The occurrence of Z-type diabetes (tropical pancreatic diabetes) in the South African Indian

The presentation of diabetes in the young South African Indian is atypical in that insulin-dependent diabetes mellitus is rare, while non-insulin-dependent diabetes mellitus is common. In addition, youthful onset of tropical diabetic syndrome (J-type diabetes) is extremely rare. To date there appear to be no reports on a further tropical malnutrition diabetic syndrome associated with pancreatic fibrosis and calcification (Z-type diabetes). Four Indian patients with features consistent with the diagnosis of Z-type diabetes are described. All were asthenic, came from a poor socio-economic background and developed insulin-requiring diabetes in their youth; 3 of the 4 patients had pancreatic calcification.