The Department of Endocrinology, 
Atypical diabetes subtypes in Black African populations.
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Exeter, UK. j.njabou-katte@exeter.ac.uk.
- Department of Non-Communicable Diseases Research, RSD Institute, Yaoundé, Cameroon. j.njabou-katte@exeter.ac.uk.
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
- Department of Medicine, University Teaching Hospital, Kigali, Rwanda.
- Usher Institute, University of Edinburgh, Edinburgh, UK.
- Global Diabetes Institute, Diabetes Research Centre, Albert Einstein College of Medicine, Bronx, NY, USA.
- Department of Endocrinology, Diabetes, and Metabolism, Christian Medical College, Vellore, India.
- Centre for Stem Cell Research, Christian Medical College, Vellore, India.
- Department of Non-Communicable Diseases Research, RSD Institute, Yaoundé, Cameroon.
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
- National Obesity Centre and the Endocrinology and Metabolic Diseases Unit, Yaoundé Central Hospital, Yaoundé, Cameroon.
- Department of Non-Communicable Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
- 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 Non-Communicable Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. kibirigedavis@gmail.com.
- Department of Medicine, Uganda Martyrs Hospital Lubaga, Kampala, Uganda. kibirigedavis@gmail.com.
Diabetologia Vol. 69 · Issue 6 · pp. 1432-1443
PMID 41770244 DOI 10.1007/s00125-026-06697-3
Cite This Article
Jean Claude Katte, Charlotte Bavuma, Sarah H Wild, Meredith Hawkins, Nihal Thomas, Eugene Sobngwi, Moffat J Nyirenda, Davis Kibirige. Atypical diabetes subtypes in Black African populations. Diabetologia. 2026;69(6):1432-1443. doi:10.1007/s00125-026-06697-3
Abstract
Atypical diabetes subtypes and presentations are disproportionately prevalent in populations of African and Asian ancestry. This review discusses the epidemiology, clinical presentation, aetiopathogenesis and management of four atypical diabetes subtypes commonly reported in Black African populations. These are ketosis-prone diabetes (KPD), fibrocalculous pancreatic diabetes (FCPD), type 2 diabetes in individuals without overweight or obesity, and malnutrition-related diabetes (MRD). The review summarises current insights into these atypical diabetes subtypes in Black African populations and provides practical recommendations to guide their precision diagnosis and management in the African region. These four atypical diabetes subtypes exhibit phenotypic features that diverge from those of classical type 1 and type 2 diabetes. KPD is characterised by unprovoked, transient, index episodes of diabetic ketoacidosis, often in the absence of markers of islet cell autoimmunity, with frequent subsequent insulin independence and diabetes remission. FCPD typically presents in young lean individuals, with a strong male preponderance and with radiological evidence of pancreatic calcifications, reduced beta cell reserve and severe hyperglycaemia without ketosis. Type 2 diabetes in individuals without overweight or obesity is characterised by normal BMI with a trend towards low levels of markers of visceral adiposity, insulin resistance and an exaggerated beta cell secretory dysfunction. MRD is associated with a previous and persistent history of undernutrition, with features of undernutrition such as stunting and BMI
Keywords
- Africa
- African populations
- Atypical diabetes subtypes
- Fibrocalculous pancreatic diabetes
- Ketosis-prone diabetes
- Malnutrition-related diabetes
- Review
- Type 2 diabetes in individuals without overweight and obesity
