Diabetes in adolescents without obesity in India: An underrecognized phenotype

Adolescent type 2 diabetes mellitus (T2DM) is on the rise in India and is commonly attributed to co-existence of overweight and obesity in adolescents. In this line, a study by Maheshwari et al titled ‘Prevalence of obesity, determinants, and its association with hyperglycaemia among community dwelling older adolescents in India’ concluded that overweight, obesity, socioeconomic factors and higher education status were responsible for hyperglycemia in adolescents aged 15-19 years in India. We highlight that there is a significant prevalence of T2DM even in normal body mass index (BMI) and below normal BMI subjects, as mentioned in their study. There is a high prevalence of normal weight obesity in Indian adolescents which often gets missed due to a large population with normal BMI in the country. In this letter, we analyze the importance of measurement of central adiposity beyond routine BMI measurements.