Background: Diabetes is metabolic disorder that is diagnosed based on the presence of continuous hyperglycemia caused by impaired insulin action or insulin secretion. Obesity is a major risk factor for type 2 diabetes (T2D) and is associated with insulin resistance. Thus, weight loss is the most effective method for glycemic control in obese patient with diabetes. However, the population of Asian countries including Korea have been found to have a significantly higher risk of T2D than Caucasian, despite having a lower body mass index (BMI).
Current status: Approximately half of Korean patients with T2D are non-obese, with an average BMI of 24.7 kg/m2, whereas patients in the USA are mostly obese, with an average BMI of 32.2 kg/m2. According to recent reports, non-obese diabetic patients in Asia show more a rapid failure of β-cell function than obese patients, as well as a lower volume density of β-cell; these are unfavorable to compensatory mechanism following insulin resistance. In fact, the impacts of impaired insulin secretion and insulin sensitivity on the development of T2D could vary depending on the difference in ethnic and clinical characteristics.
Prospective future: In these regards, fully understanding the pathophysiological distinction and characteristics in non-obese diabetes is essential to set up a new diabetes prevention or intervention strategy, which is suitable for Korean population.