ArticleThe American journal of clinical nutrition2021
Prior undernutrition and insulin production several years later in Tanzanian adults.
Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Associations of prior wasting malnutrition with later indicators of glucose tolerance across 4 countries in Africa and Asia: The Severe Acute Malnutrition - the Role of the Pancreas (SAMPA) study.The American journal of clinical nutrition · 2025Article
- Undernutrition-Associated Diabetes Mellitus: Pathophysiology of a Global Problem.Physiology (Bethesda, Md.) · 2025Review
- Association between protein undernutrition and diabetes: Molecular implications in the reduction of insulin secretion.Reviews in endocrine & metabolic disorders · 2024Review
- Phenotypic characterization of nonautoimmune diabetes in adult Ugandans with low body mass index.Therapeutic advances in endocrinology and metabolism · 2024Article
- Dietary patterns and diabetes mellitus among people living with and without HIV: a cross-sectional study in Tanzania.Frontiers in nutrition · 2023Article
- Pathophysiology of type 2 diabetes in sub-Saharan Africans.Diabetologia · 2022Review
- Long-term health after Severe Acute Malnutrition in children and adults- the role of the Pancreas (SAMPA): Protocol.F1000Research · 2022Article
- Apparent Insulin Deficiency in an Adult African Population With New-Onset Type 2 Diabetes.Frontiers in clinical diabetes and healthcare · 2022Article
- The association of physical activity and cardiorespiratory fitness with β-cell dysfunction, insulin resistance, and diabetes among adults in north-western Tanzania: A cross-sectional study.Frontiers in endocrinology · 2022Article
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Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundThe prevalence, pathology, and existence of malnutrition-associated diabetes remain uncertain, especially with respect to adult-acquired undernutrition.
objectiveThe aim was to investigate the association of prior undernutrition (low BMI, in kg/m2), acquired in adulthood and insulin during an oral glucose tolerance test (OGTT).
methodsWe followed up 630 adults recruited 7-14 y previously for other studies. Plasma insulin was measured fasting and at 30 and 120 min during an OGTT. The main exposure was BMI measured 7-14 y prior. The main outcome of interest was plasma insulin, controlling for time during the OGTT using generalized estimating equations, and exploratory outcomes were early insulin response (relative change in insulin and glucose from 0-30 min) and relative insulin and glucose AUCs from 0 to 120 min. Current confounding factors were age, sex, BMI, HIV, socioeconomic status, and physical activity.
resultsIn unadjusted analyses, increasing severity of prior malnutrition was associated with lower insulin concentration. In multivariate adjusted analyses, only current BMI was a strong predictor of overall insulin concentration. Associations with prior BMI of insulin responses accounting for glucose were also seen in unadjusted but not adjusted analyses. For insulin concentration but not the outcomes accounting for glucose, there was a sex interaction with prior BMI such that only men had lower insulin if previously malnourished: insulin (pmol/L) at 120 min was 311 (95% CI: 272, 351) for prior BMI ≥18.5, 271 (95% CI: 221, 321) for prior BMI 17.0-18.5, and 237 (95% CI: 194, 297) for prior BMI <17.0; P = 0.03. HIV status showed limited and variable associations with insulin.
conclusionsInsulin concentration, fasting and during an OGTT, was normalized in women more than in men several years after adult malnutrition. Chronic malnutrition, as indicated by low prior and current BMI, may contribute to diabetes through low insulin secretion.
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