Linguistic, Ethnicity, and Geographical distribution of type 1 diabetes mellitus in Sudanese patients

Abstract The pattern of linguistic, ethnic, and geographical distribution of type 1 diabetes mellitus (T1D) among Sudanese patients is not well recognized. To determine this disturbuation, 50 T1D patients from diverse Sudanese ethnic groups who reported to Sudan Childhood Diabetes Center in Khartoum and two groups of controls, 118 genome data with other complaints, microarray data of 221 healthy controls of the Sudanese national genome (SNGP), were enrolled. In order to compare and examine how the disease is distributed among Sudanese tribes. It was found that the majority of patients with T1D were Arabs (82% Gaalien 26%, Shaigia 8%, Messiria 8%, Hammar 8%, Rufa'a 26%, Rawashda and Rekabia 4%), 2% were Hausa and 2% were Falata. 14% of the population was Nubian (4% Halfawi, 4% Mahas and 6% Danagla). The distribution was 78% for Afro-Asiatic (AA), 20% for Nilo-Saharan (NS) and 2% Niger-Kordofanian (NK), based on language groups. Geographically, the data showed that 52% of cases originated in North Sudan, 22% in the West, 24% in the Center, and 2% of the entire research group in East Sudan. Significant variation was found between the linguistic groups (AA and NS + NK) of T1D patients (p < 0.0001). There was a significant difference between the prevalence of language groups in the T1D group and the 118 control group (P < 0.002824). When comparing SNGP data and T1D data, a pattern of linguistic and geographical distribution of Sudanese tribes was statistically significant (P < 0.0001). It was found that 18 variants were shared with the T1D data. According to minor allele frequency (MAF), some variants were rare in some populations while they were common in other populations. Seven variants were classified as common variants in all linguistic groups based on MAF > 0.05. Eight variants were rare in some language groups (MAF < 0.05), but rare in others. Based on their clinical significance, the “benign” category included 13 variants (72.2%). 4 (22.2%) variants were classified as probably benign; only one variant (rs147638455) was found to have conflicting pathogenicity in all populations. Arabs make up an estimated number in Sudan, while the majority are Africans. Nevertheless, the majority of the population with T1D consists of Arabs, where they lived in central and then in northern Sudan. It is therefore extremely unlikely that changes in the genetic background are responsible for the observed regional differences against this background. Minor alleles are more likely to be risk alleles, particularly for some diseases where minor allele frequency (MAF) is low. Due to the complicated ethnic composition of the Sudanese population, there can be significant fluctuations. In conclusion, in this study, it was very clear that there is a pattern of spread of the disease among the Arab population or among people of Arab descent, most of whom return to the Arabian Peninsula. The highest rates of T1D are in Nordic countries and in high-income Arab countries. This could explain some issues related to the degree of closeness between these populations and the Sudanese tribes. Future research to estimate the extent of negative natural selection in various complicated disorders may use these findings as a starting point.