Type 1 Diabetes in a Resource-Poor Setting: Malnutrition Related, Malnutrition Modified, or Just Diabetes?

• Published in: Current diabetes reports Vol. 18; no. 7; pp. 47 - 6
• Main Authors: Balcha, Shitaye Alemu, Phillips, David I.W., Trimble, Elisabeth R.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2018; Springer Nature B.V
• Subjects: Diabetes; Epidemiology; Malnutrition; Medicine; Medicine & Public Health; Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit; Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors); Section Editors; Topical Collection on Other Forms of Diabetes and Its Complications; Type 1 DM; Malnutrition-related diabetes; Resource-poor countries; Epidemiology; Undernutrition
• ISSN: 1534-4827; 1539-0829
• DOI: 10.1007/s11892-018-1003-7

Purpose of Review Very little is known about the occurrence of type 1 diabetes (T1DM) in resource-poor countries and particularly in their rural hinterlands. Recent Findings Studies of the epidemiology of T1DM in Ethiopia and similar countries in sub-Saharan Africa show that the pattern of presenting disease differs substantially from that in the West. Typically, the peak age of onset of the disease is more than a decade later with a male excess and a low prevalence of indicators of islet-cell autoimmunity. It is also associated with markers of undernutrition. Summary These findings raise the question as to whether the principal form of T1DM seen in these resource-poor communities has a different pathogenesis. Whether the disease is a direct result of malnutrition or whether malnutrition may modify the expression of islet-cell autoimmunity is unclear. However, the poor prognosis in these settings underlines the urgent need for detailed clinical and epidemiological studies.