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What is Type 5 Diabetes?
“Type 5 diabetes is a recently recognized form of diabetes, known as malnutrition-related diabetes, which mainly affects lean and malnourished teenagers and young adults in low- and middle-income countries.“
In a major step forward, the International Diabetes Federation (IDF) has officially recognized Type 5 diabetes—also known as malnutrition-related diabetes—as a distinct form of the disease. This condition, which primarily affects lean, undernourished teens and young adults in low- and middle-income countries, has long been misunderstood and misclassified under the more commonly known types: Type 1 or Type 2. Type 5 diabetes is distinct from type 1 and type 2 diabetes due to its unique causes, symptoms, and treatment approaches.
At Esteve Pharma, we are committed to advancing diabetes care in India and beyond. In this article, we explore the history, causes, and symptoms of type 5 diabetes, shedding light on this underdiagnosed condition and how it impacts millions globally.
Type 5 Diabetes:
Type 5 diabetes is a unique form of diabetes seen mainly in people who have experienced long-term undernutrition, especially during their early years of life. It’s been around for decades—particularly in parts of Asia and Africa—but has often been misdiagnosed or overlooked.
Unlike Type 2 diabetes, which is linked to obesity and insulin resistance, Type 5 diabetes results from a poorly developed pancreas. Why? Because of chronic malnutrition in childhood. The pancreas doesn’t produce enough insulin—not because of autoimmune destruction like in Type 1, and not due to insulin resistance like in Type 2.
That’s what makes this condition so unique and different.
How Type 5 Diabetes Differs from Type 1 and Type 2
Understanding the differences between diabetes types is crucial for accurate diagnosis and treatment. Below is a comparison:
| Type | Main Cause | Body Type | Insulin Function |
|---|---|---|---|
| Type 1 | Autoimmune attack on pancreas | Often lean | No insulin production |
| Type 2 | Obesity and insulin resistance | Often overweight | Insulin doesn’t work well |
| Type 5 | Malnutrition and poor pancreatic development | Lean and undernourished | Low insulin, but body responds well to it |
The History and Recognition of Type 5 Diabetes
Type 5 diabetes was first described in Jamaica in 1955 as a form of diabetes affecting malnourished individuals.
In 1985, the World Health Organization (WHO) classified it as malnutrition-related diabetes mellitus. However, it wasn’t until April 2025 that the IDF formally recognized it as “type 5 diabetes” following advocacy from researchers like Dr. Meredith Hawkins of the Albert Einstein College of Medicine.
This recognition is a game-changer for global health. It highlights the need for tailored treatments for individuals in low- and middle-income countries, where malnutrition and poverty exacerbate diabetes risks.
The IDF’s endorsement also calls for increased research and funding to address this condition, particularly in regions like South Asia and Sub-Saharan Africa.
Timeline:
| Year | Event |
|---|---|
| 2005 | Dr. Meredith Hawkins first learns about unusual diabetes cases during global health meetings. Doctors report young, lean patients who don’t fit the typical patterns of type 1 or type 2 diabetes. |
| 2010 | Dr. Hawkins establishes the Global Diabetes Institute at Albert Einstein College of Medicine to investigate the causes of malnutrition-related diabetes and to improve treatment strategies. |
| 2022 | A groundbreaking study by Dr. Hawkins and her team at Christian Medical College, Vellore is published in Diabetes Care. It confirms that this form of diabetes is due to low insulin secretion, not insulin resistance. |
| January 2025 | An international meeting is held in India to discuss the classification and management of malnutrition-related diabetes. Global experts and organizations participate. |
| January 2025 | The panel, including heads of the IDF and ADA, votes unanimously to recognize malnutrition-related diabetes as a distinct type. |
| 2025 (Later) | The decision is officially endorsed at the IDF World Diabetes Congress in Bangkok, establishing global recognition of this condition as Type 5 Diabetes. |
In January 2025, a landmark meeting took place in India, where diabetes experts from around the world—including leaders from the IDF and American Diabetes Association—came together to examine new data.
After strong presentations from countries across Asia and Africa, the group unanimously voted to recognize malnutrition-related diabetes as a separate category: Type 5 diabetes.
This decision was later confirmed at the IDF Congress in Bangkok, making it official.
Causes and Risk Factors of Type 5 Diabetes
Unlike type 1 diabetes (autoimmune) or type 2 diabetes (insulin resistance), type 5 diabetes is driven by chronic malnutrition and environmental factors. Key causes and risk factors include:
- Chronic Malnutrition: Prolonged undernutrition, especially protein and micronutrient deficiencies, impairs insulin secretion and glucose metabolism.
- Low Body Mass Index (BMI): Type 5 diabetes typically affects individuals with a BMI below 19, unlike type 2 diabetes, which is often linked to obesity.
- Poverty and Food Insecurity: Limited access to nutritious food in LMICs increases risk, particularly among young men aged 15–30.
