INS and obesity due to melanocortin 4 receptor deficiency: Within this limitation, Asian children with T2D tended to have a lower prevalence of obesity than the other racial groups; there is evidence that these children develop T2D at lower BMI levels than other groups.18 There are subgroups of children in Japan with a nonobese, nonautoimmune phenotype with T2D and reduced insulin secretion with insulin resistance, and female patients with a history of low birth weight are at particular risk.109 Having a higher total and visceral adiposity than other groups are postulated mechanisms driving T2D in this population.19