It has not yet been officially named. In addition to type 1 and type 2 diabetes, the most well-known today, another type of diabetes has just been described in an article in the journal Lancet Diabetology & Endocrinology. The latter appears from birth, like type 1 diabetes, but presents several new characteristics specific to it.
More than nine million people worldwide are affected by type 1 diabetes, a chronic disease in which the immune system attacks and destroys the cells in the pancreas that produce insulin—a so-called autoimmune disease. To avoid serious or even fatal complications, these patients must rely on insulin injections. However, in some areas of the African continent, medical staff had already noticed that some children diagnosed with type 1 diabetes did not quite fit the typical patient profile. “ Many of them were able to survive without insulin for a while", before having access to treatment, explains Dr. Jean-Claude Katte of the University of Exeter (United Kingdom) and author of this research. This time, this track is confirmed.
Analyzing data from more than 900 young participants across the African continent, in Cameroon, Uganda, and South Africa, all diagnosed with type 1 diabetes more than 30 years earlier, the researchers realized that two-thirds of them (65%) actually had a new subtype of diabetes. They did not have either of the two main features of type 1 diabetes: none of the antibodies characteristic of autoimmune diabetes were found, nor was there any genetic predisposition for type 1 diabetes. The disease also did not correspond to type 2 diabetes, nor to diabetes caused by malnutrition.
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Who is affected by this new type of diabetes?
At this stage, the results only concern the sub-Saharan population. To determine whether this new subgroup is also present outside the African continent, the team reviewed more than 3,000 child profiles in a US database. The result: this new type of diabetes was found in a small proportion of children of African immigrant origin, but not in Caucasian participants.
What is this due to?
Since the disease is only found in sub-Saharan patients or those of African descent, researchers believe it may be due to environmental or hereditary factors. However, our work is very preliminary. Since it involves American children with African ancestry, it suggests a hereditary component, but we plan to conduct further research to test this hypothesis." explains Dr. Katte.
Is a new treatment needed for these people?
“ These patients are treated with insulin, just like other patients because they too have an insulin deficiency.", continues the researcher. His team is currently conducting work to determine whether these patients also suffer from endocrine dysfunction (the secretion of hormones into the blood) or exocrine dysfunction (the secretion of hormones outside the body or into body cavities). " Certain therapies will then need to be added to best manage them. But insulin remains their main treatment to ensure their survival.. »
How do you know if you are part of this subgroup?
It is impossible for a patient – and even more so for a doctor – to guess that an individual is carrying this new version of diabetes. Our current research shows that this new subtype of diabetes has exactly the same clinical presentation as true type 1 diabetes. We have not been able to clinically distinguish those with autoimmune type 1 diabetes from those with type 1 diabetes without insulin deficiency due to an autoimmune reaction.", specifies Dr. Jean-Claude Katte.
What separates them: their genetic and immunological characteristics. The researcher emphasizes the importance of new work aimed at better describing the presentation of this new disease: the patients' BMI, age at diagnosis, as well as the presence of specific biomarkers.
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How did these people survive without insulin in the first place?
In type 1 diabetes, the body no longer produces insulin. Without this hormone, the body can no longer eliminate sugar from the blood. This phenomenon can be serious, even fatal if it is not corrected by an intake of exogenous insulin." , explains theInserm. Due to excessive concentration of glucose in the blood, the heart and blood vessels end up being damaged. Diabetes-induced vascular lesions in particular increase the risk ofatherosclerosis, myocardial infarction, stroke or even arteritis of the lower limbs. » However, individuals in this subgroup of diabetes showed a high survival rate compared to those without insulin intake. The researchers assume that this is due to higher levels of residual insulin than those with autoimmune type 1 diabetes. The very low levels secreted would have allowed temporary survival without insulin.
This is not the first time that a new subtype of diabetes has been identified. In April 2025, the International Diabetes Federation officially recognized the type 5 diabetes, also called " diabetes malnutrition", which develops in children suffering from nutritional deficiencies, often in low-income countries. It could affect up to 20 million people worldwide. It remains to be seen how many people suffer from the new subtype identified on the African continent and to better understand how this disease works. In order to provide the best possible treatment for this new category of patients.
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