MON-618 Lean Non-Autoimmune Diabetes Dyslipidemia

Abstract Disclosure: V.R. Bacot-Davis: None. P. Wadivkar: None. M. Hawkins: None. Lean, non-autoimmune diabetes in individuals with low BMI (<19 kg/m2) was previously classified as “malnutrition-related diabetes mellitus” by the World Health Organization (WHO) in 1985 and then withdraw in 1999 due to lack of pathophysiological characterization of this state as a distinct form on diabetes. Additional studies in the interim, such as by Lontchi-Yimagou et al. and Kibirige et al., have found that this adult-onset non-autoimmune diabetes in low BMI individuals was associated with reduced pancreatic secretory function rather than insulin resistance, which has strong connotations regarding medical management. While there is no official "type 3" or "type 4" diabetes, "type 3" diabetes is a term used to accentuate insulin resistant diabetes associated with cognitive decline, while "type 4" diabetes highlights age-related insulin resistant in the setting of a normal BMI. Lean, non-autoimmune diabetes has been found to have decreased insulin secretion (28.6 pmol/L) after a mixed meal test compared to the lean group without diabetes (82.9 pmol/L). Individuals with type 2 diabetes have an insulin secretion rate of 38.8 pmol/L while people with type 1 diabetes have barely detectable insulin secretion (3.6 pmol/L). The minimum level of insulin required to inhibit lipolysis has been calculated as 44pmol/L as the concentration needed to achieve half-maximal suppression of lipolysis in muscle. These results further support that reduced insulin secretion as well as dyslipidemia with a different mechanism than is seen in type 1 and type 2 diabetes, act in the pathophysiology of lean, non-autoimmune diabetes. Further studies will need to be done to further characterize this unique form of diabetes from a biochemical and physiological perspective. Presentation: Monday, July 14, 2025