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Review
. 2018 Jun 14;18(7):47.
doi: 10.1007/s11892-018-1003-7.

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

Shitaye Alemu Balcha  1 , David I W Phillips  2 , Elisabeth R Trimble  3
Affiliations
Review

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

Shitaye Alemu Balcha et al. Curr Diab Rep. .

Abstract

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. 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.

Keywords: Epidemiology; Malnutrition-related diabetes; Resource-poor countries; Type 1 DM; Undernutrition.

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Conflict of interest statement

Conflict of Interest

Shitaye Alemu Balcha, David I.W. Phillips and Elisabeth R. Trimble declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standard.

Figures

Fig. 1
Fig. 1
Age frequency of a series of 2280 patients with diabetes presenting at Gondar and Jimma hospitals, Ethiopia, 1995–2008. (Based on ref. 5). T1DM type 1 diabetes, T2DM type 2 diabetes
See this image and copyright information in PMC

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