African immigrants with type 2 diabetes present with three physiologic subtypes: implications for screening, diagnosis and treatment
Authors' conclusion
Spanning the BMI spectrum from normal to obese, African immigrants have three subtypes of T2D. Weight gain was greatest in immigrants who developed T2D but did not differ by subtype. As life in America promotes weight gain, sharing information about the consequences of weight gain with all Americans, both native and foreign-born, is key to T2D prevention and treatment.
Study context
- Population
- African immigrants (male 62%, age 39±11 years, body mass index (BMI) 27.8±4.6 kg/m²) undergoing OGTT
- Participants
- 633 participants
- Exposure
- T2D subtypes: Insulin-deficient-T2D (ID-T2D) vs insulin-resistant-T2D (IR-T2D) vs ID+IR-T2D
- Outcome
- Glucose tolerance category and T2D subtypes
Main finding
As reported in the abstract
- Normal glucose tolerance
- 61%
- Pre-diabetes
- 32%
- T2D
- 7%
- Highest glucose concentrations in ID+IR-T2D
- all p<0.05
- Highest insulins in IR-T2D
- all p<0.01
Observational data: associations, not effects.
Further findings
Phenotype by T2D subtype
- ID-T2D: healthy weight
- 20%
- ID-T2D: central obesity
- 55%
- IR-T2D and ID+IR-T2D: central obesity and overweight or obese BMI
- 100%
Sociodemographic factors (weight gain, sedentary lifestyle, percent married)
- Increased across glucose tolerance category
- P < 0.01
- Did not differ by T2D subtype
- P ≥ 0.3
Original publication
African immigrants with type 2 diabetes present with three physiologic subtypes: implications for screening, diagnosis and treatment. BMJ Open Diabetes Res Care. Published 18 March 2026. doi:10.
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