Nutritional status of young adult Ethiopians before onset and after treatment of diabetes mellitus.

Young diabetics in tropical countries are often undernourished, insulin-requiring and ketosis-resistant, and are sometimes considered to have a distinct type of diabetes. Therefore, a survey of young adult diabetics attending Yekatit 12 Hospital, Addis Ababa, was made to determine clinical features and the relation between their diabetes and their nutritional state. In May, 1988, 894 of 1490 registered diabetic patients were attending regularly, of whom 248 became diabetic between the ages of 15 and 35 years. Many had been followed for 6 years or more. Of the 248,69 males and 29 females (39.5%) had body mass index (BMI) of less than 18 kg/m2 at diagnosis of diabetes. However, only 3.5% of the 199 who knew their pre-diabetic weight had been less than 18 kg/m2; 13.8% of males and 48.5% of females had been obese. At their last attendance, 50% of those whose BMI at diagnosis was less than 18 were of normal weight and only 13% had gained no weight. Of the 98 with BMI less than 18 at diagnosis, and the further 18 less than 18 kg/m2 by the time insulin was started, ketosis occurred at some time in 22%. Only 1 patient takes more than 1.5 units of insulin per kg per day, and 30% of those needing 1.0 to 1.5 U/kg have had tuberculosis. Only 15 of the 116 patients who had BMI less than 18 failed to gain weight on treatment. It is concluded that, in most, the malnutrition at presentation was due to the diabetic state and did not precede the diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)