, Germany.
FAU - Holl, Reinhard W
AU  - Holl RW
AD  - Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, 
      Germany.
AD  - German Center for Diabetes Research (DZD), Neuherberg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20170821
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Adult
MH  - Body Weight
MH  - Diabetes Mellitus, Type 2/drug therapy/epidemiology/*physiopathology
MH  - Female
MH  - Germany
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - *Registries
PMC - PMC5565180
COIS- Competing Interests: The DIVE registry was supported by Sanofi Aventis 
      Deutschland GmbH, www.sanofi.de. There are no patents, products in development or 
      marketed products to declare. PB and TD report to have received consultancy 
      honoraria from Sanofi Aventis. This does not alter the authors' adherence to all 
      the PLOS ONE policies on sharing data and materials. It does not interfere with 
      the full and objective presentation and publication of our study. The other 
      authors have declared that no competing interests exist.
EDAT- 2017/08/23 06:00
MHDA- 2017/10/14 06:00
PMCR- 2017/08/21
CRDT- 2017/08/23 06:00
PHST- 2017/06/04 00:00 [received]
PHST- 2017/08/01 00:00 [accepted]
PHST- 2017/08/23 06:00 [entrez]
PHST- 2017/08/23 06:00 [pubmed]
PHST- 2017/10/14 06:00 [medline]
PHST- 2017/08/21 00:00 [pmc-release]
AID - PONE-D-17-21362 [pii]
AID - 10.1371/journal.pone.0183235 [doi]
PST - epublish
SO  - PLoS One. 2017 Aug 21;12(8):e0183235. doi: 10.1371/journal.pone.0183235. 
      eCollection 2017.