Divergent complication patterns of type 2 diabetes in African individuals who are lean versus overweight or obese: a multi-cohort analysis
Authors' conclusion
Complication patterns in Africans with type 2 diabetes who are lean vs overweight/obese follow divergent paths.
Study context
- Population
- Adults with T2D from Ghana, Nigeria and Kenya in two African cohorts (AADM, n=2790; RODAM, n=541)
- Participants
- 3,331 adults2 cohorts
- Exposure
- Lean vs overweight/obese
- Outcome
- Retinopathy, CKD, stroke, hypertension and 10-year CVD risk
Methodological detailsmulti-cohort, harmonised individual-level data, robust Poisson regression, random-effects pooling, mediation analysis
- Multi-cohort
- Harmonised individual-level data
- Robust Poisson regression
- Random-effects pooling
- Mediation analysis
Main finding
As reported in the abstract
Complication prevalence, lean vs overweight/obese (adjusted for age, sex, education, treatment)
- Lean
- pPR, retinopathy 1.36 (95% CI 1.13–1.63)
- Lean
- pPR, stroke 1.41 (95% CI 1.01–1.99)
- Lean
- pPR, hypertension 0.77 (95% CI 0.71–0.85)
- Lean
- pPR, 10-year CVD risk 0.85 (95% CI 0.74–0.97)
Observational data: associations, not effects.
Further findings
Beta cell function and insulin
- Lean T2D characterised by lower beta cell function and low insulin levels
Mediation by body fat percentage
- Body fat percentage accounted for most differences
- up to 92%
Original publication
Divergent complication patterns of type 2 diabetes in African individuals who are lean versus overweight or obese: a multi-cohort analysis. Diabetologia. Published 23 August 2026. doi:10.
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