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.


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.


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.


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

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