- A new form of type 1 diabetes has been identified in black people
- 65% of participants did not have the usual autoimmune markers traditionally linked with type 1 diabetes.
- This landmark study challenges long-held assumptions
A major new study is transforming how we understand and diagnose type 1 diabetes in people of African descent and could influence care in the UK and beyond.
Researchers studying nearly 900 young people with diabetes in Cameroon, Uganda and South Africa discovered that 65% of participants did not have the usual autoimmune markers traditionally linked with type 1 diabetes.
These young people also lacked the genetic features typically associated with the condition and didn’t fit the profile for type 2 or malnutrition-related diabetes either.
This suggests that a previously unrecognised, non-autoimmune form of type 1 diabetes may be common in African populations; a finding that directly challenges long-held medical assumptions.
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The research team, led by Professor Dana Dabelea from the University of Colorado and Professor Moffat Nyirenda from the London School of Hygiene & Tropical Medicine, published their findings in The Lancet Diabetes & Endocrinology.
They also noted that 15% of Black Americans diagnosed with type 1 diabetes showed similar features – lacking autoantibodies and carrying a low genetic risk score for the condition.
By contrast, White Americans with type 1 diabetes almost always had the typical autoimmune presentation, whether or not autoantibodies were detected.
“These findings are a wake-up call,” said Professor Nyirenda. “They challenge our assumptions about type 1 diabetes and show that the disease may present differently in African children and adolescents.”
Clinicians across Africa had long reported that some children didn’t match the typical type 1 diabetes profile, but lacked robust evidence.
This study is the first to document the issue at scale and with genetic and biochemical testing.
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This research has important implications for the UK, where people of African and Caribbean heritage may be misdiagnosed or mismanaged based on outdated diagnostic assumptions.
It also raises critical questions around equity in research and clinical guidelines, which have largely been shaped around studies in white Western populations.
The researchers are calling for urgent investment into understanding the biological and environmental drivers behind this form of diabetes, and for health systems worldwide to adapt diagnostic criteria to better serve diverse populations.
