New Subtype of Diabetes Discovered in Sub-Saharan Africa and Among Black Americans

Researchers from around the world have identified a novel form of diabetes prevalent among children and young adults in Sub-Saharan Africa. Unlike the typical autoimmune type 1 diabetes (T1D), this variant appears to develop independently of the immune system. This significant discovery could revolutionize the diagnosis, treatment, and management of diabetes in the region, leading to more personalized and effective care.

The study, published in Lancet Diabetes and Endocrinology, involved 894 young participants from Cameroon, Uganda, and South Africa. These individuals were compared to similar groups in the United States. Notably, many diagnosed with T1D in Africa lacked the traditional blood markers known as islet autoantibodies, which are usually present in autoimmune T1D cases. Specifically, 65% of African participants with T1D did not have these autoantibodies, hinting at a different disease mechanism.

Islet autoantibodies are crucial for distinguishing autoimmune T1D from other forms like type 2 diabetes or rare genetic types. The absence of these markers suggests that in this African cohort, T1D may not be autoimmune in origin but could involve alternative pathways.

Further analysis revealed that about 15% of Black Americans with T1D share this non-autoimmune profile—lacking autoantibodies and having a low genetic risk score associated with traditional T1D. In contrast, white Americans with T1D typically exhibit the autoimmune pattern, even if autoantibodies are undetectable, due to genetic predisposition.

This research underscores a potential ancestral or genetic link between the newly identified subtype in Africa and some cases among African Americans. Understanding these genetic and biological differences can help in developing targeted strategies for prevention and treatment. It also highlights the importance of accurate diagnostic tools to identify various diabetes subtypes in diverse populations.

The findings open avenues for further research into the underlying mechanisms of this non-autoimmune diabetes form and could lead to improved therapeutic approaches tailored to these unique patient groups. Ultimately, recognizing this heterogeneity in diabetes will enhance personalized medicine and improve health outcomes for affected populations.