In a significant advancement in diabetes research and clinical care, medical experts have formally began recognising Type 5 diabetes as a distinct category of the disease. Type 5 diabetes affects lean, undernourished young adults in low- and middle-income countries.
The vote to endorse the category took place on April 8, during the International Diabetes Federation’s (IDF’s) World Diabetes Congress, held in Bangkok, Thailand.
“The recognition of type 5 diabetes marks a historic shift in how we approach diabetes globally. For too long, this condition has gone unrecognized, affecting millions of people and depriving them of access to adapted care,” said IDF President Peter Schwarz, while announcing the new classification.
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The Type 5 diabetes was first reported in Jamaica as J-type diabetes in 1955. In 1985, the WHO classified the condition as “malnutrition-related diabetes mellitus” which was subsequently removed in 1999 for lack of evidence. Subsequently it was reported in many other countries, such as India, Sri Lanka, Bangladesh, Uganda, Ethiopia, Rwanda, and Korea, with a current estimate of 25 million people affected globally.
Recent research has brought renewed attention to the impact of malnutrition on pancreatic development and insulin function, particularly in individuals with poor nutrition in childhood or early adulthood. This research has led to the re-classification of malnutrition-related diabetes as Type 5.
Malnutrition-related diabetes is seen most commonly in young men in low- and middle-income countries (LMICs) who have a body mass index < 19. Key symptoms include extreme fatigue, weight loss, and frequent infections, often mistaken for other diabetes types.
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Unlike Type 1 diabetes, driven by autoimmune destruction of insulin-producing cells, or Type 2, characterized by insulin resistance, Type 5 stems from malnutrition-induced damage to pancreatic beta cells. This leads to insulin secretion levels up to 70% lower than in healthy individuals. People with type 5 diabetes are insulin deficient, but not insulin resistant.
The IDF estimates that between 20 to 25 million people around the world may be suffering from this form of diabetes. It is most prevalent in Asia and Africa.
