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Health promotion and public health
Optimising the knowledge of the characteristics of low BMI diabetes will allow a correct diagnosis and appropriate treatment
  1. Ilaria Baruffaldi
  1. Paula Carr Diabetes Centre, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
  1. Correspondence to Ms Ilaria Baruffaldi, Paula Carr Diabetes Centre, Maidstone and Tunbridge Wells NHS Trust, maidstone, kent, UK; ilaria.baruffaldi{at}

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Commentary on: Lontchi-Yimagou E, Dasgupta R, Anoop S, Kehlenbrink S, Koppaka S, Goyal A, Venkatesan P, Livingstone R, Ye K, Chapla A, Carey M, Jose A, Rebekah G, Wickramanayake A, Joseph M, Mathias P, Manavalan A, Kurian ME, Inbakumari M, Christina F, Stein D, Thomas N, Hawkins M. An Atypical Form of Diabetes Among Individuals With Low BMI. Diabetes Care. 2022 Jun 2;456,:1428–1437. doi: 10.2337/dc21-1957.

Implications for practice and research

  • Low body mass index (BMI) diabetes mellitus (DM) represents a prevalent entity in low-income and middle-income countries (LMICs) but still needs to be understood.

  • Diagnosing low diabetes (LD) correctly will avoid prescribing complex treatment to people particularly vulnerable to hypoglycaemia due to food insecurity.


A very distinctive form of diabetes was described for the first time in Jamaica in 1955. Individuals diagnosed with this variant were characterised by low BMI, absence of ketones and high insulin requirements. WHO introduced ‘malnutrition-related diabetes mellitus’ as a diagnosis in 19851 and …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.