For the past 12 years, Meredith Hawkins, M.D., M.S., founding director of Einstein’s Global Diabetes Institute, has spearheaded an international collaborative study aimed at finding the underlying metabolic defects leading to what she and her colleagues term “low BMI [body mass index] diabetes”—a mysterious form of diabetes that afflicts millions of people in Asia and sub-Saharan Africa.
These patients—mainly thin and impoverished adolescents and young adults—tend to suffer severe complications. The disease was first described nearly 70 years ago, yet lack of research into the condition means that doctors are still unsure how to treat it.
Dr. Hawkins and colleagues carried out their study at the Christian Medical College in Vellore, India. They used state-of-the-art techniques for assessing insulin secretion and insulin action in evaluating 20 men identified as likely to have this form of diabetes. For comparison, people with type 1 diabetes (T1D), type 2 diabetes (T2D), and healthy controls underwent the same tests.
The results, published in June 2022 in Diabetes Care, indicate that malnutrition-related diabetes should be considered a distinct type of diabetes. Patients with the condition differed significantly from T1D and T2D patients, exhibiting a profound defect in insulin secretion that wasn’t previously recognized.
“These findings have revolutionized how we think about the condition and how we should treat it,” Dr. Hawkins says. She is a professor of medicine and holds the Harold and Muriel Block Chair in Medicine at Einstein and is an endocrinologist at Montefiore.