A recent discovery will reshape our understanding of how type 1 diabetes develops, particularly in individuals of African descent. Researchers have identified a new African form of type 1 diabetes that appears to be distinct from the typical autoimmune response. This finding could have profound implications for diagnosis and management worldwide, especially concerning the African form of type 1 diabetes.
Scientists have recognised Type 1 diabetes as an autoimmune disease for decades. The body’s immune system mistakenly produces autoantibodies that attack and destroy the insulin-producing beta cells in the pancreas. This process typically begins in childhood or early adulthood. This model has served as the basis for diagnosis and treatment worldwide, but it does not explain the African form that has been identified.
However, a landmark study published in The Lancet Diabetes & Endocrinology has revealed that this is not the whole story. This is especially true for people in Sub-Saharan Africa. Indeed, a unique African form of type 1 diabetes has emerged from recent research.
A Different Disease Profile in Africa
The international research team studied 894 volunteers with youth-onset diabetes in Cameroon, Uganda, and South Africa. The results were startling. A huge 65% of these individuals did not have the autoantibodies typically associated with type 1 diabetes.
Furthermore, they lacked the genetic markers that usually predispose individuals to the autoimmune form of the disease. The findings also ruled out other known forms of diabetes, such as type 2 or malnutrition-related diabetes. Instead, an African form of type 1 diabetes suggests a new path.
Study leader Dana Dabelea of the University of Colorado Anschutz Medical Campus explained that this suggests many young people in this region have a different form of type 1 diabetes altogether. It is one that is not autoimmune in origin. This African form of the condition stands out in the findings.
Challenging a 'One-Size-Fits-All' Approach
The study highlights a significant gap in medical knowledge. Historically, this knowledge has been based on research focused predominantly on white Western populations. For years, clinicians in some parts of Africa have suspected that many of their young patients did not fit the classic type 1 diabetes profile. This new data now provides firm evidence to support those observations. It hints at an African form of type 1 diabetes.
Comparing their findings with data from the United States, the researchers found that 15% of Black Americans diagnosed with type 1 diabetes showed a similar pattern. This is similar to the African form of type 1 diabetes observed among participants. Negative auto-antibodies and a low genetic risk score characterise it.
In contrast, white Americans with the condition almost always showed the standard autoimmune pattern. Even in cases where autoantibodies were not detected, their genetic makeup still pointed towards an autoimmune origin.
African Form of Type 1 Diabetes is a Wake-Up Call for Global Health
Researchers say these findings are a crucial alert to the global medical community to move beyond a single, Eurocentric view of type 1 diabetes. Discovering an African form of type 1 diabetes expands our understanding drastically.
The discovery highlights the pressing need for new research. This aims to comprehend the distinct biological and environmental factors that underlie this non-autoimmune form of diabetes.
The implications are far-reaching. These affect not only clinical practice in Africa but also how diabetes is diagnosed and managed within diverse communities in the UK, Europe, and North America, acknowledging the African form of type 1 diabetes.