Overview

• The Young-Onset Diabetes in Sub-Saharan Africa (YODA) study enrolled 894 youth in Cameroon, Uganda and South Africa and applied uniform lab tests and genetic analyses across cohorts
• 65% of Sub-Saharan African participants lacked islet autoantibodies and genetic risk markers typical of autoimmune type 1 diabetes, defining a novel insulin-deficient subtype
• A parallel analysis of the U.S. SEARCH for Diabetes in Youth cohort found the same non-autoimmune form in 15% of Black American youth but not in white participants
• Findings challenge current diagnostic guidelines that rely on autoantibody presence and genetic risk scores, risking misclassification and suboptimal insulin management
• New investigations into environmental, nutritional and infectious drivers aim to improve diagnosis, tailor therapies and uncover underlying mechanisms