Type 5 Diabetes Recognized: A New Malnutrition-Induced Form of Diabetes

What’s in Today’s Article?

• Type 5 Diabetes Latest News
• About Type 5 Diabetes
• Global Prevalence
• Markers of Type 5 Diabetes
• Treatment Approaches
• Type 5 Diabetes FAQs

Type 5 Diabetes Latest News

• Type 5 diabetes, a form of the disease affecting lean and undernourished young adults in low- and middle-income countries, has been officially recognised by the International Diabetes Federation (IDF). 
• Often misdiagnosed and overlooked in research, this type is caused by malnutrition-induced reduced insulin production and has only recently gained formal acknowledgment after decades of neglect.

About Type 5 Diabetes

• Type 5 diabetes is a distinct form of diabetes that primarily affects lean and malnourished teenagers and young adults in low- and middle-income countries. 
• It is caused by malnutrition-induced abnormal functioning of pancreatic beta cells, leading to insufficient insulin production. 
• Unlike Type 2 diabetes, where the issue is insulin resistance, Type 5 involves impaired insulin secretion due to poor nutritional history.

Recognition and Endorsement

• The term ‘Type 5 diabetes’ was introduced and endorsed by Prof Peter Schwarz, president of the International Diabetes Federation (IDF), in January 2025. 
• It received official recognition recently at the 75th World Congress for Diabetes held in Bangkok.

Historical Background

• Although newly named, Type 5 diabetes is not a new disease. It was first reported in Jamaica in 1955 as "J-type diabetes." 
• In 1985, the World Health Organization (WHO) classified it as “malnutrition-related diabetes mellitus,” but the category was removed in 1999 due to a lack of conclusive evidence linking it to malnutrition.

Global Prevalence

• This condition has been observed in several countries including India, Sri Lanka, Bangladesh, Uganda, Ethiopia, Rwanda, and Korea—mostly across the Global South. 
• It currently affects around 25 million people worldwide.

Recent Research and Renewed Focus

• Recent studies have shed light on how childhood and early adulthood malnutrition affects pancreatic development and insulin function. 
• This new evidence has been key in securing the disease's formal recognition as a separate type of diabetes.

Markers of Type 5 Diabetes

• It is a unique form of diabetes, observed in Asian Indians, has no evidence of autoimmune or genetic causes. 

Key Indicators Include

• Very low Body Mass Index (BMI): Less than 18.5 kg/m²
• Severely reduced insulin secretion: Much lower than in Type 2 diabetes, but slightly higher than in Type 1
• Low body fat: Significantly less than seen in Type 2 diabetes cases
• Poor nutritional intake: Especially low in proteins, fibre, and essential micronutrients

Underlying Cause: Malnutrition from the Womb

• The root of Type 5 diabetes lies in malnutrition, beginning as early as the fetal stage.
• Health experts explain that:
  • Undernourishment during pregnancy can impair fetal development and increase diabetes risk.
  • Historical factors like colonial hardships and food scarcity contributed to generational malnutrition.
  • If a child remains undernourished both before and after birth, without experiencing later weight gain, they are more prone to developing Type 5 diabetes, unlike those who develop Type 2 diabetes after postnatal overnutrition.

Treatment Approaches

• Since the disease has only recently been officially recognised, standard diagnostic and treatment guidelines are still under development.
• Preliminary suggestions include:
  • High-protein diet: To combat malnutrition and support insulin function
  • Balanced intake of carbs and fats: Tailored to BMI and physical activity for healthy weight gain
  • Medication: Anti-diabetic drugs or insulin may be prescribed based on individual glucose levels and response to therapy
• The Type 5 Diabetes Working Group aims to establish concrete protocols over the next two years, focusing on affected populations in low-resource settings.

Type 5 Diabetes FAQs

Q1. What is Type 5 diabetes?

Ans. Type 5 diabetes is a malnutrition-induced form affecting lean, young adults in low-income countries, leading to reduced insulin production.

Q2. What causes Type 5 diabetes?

Ans. Malnutrition, especially during fetal development, causes abnormal pancreatic beta cell function, leading to insufficient insulin production.

Q3. What are the markers of Type 5 diabetes?

Ans. Markers include low BMI, reduced insulin secretion, low body fat, and poor intake of proteins, fiber, and micronutrients.

Q4. How is Type 5 diabetes treated?

Ans. Treatment includes high-protein diets, balanced carbs and fats, and anti-diabetic medications or insulin based on glucose levels.

Q5. Where is Type 5 diabetes most prevalent?

Ans. It is common in countries like India, Sri Lanka, Uganda, and Bangladesh, primarily affecting populations in the Global South.

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