Why in 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.

What’s in Today’s Article?

• About Type 5 Diabetes
• Markers of Type 5 Diabetes
• Treatment Approaches

About Type 5 Diabetes

• It 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 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.