Scientists have discovered a mysterious type of diabetes known as malnutrition-related diabetes, which affects tens of millions in Asia and sub-Saharan African countries. This condition, referred to as "low body mass index diabetes" (LD), primarily affects thin, impoverished adolescents and young adults, who rarely live more than a year after diagnosis, according to a recent study published in the journal Diabetes Care. The victims are young and thin, suggesting they may have type 1 diabetes (T1D). Scientists, including those from Christian Medical College in Vellore, India, indicate that insulin injections typically do not help them and can lead to death due to low blood sugar. Additionally, patients do not appear to have type 2 diabetes (T2D), which is commonly associated with obesity.
While this rare type of diabetes was first described nearly 70 years ago, scientists say doctors are uncertain how to treat the condition due to a lack of research on it. Meredith Hawkins, a professor of medicine at Albert Einstein College of Medicine in the United States, stated, "Current scientific literature does not provide any guidance on managing malnutrition-related diabetes, which is rare in high-income countries but exists in over 60 low and middle-income countries."
She continued, "Doctors in those countries read Western medical journals, so they do not recognize malnutrition-related diabetes and do not suspect it in their patients. We hope that our findings will raise awareness of this disease, which is devastating for many people, and pave the way for effective treatment strategies." In the study, researchers utilized the latest technologies to evaluate insulin secretion and action in 20 men aged 19 to 45 who were identified as likely having malnutrition-related diabetes. Groups of individuals with type 1 diabetes and type 2 diabetes, along with healthy controls, underwent the same metabolic tests and served as comparison groups in the study.
The researchers wrote in the research paper: "These studies are the first to demonstrate that individuals with learning difficulties in low and middle-income countries have a unique metabolic profile, indicating that this is a distinct entity that warrants further research." The study includes a range of limitations, one of which, the researchers say, is that the analysis was limited to male participants, as males represent about 85% of those affected by malnutrition-related diabetes.
With this new discovery, scientists state that many new drugs recently made available for treating type 2 diabetes and increasing insulin secretion could enhance the potential for finding safe and effective ways to treat this condition. Diabetes appears to be a true global pandemic, with Dr. Hawkins stating, "One in ten adults worldwide has the disease, and three-quarters of them, about 400 million people, live in low and middle-income countries." She added, "In the countries where the study was conducted, the prevalence of malnutrition-related diabetes among diabetes patients is about 20%, indicating that around 80 million people could be affected worldwide. Therefore, it is clear that we need to learn more about malnutrition-related diabetes and the best ways to treat it."
