When we think of diabetes, we usually think of two types—Type 1 and Type 2. But now, a lesser-known and often overlooked form of diabetes, linked to malnutrition, is making headlines again. It has been officially named Type 5 Diabetes, and though it was first recorded over 70 years ago, it’s only now gaining global recognition.
This rare form of diabetes was highlighted at the recent World Diabetes Congress held by the International Diabetes Federation (IDF) in Bangkok, Thailand. The event drew attention to a condition that has long been misunderstood, especially in lower-income regions of the world.
What is Type 5 Diabetes?
Type 5 Diabetes is a form of diabetes directly linked to chronic undernutrition. Unlike Type 2 diabetes, which is usually caused by obesity and poor lifestyle choices, or Type 1, which is an autoimmune condition, Type 5 diabetes affects underweight teenagers and young adults—primarily in low- and middle-income countries.
People with this form of diabetes are often very thin, have suffered from long-term malnutrition, and come from regions like South Asia and Sub-Saharan Africa. Experts estimate that 20 to 25 million people worldwide may be living with Type 5 diabetes, many of them undiagnosed.
The History Behind It
This condition isn’t new. It was first reported back in 1955 in Jamaica and initially referred to as J-type diabetes. By the 1960s, similar cases were being observed in parts of India, Pakistan, and Africa, especially among malnourished populations. In 1985, the World Health Organization (WHO) recognized it as a distinct form of diabetes. However, in 1999, due to lack of sufficient follow-up studies and clear diagnostic criteria, the condition was dropped from classification systems.
Fast forward to today, and researchers have finally begun to revisit and better understand this neglected disease. It has now been formally reintroduced as Type 5 diabetes.
Why It’s Dangerous and Hard to Treat
The real danger of Type 5 diabetes lies in how different it is from other forms—and how often it’s misdiagnosed or misunderstood.
For example, patients with Type 1 diabetes rely on insulin injections because their bodies can’t produce insulin. However, in the case of Type 5, insulin treatment can actually be harmful. That’s because these patients may not have severe insulin resistance like those with Type 2 diabetes, nor do they completely lack insulin production like Type 1 patients. Instead, they have a specific defect in how their body secretes insulin, which standard treatments don’t address.
In fact, using insulin in Type 5 patients can sometimes cause dangerously low blood sugar, which is life-threatening. This makes treatment extremely tricky.
How It Differs from Type 2 Diabetes
A recent study published in 2022 confirmed that Type 5 diabetes is fundamentally different from Type 2. While Type 2 is usually a result of obesity, poor diet, and lack of exercise, Type 5 stems from the long-term effects of malnutrition. The body, weakened by years of nutrient deficiency, struggles to maintain normal insulin function—despite not having excess body fat.
Unfortunately, because many doctors are unfamiliar with Type 5, they often misdiagnose it as either Type 1 or Type 2 and prescribe incorrect treatments. As a result, many patients don’t survive beyond a year after diagnosis.
Why the Delay in Recognition?
One of the main reasons Type 5 diabetes has been ignored for so long is the lack of a formal name and diagnostic criteria. Without these, it’s been incredibly difficult for doctors to identify, track, or treat patients effectively.
Now that the IDF has officially recognized Type 5 diabetes, steps are being taken to change this. A special working group has been created to:
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Develop official diagnostic guidelines
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Establish global treatment protocols
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Create a registry to help researchers track and study cases
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Build educational programs for healthcare providers around the world
These efforts are crucial in ensuring that people suffering from this condition get the care they need—before it’s too late.
Why This Matters
The resurgence of interest in Type 5 diabetes couldn’t come at a better time. Rates of malnutrition, especially in lower-income countries, continue to be a major health challenge. While diseases like tuberculosis and HIV/AIDS receive global attention and funding, Type 5 diabetes has slipped through the cracks—despite affecting as many people.
Experts believe that with better awareness and research, millions of lives could be saved. But the first step is making sure people, especially doctors and public health professionals, know that Type 5 diabetes exists, and that it’s not just a variation of the more common forms.
Looking Ahead
Over the next two years, the IDF working group will focus on creating clear diagnostic and treatment plans for Type 5 diabetes. This will include:
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Defining diagnostic criteria based on clinical signs, blood tests, and patient history
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Recommending treatment options that don’t rely heavily on insulin
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Launching global collaborations to study this condition in more depth
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Training healthcare workers to identify and manage it
As more countries begin to include Type 5 diabetes in their health surveillance systems, there is hope that this once-forgotten disease will finally receive the attention and resources it needs.
