*1.3.5 Genetics of T1 diabetes mellitus from sub-Saharan Africa*

Data from certain areas in the world are very limited including sub-Saharan Africa. A recent study from Sudan by Tamador et al. has concluded that young Sudanese individuals with T1DM generally have similar characteristics as reported from European-origin T1DM populations. However, they have higher rates of DKA and slightly lower autoantibody rates than those reported from European-origin populations and a particularly strong association with *HLA-DRB1\*03:01*. Another study from Ethiopia by Shitaye et al., which has studied specifically the Amhara genomes, has concluded that Amhara genomes were distinct from modern European and other African genomes. *HLA-DRB1\*03:01 (p = 0.0014) and HLA-DRB1\*04 (p = 0.0001)* were positively associated with this form of diabetes, while HLA-DRB1\*15 was protective (p < 0.0001). This means type 1 diabetes genetic risk score (derived from European data) was higher in patients than in control participants (p = 1.60 × 10–7). Interestingly, despite the modest sample size, autoantibody-positive patients revealed evidence of association with SNPs in the well-characterized MHC region, already known to explain half of type 1 diabetes heritability in Europeans.
