[Tropical diabetes mellitus, a new nutritional indicator?]

Area of Science:

• Endocrinology
• Nutritional Science
• Tropical Medicine

Context:

• Traditional understanding links diabetes mellitus to overnutrition, influenced by socioeconomic, ethnic, social, and cultural factors.
• Emerging evidence highlights an unexpected association between diabetes mellitus and undernutrition in tropical zones.
• This includes infantile forms with calcareous pancreatitis (India, Nigeria) and less severe forms in Africa.

Purpose:

• To explore the complex relationship between diabetes mellitus and nutritional status in tropical environments.
• To investigate the potential of tropical diabetes mellitus as an indicator of nutritional disorders or dietary toxic factors.
• To consider diabetes mellitus within a multifactorial framework involving genetic and environmental influences.

Summary:

• Tropical diabetes mellitus presents atypically, often in individuals with normal or below-normal weight.
• It is characterized by reduced ketogenesis and responsiveness to glucagon stimulation.
• The condition appears more prevalent in areas with chronic malnutrition.

Impact:

• Re-evaluates the etiology of diabetes mellitus in tropical settings, moving beyond solely overnutrition.
• Suggests diabetes mellitus can serve as a biomarker for nutritional deficiencies and environmental toxins.
• Emphasizes the need for a multifactorial approach, integrating genetics and tropical environmental factors, for a comprehensive understanding.