Malnutrition-related diabetes mellitus in young adult diabetic patients attending a Nigerian diabetic clinic

Although malnutrition-related diabetes mellitus (MRDM) is reported to affect about 40-50% of young adult diabetics in the Indian subcontinent and possibly other tropical and subtropical countries, anecdotal reports have suggested its relative uncommonness in Africa. The presentation of subjects (aged 15-30 years) attending a major Nigerian diabetic clinic in 1984 was therefore reviewed. The results (i) confirm previous observations on the rarity of diabetes in young adult Africans: only 45 of a total of 756 registered diabetics presented when aged 15-30 years; (ii) indicate that classical MRDM from established clinical criteria was uncommon, affecting only about 6% of the subjects, the majority of whom were either atypically or classically insulin-dependent (about 90%), although a small proportion (about 6%) appeared non-insulin-dependent. These observations suggest that diabetes in young adult Nigerians is heterogeneous in clinical presentation and aetiopathogenesis and, furthermore, that classical malnutrition-related diabetes mellitus is rarely seen, being much the least common mode of presentation, unlike the indication of the WHO Expert Committee on Diabetes Report (1985).