Atypical diabetes subtypes in Black African populations – published online 02/03/2026

Jean Claude Katte, Charlotte Bavuma, Sarah H. Wild, Meredith Hawkins, Nihal Thomas, Eugene Sobngwi, Moffat J. Nyirenda, Davis Kibirige

African populations exhibit a distinctive spectrum of atypical diabetes forms that challenge the traditional dichotomy of type 1 and 2 diabetes. Four main types have been consistently described in the literature: ketosis-prone diabetes (KPD), fibrocalculous pancreatic diabetes (FCPD), type 2 diabetes in individuals without overweight and obesity, and malnutrition-related diabetes. In this issue, Katte et al (https://doi.org/10.1007/s00125-026-06697-3) synthesise current evidence on the clinical characteristics, underlying pathophysiology and diagnostic challenges of these different diabetes forms in African-ancestry populations. The authors explore the clinical specificities of KPD and FCPD and highlight emerging data demonstrating beta cell dysfunction in individuals with type 2 diabetes without overweight or obesity and the resurgence of malnutrition-related diabetes. They conclude by discussing implications for management and research priorities, emphasising the need for context-specific diagnostic tools and longitudinal studies.