Chicowore claims that there are many possible explanations, from yet undiscovered genetic variants to the physiological structure of the pancreas. The latter theory is created Research conducted in East Africawho stated that some men develop type 2 diabetes, despite fit weight. Some ongoing study Leaded by Uganda Medical Research Council, in cooperation with British researchers, measures the size of the pancreas in such men and assesses its function.
“These cases do not seem to be related to fat, so we want to understand what is happening,” says Chicowore. “Is it genetics? Is it because of how the pancreas developed? Some scientists believe that this is associated with malnutrition in an early period of life, affecting the development of beta cells so that they do not produce so much insulin.”
In addition to disclosing the path to recent treatment methods, understanding these cases can lead to improved screening tools. Currently, the golden methods of diagnosing and assessing the progress of type 2 diabetes are fasting glucose tests that measure blood sugar levels after fasting, and a blood test of HBA1C, which detects chemical levels called HBA1C, which over time indicates blood sugar levels. But in some populations it has been shown that such tests are ineffective.
Last year serious examination He emphasized that a significant number of people of African origin was diagnosed with type 2 diabetes much later, because they carry shortcomings in an enzyme called G6PD. This genetic variability is relatively common In the part of Sub -Saharan Africa, because it provides protection against hefty malaria, but also reduces HBA1C, thanks to which blood sugar levels are healthier than in reality. The study showed that many of these patients experience preventive complications, such as diabetic retinopathy, which can cause blindness.
Meanwhile, scientists such as Julia Goedecke, a professor and chief specialist scientist from the South African medical research council, said that the employ of glucose in fasting plasma as a way to diagnose type 2 diabetes in African women is usually ineffective because it assumes that the patient has a significant amount of liver fat. “Fasting glucose is often used as a risk marker of diabetes, but this is because the liver’s fat is a great fasting factor on glucose,” says Goedecke. “In Africans, this is actually a weak marker, because most women presenting themselves with diabetes have low liver fat, so you often miss diabetes if you only take the value of glucose on an empty stomach.”
Instead of liver fat, Goedecke research He pointed out that many of these cases are driven by the handicapped ability to remove insulin from the bloodstream, causing that people already have an abnormally high level of insulin.
Goedecke and others are now conducting a study, including men and women from the South African town of Soweto, various communities in Ghana and immigrants from Ghana to Germany and the Netherlands. For many years they will regularly assess a number of biological features. “We hope that these data will also give us a better understanding of the mechanisms related to the disease and ideas for interventions to prevent it,” he says.
While diabetes research in Africa should have a direct impact on patients in the region, Chicowore believes that this may also benefit to all diseases. Understanding why African sub -Saharan women seem to be more resistant to gaining fat from the liver, for example, it can lead to the development of drugs that can improve metabolic health in other ethnic groups. “With diversity you have both ends of the spectrum: people who are susceptible and people who are protected,” he says. “We have a better chance of finding people in Africa than anywhere else.”
As an example of what can be possible, Chicowore cites how genetic tests in African populations led to the development of a recent class of drugs that reduce cholesterol, with one company even studying the edition of genes in the treatment of patients. “Imagine that one day we could do the same for diabetes,” he says. “A genetically informed drug that can make people respond to diabetes. I think this is what the world is looking for.”