One Component of Africa's Diabetes Challenge: 'Type 5'

The story of diabetes in Africa is a worsening one. In a detailed report for the New York Times, Stephanie Nolen describes how the disease—long overshadowed by malaria, HIV, and other infectious threats in terms of attention and health-care funding—is quietly surging across the continent and overwhelming health systems built for a different battle. In Cameroon, three-quarters of people with diabetes are believed to be undiagnosed; among those who know, only about a third are on medication. Costs are crushing: Insulin for adults can equal a month's wages, and even the blood glucose test that can screen for diabetes is too pricey for many.

Nolen also highlights the recently classified "Type 5" diabetes, which is prevalent among lean, undernourished patients and likely rooted in childhood or chronic malnutrition—a form that upends standard assumptions about who gets diabetes and how to treat it. "They don't need heavy doses of insulin, weight-loss drugs or high-carbohydrate diets," explains Nolen. Research is in the early stages, but a legume-rich diet and medications that support insulin production are being explored. Despite the challenges, Nolen sees glimmers of progress, including a 2026 effort to use community health workers, blood glucose meters, and blood pressure machines to screen six million people in Cameroon. Read the full article for more.