INS and diabetic ketoacidosis: Similarly, in a region of Northern Ethiopia recently affected by severe famine, clinical features of 100 insulin-treated diabetic patients were consistent with previous descriptions of malnutrition-related diabetes mellitus (MRDM): young age of onset (70% < 30 yrs), low BMI (mean 15.8), and resistance to ketosis (only 4% admitted with diabetic ketoacidosis despite 48% reporting insulin treatment interruption) [90].