Il diabete mellito J o Tipo 5: un vecchio problema clinico nella nuova medicina delle migrazioni e degli stili di vita
摘要
Historically, malnutrition has been considered either an insufficient or inappropriate nutrient intake, thus playing a key role in clinical diagnoses related to glycolipidic dysmetabolism. As a necessary and sufficient evidence to a parsimonious diagnostic reasoning, it emerges as a relevant factor for diagnosis of malnutrition-related diabetes, a glycolipidic disorder traced back to the early 20th century, now very timely in Italy in relation to the immigration from countries where it was originally identified (Africa, Asia). Described in Jamaica at the half of the 20th century as diabetes J, it resulted as a “hybrid” between diabetes Type 1 and 2 in underweight young subjects, recently found having phenotypic similarities with normal-weight metabolically-unhealthy people. Leading to ketosis only rarely, it requires high insulin doses, it does not associate with steatotic liver disease, it might favourably respond to high-protein diet and combined therapy with insulin and oral hypoglycaemic agents, and, this year, the International Diabetes Federation classified it as Type 5 diabetes mellitus.