Investigating innovative approaches to identify lean individuals at risk of type 2 diabetes in SSA.

Type 2 diabetes (T2D) poses a major threat in sub-Saharan Africa (SSA); 24 million people are thought to have T2D, but this is projected to increase by 129% by 2045 (the greatest increase of all regions). However, most people living with T2D are undiagnosed. Established risk factors for T2D include family history, old age and obesity, and these are widely used in screening tools. Increasing evidence suggests that in Africa T2D occurs at relatively young age and in lean individuals who would be missed by these screening approaches. For example, in Uganda, nearly 60% of those identified to have diabetes through community screening are lean (<25kg/m2). This may explain, at least in part, why most people with T2D in the region remain undiagnosed, and those who are diagnosed present late with established complications of this condition. This project will capitalize on a large and rigorous ongoing community survey of diabetes and other existing datasets to examine and validate which simple clinical features and biomarkers can identify risk of T2D in lean individuals in in Africa. The end result will be development of clinical tools needed to guide risk prediction and increase T2D detection in lean individuals in SSA.