Researchers Launch Major Study to Understand a Puzzling Form of Diabetes in Young Africans

Diabetes affects more than 24 million people across Africa, but not all cases fit neatly into the familiar categories of Type 1 or Type 2. Recent research in sub-Saharan Africa has uncovered something unexpected: a significant number of children and young adults diagnosed with Type 1 diabetes lack the autoimmune markers—called islet autoantibodies—that typically define the condition. Yet these young people have severe insulin deficiency, the hallmark of Type 1 diabetes. This mismatch has led researchers to identify what may be a distinct diabetes subtype: non-autoimmune insulin-deficient diabetes, or NAID.

The PANDA study (Prospective Study of Non-Autoimmune Insulin-Deficient Diabetes Subtype in Young Individuals in sub-Saharan Africa) is a large, long-term investigation designed to understand this puzzling form of diabetes. Researchers will recruit 355 young people aged 25 and under who were recently diagnosed with Type 1 diabetes—expecting to identify about 240 cases of NAID and 115 cases of autoimmune Type 1 diabetes. They will also include at least 240 healthy young people without diabetes as a comparison group.

The study combines two approaches. First, participants will undergo detailed testing at the start, including blood work to check for autoimmune markers and measure C-peptide (a marker of insulin production), along with biospecimen collection for further analysis. A smaller group will also receive advanced imaging of the pancreas and a mixed meal tolerance test to assess how the pancreas is functioning. Second, all participants with diabetes will be followed for 3 years, with researchers tracking changes in insulin secretion, blood sugar control, and any acute complications.

Understanding NAID could reshape how clinicians recognize and manage diabetes in young people across sub-Saharan Africa and potentially beyond. If NAID is indeed a separate disease process—one without autoimmunity but with severe insulin deficiency—it may require different diagnostic approaches and treatment strategies than classic Type 1 diabetes. By studying the pancreas structure, function, and how the condition progresses over three years, researchers hope to uncover what actually drives insulin loss in this group and whether the disease course differs from autoimmune Type 1 diabetes.

This research is also a step toward more precise diabetes care. Recognizing distinct subtypes helps doctors tailor their understanding and management of each young person's individual condition, rather than assuming all insulin-deficient diabetes follows the same pattern.

Source: BMJ open. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.