Trends in the Prevalence of Lean Diabetes Among U.S. Adults, 2015-2020

Diabetes Care. 2023 Apr 1;46(4):885-889. doi: 10.2337/dc22-1847.


Objective: To examine trends and prevalence of lean diabetes among adults in the U.S. from 2015 to 2020, overall and stratified by age, sex, and race/ethnicity.

Research design and methods: An exploratory study design evaluated the prevalence and trends of lean diabetes among 2,630,463 (unweighted) adults aged ≥18 years who responded to the Behavioral Risk Factor Surveillance System (BRFSS), years 2015 to 2020.

Results: Diabetes increased significantly among lean adults with BMI of <25 kg/m2 from 4.5% (95% CI 4.3-4.7) in 2015 to 5.3% (95% CI 5.0-5.7) in 2020, representing a 17.8% increase (odds ratio 1.21; 95% CI 1.12-1.31), with no significant change among overweight/obese adults. Increases in diabetes prevalence among lean adults varied by subgroup with Black, Hispanic, and female populations seeing the largest growth.

Conclusions: The prevalence of lean diabetes among the U.S. adult population is increasing, with larger increases among women and populations of color.

MeSH terms

  • Adolescent
  • Adult
  • Black or African American
  • Diabetes Mellitus* / epidemiology
  • Ethnicity
  • Female
  • Hispanic or Latino
  • Humans
  • Obesity / epidemiology
  • Prevalence
  • United States / epidemiology