New diabetes subtype found in African youth

Scientists have identified a new subtype of diabetes in children and young adults, one that lacks the usual markers of type 1 diabetes and that will change how the disease is treated.

This new diabetes subtype was seen in 15.1% of participants with Black ancestry in a study published online July 21 in The Lancet Diabetes and Endocrinology.

The findings emerged from the Young-Onset Diabetes in Sub-Saharan Africa (YODA) study, involving nearly 900 participants under the age of 25 across Cameroon, Uganda, and South Africa.

The research was conducted by scientists from the University of Exeter, the University of Yaoundé I, the Medical Research Council/Uganda Virus Institute/London School of Hygiene & Tropical Medicine Uganda Research Unit (MRC/UVRI & LSHTM) and the University of the Witwatersrand.

To explore whether the subtype exists beyond Africa, the researchers also examined more than 3,000 young people in the US-based SEARCH for Diabetes in Youth study.

While a small number of Black American children exhibited similar characteristics, the subtype was absent in white participants, pointing to possible environmental or ancestral influences.

Dr Jean Claude Katte, Principal Investigator (PI) of the Young-Onset Diabetes in Sub-Saharan Africa (YODA) study, said, “These new research findings confirm our long-standing suspicion. We have always wondered why many young people diagnosed with type 1 diabetes manage to survive without insulin, at least for some time, which would be unusual in typical type 1 diabetes.”

Professor Moffat Nyirenda, Co-PI and Director of the MRC/UVRI and LSHTM Uganda Research Unit, said, “They challenge our assumptions about type 1 diabetes and show that the disease may present differently in African children and adolescents. We urgently need to deepen our investigations into the biological and environmental factors driving this form of diabetes and ensure our diagnostic and treatment approaches are fit for purpose in African settings.”

The team is now expanding its work to investigate the causes of this unique diabetes subtype, which range from infections and nutritional factors to environmental exposures.

They also hope to determine whether some young, slim individuals diagnosed with type 2 diabetes in Africa may have a milder form of this newly discovered subtype.

The findings highlight a critical gap in global diabetes research, which has often focused on white Western populations.

The team is calling for greater investment in region-specific studies, noting that sub-Saharan Africa may be home to distinct forms of diabetes with different causes, trajectories, and treatment needs.

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