- Micronutrient Deficiencies: Lack of zinc, magnesium, or vitamin A may contribute to pancreatic dysfunction.
- Geographic Prevalence: Type 5 diabetes is more common in tropical and subtropical regions, including India, Bangladesh, and parts of Africa.
Research by Dr. Hawkins and the Global Diabetes Institute suggests that type 5 diabetes may result from a defective insulin secretion mechanism, distinct from the autoimmune destruction seen in type 1 diabetes.
Symptoms and Diagnosis of Type 5 Diabetes
Symptoms:
Type 5 diabetes presents unique symptoms that can be mistaken for type 1 or type 2 diabetes. Common signs include:
- High blood glucose levels without ketoacidosis (unlike type 1).
- Extreme thirst and frequent urination.
- Unexplained weight loss despite normal or increased appetite.
- Fatigue and weakness due to malnutrition.
- Slow-healing wounds or frequent infections.
Because symptoms overlap with other diabetes types, misdiagnosis is common, especially in resource-limited settings.
Diagnosis:
- Diagnosing type 5 diabetes requires a combination of clinical and laboratory assessments:
- Blood Tests: Elevated fasting blood glucose (>126 mg/dL) or HbA1c (>6.5%) without ketosis.
- Immunogenetic Analysis: Absence of autoimmune markers (e.g., GAD antibodies) rules out type 1 diabetes.
- Nutritional Assessment: Low BMI, protein deficiency, or micronutrient imbalances support a type 5 diagnosis.
- Clinical History: History of malnutrition or residence in high-risk regions.
Experts estimate that 20 to 25 million people worldwide are living with Type 5 diabetes, mostly in developing countries. That’s a massive number of people who could benefit from better diagnosis, treatment, and care.
As Dr. Hawkins, an endocrinologist who has studied the condition for years says:
“Malnutrition-related diabetes has historically been vastly under-diagnosed and poorly understood. By recognizing it as Type 5 diabetes, we’re giving a voice and a path forward to millions who were previously left behind.“
Dr. Schwarz, one of the global diabetes advocates, summed it up perfectly:
“This is about equity, science, and saving lives.”
What’s Next for Type 5 Diabetes?
Recognition is just the beginning. Now, the focus is on:
Spreading awareness—so healthcare professionals and patients can recognize it early.
Developing treatment guidelines—to ensure accurate diagnosis and affordable treatment.
Creating a global research registry—to gather more data and track patients.
Training health workers—especially in low-resource settings.
A Type 5 Diabetes Working Group has already been formed to lead these efforts.
If you’re a doctor, healthcare worker, student, or just someone who cares about global health—this is your chance to help spread the word.
Type 5 diabetes is real. It’s different. And with the right attention, it can be better diagnosed and treated, giving hope to millions who need it most.
FAQs About Type 5 Diabetes
1. What is type 5 diabetes?
Type 5 diabetes, or malnutrition-related diabetes, is a form of diabetes caused by chronic malnutrition, primarily affecting lean individuals in LMICs. It was recognized by the IDF in 2025.
Type 5 diabetes, or malnutrition-related diabetes, is a form of diabetes caused by chronic malnutrition, primarily affecting lean individuals in LMICs. It was recognized by the IDF in 2025.
2. How is type 5 diabetes different from type 1 and type 2?
Unlike type 1 (autoimmune) or type 2 (insulin resistance), type 5 diabetes results from malnutrition and defective insulin secretion, with no ketosis and a low BMI.
Unlike type 1 (autoimmune) or type 2 (insulin resistance), type 5 diabetes results from malnutrition and defective insulin secretion, with no ketosis and a low BMI.
3. Who is at risk for type 5 diabetes?
Young adults in LMICs with low BMI, chronic malnutrition, or food insecurity are at highest risk, especially in regions like India and Africa.
Young adults in LMICs with low BMI, chronic malnutrition, or food insecurity are at highest risk, especially in regions like India and Africa.
4. Can type 5 diabetes be cured?
While not curable, type 5 diabetes can be managed with insulin, nutritional rehabilitation, and lifestyle changes to achieve stable blood sugar levels.
While not curable, type 5 diabetes can be managed with insulin, nutritional rehabilitation, and lifestyle changes to achieve stable blood sugar levels.
Expert
April 23, 2025Esteve Pharma could be more comprehensive in acknowledging the names of the Indian researchers who have done ground breaking research at the Christian Medical College Vellore over the last 20 years. Without those efforts, this form of diabetes would have never been recognized.
Admin
April 23, 2025Thank you for your valuable suggestion. We truly appreciate your input and recognize the importance of acknowledging the contributions of Indian researchers. We will certainly look into the groundbreaking work done at Christian Medical College, Vellore, and incorporate this information after conducting proper research. Your feedback helps us improve the quality and depth of our content.