Archive · 24 Aug 2026
Study Finds Type 2 Diabetes Differs in Lean, Overweight Patients
Type 2 diabetes can happen for different reasons in different people.
In people who are overweight, the body may not respond properly to insulin.
In lean people, the pancreas may not make enough insulin.
Researchers studied more than 3,300 African adults with diabetes.
They found that lean patients more often had eye damage and strokes.
Overweight patients more often had high blood pressure and heart-related problems.
Kidney disease appeared about equally often in both groups.
The researchers said that using the same treatment for everyone may not work well and that more studies are needed.
Researchers found that type 2 diabetes may have different biological drivers in lean and overweight patients.
In people with higher BMI, the disease was linked mainly to insulin resistance.
In lean patients, researchers found evidence that the pancreas produces too little insulin.
Lean patients more often experienced retinopathy and strokes, while overweight patients more often had high blood pressure and cardiovascular disease.
The study analyzed more than 3,300 African adults and called for clinical trials and treatments suited to lean patients.
- Who
- Researchers from Amsterdam University Medical Center and the University of Ghana studied African adults with type 2 diabetes.
- What
- The study found different disease mechanisms and complication patterns in lean and overweight patients.
- When
- The research was recently reported and published in Diabetologia; the publication date was not specified.
- Where
- The study focused on more than 3,300 African adults, with research involving Amsterdam University Medical Center and the University of Ghana.
- Why
- Researchers want to determine whether lean patients need treatments designed for insufficient insulin production rather than insulin resistance.
Current Treatment Approach
Researchers’ Tailored-Treatment View
Use of Existing Guidelines
Current Treatment Approach
International guidelines currently provide the basis for treatment, including for many lean patients with type 2 diabetes.
Researchers’ Tailored-Treatment View
Researchers argue that these guidelines may not match the underlying insulin shortage in lean patients.
Need for Different Therapies
Current Treatment Approach
The article reports that treatment and medication are currently the same despite different disease mechanisms.
Researchers’ Tailored-Treatment View
Researchers call for clinical trials and treatments better suited to patients whose pancreases do not produce enough insulin.
Evidence About Harm
Current Treatment Approach
The consequences of treating lean patients for insulin resistance have not yet been investigated.
Researchers’ Tailored-Treatment View
Researchers point to poorer blood-sugar control among some African patients and say the treatment mismatch requires further study.
- Publication
- The study was published in Diabetologia.
- Researchers
- The research involved Amsterdam University Medical Center and the University of Ghana.
- Study size
- Data from more than 3,300 African adults with type 2 diabetes were analyzed.
- Higher-BMI mechanism
- Insulin resistance was identified as the main driver in people with higher BMI.
- Lower-BMI mechanism
- Lower-BMI patients were described as having insufficient insulin production from the pancreas.
- Complication pattern
- Lean patients more often had retinopathy and strokes, while overweight patients more often had high blood pressure and cardiovascular disease.
- Shared complication
- Chronic kidney disease occurred equally often in both groups.
- Treatment concern
- Researchers said current international guidelines may treat some lean patients as though they primarily had insulin resistance.