The Department of Endocrinology, 
Phenotypic characterization of nonautoimmune diabetes in adult Ugandans with low body mass index.
- Non-Communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Plot 51/59 Nakiwogo Road, Entebbe, Uganda.
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala +256, Uganda.
- Non-Communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.
- Department of Medicine, Mengo Hospital, Kampala, Uganda.
- Department of Endocrinology, Diabetes, and Metabolism, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
- Albert Einstein College of Medicine, Bronx, NY, USA.
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK.
- Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
- Department of Non-Communicable Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Therapeutic advances in endocrinology and metabolism Vol. 15 · pp. 20420188241252314
PMID 38808009 DOI 10.1177/20420188241252314
Cite This Article
Davis Kibirige, Isaac Sekitoleko, William Lumu, Nihal Thomas, Meredith Hawkins, Angus G Jones, Andrew T Hattersley, Liam Smeeth, Moffat J Nyirenda. Phenotypic characterization of nonautoimmune diabetes in adult Ugandans with low body mass index. Therapeutic advances in endocrinology and metabolism. 2024;15:20420188241252314. doi:10.1177/20420188241252314
Abstract
BACKGROUND: Type 2 diabetes is common in relatively lean individuals in sub-Saharan Africa. It is unclear whether phenotypic differences exist between underweight and normal-weight African patients with type 2 diabetes. This study compared specific characteristics between underweight (body mass index
METHODS: We collected the demographic, clinical, anthropometric, and metabolic characteristics of 160 participants with nonobese new-onset type 2 diabetes (defined as diabetes diagnosed
RESULTS: Of the 160 participants with nonobese new-onset type 2 diabetes, 18 participants (11.3%) were underweight. Compared with those with normal weight, underweight participants presented with less co-existing hypertension (5.6% 28.2%, = 0.04) and lower median visceral fat levels [2 (1-3) 6 (4-7),
CONCLUSION: This study demonstrates that nonautoimmune diabetes occurs in underweight individuals in sub-Saharan Africa and is characterized by the absence of visceral adiposity, reduced late-phase insulin secretion, and greater insulin deficiency. These findings necessitate further studies to inform how the prevention, identification, and management of diabetes in such individuals can be individualized.
Keywords
- atypical diabetes phenotypes
- low BMI type 2 diabetes
- sub-Saharan Africa
