Diabetes mechanisms differ in lean African populations

Research conducted by Amsterdam UMC and the University of Ghana suggests that type 2 diabetes may manifest through different biological mechanisms depending on a patient’s body mass index (BMI). While the condition is typically driven by insulin resistance in overweight individuals, the study indicates that lean patients—particularly in Africa—often suffer from a pancreas that fails to produce sufficient insulin.

In wealthy nations, approximately 90% of people with type 2 diabetes are overweight. However, in Africa, nearly 40% of adults with the condition are lean, with figures reaching up to 60% in certain rural areas of Ghana. Researchers estimate that roughly 10 million lean individuals in Africa do not fit the standard clinical profile of the disease.

Currently, international medical guidelines often prescribe oral medications like metformin or sulfonylureas, which are primarily effective for insulin resistance. Because these treatments do not address insulin shortages, researchers suggest that lean patients may be receiving ineffective care and require different therapeutic approaches.