Understanding Type 5 Diabetes: A landmark recognition in global health
Image: Artem Podrez / Pexels
In a landmark announcement at the International Diabetes Federation (IDF) World Diabetes Congress 2025 in Bangkok, Thailand, a new category of diabetes, Type 5 Diabetes, was formally recognised by global health experts.
This classification represents a long-overdue acknowledgement of a form of diabetes that affects millions but has remained underdiagnosed and misclassified for decades.
'The recognition of Type 5 diabetes marks a historic shift in how we approach diabetes globally. This is about equity, science, and saving lives,' says Professor Peter Schwarz, President of the IDF.
What is type 5 diabetes?
Type 5 diabetes, also known as malnutrition-related diabetes, is a newly classified form of diabetes driven primarily by chronic undernutrition, especially during the formative years of childhood and adolescence.
The condition leads to impaired development of the pancreas, resulting in severe insulin deficiency.
Unlike other types of diabetes, however, this form is not caused by autoimmunity, as in Type 1, or insulin resistance, as in Type 2.
Who is affected?
Type 5 diabetes is estimated to impact 20–25 million people worldwide, particularly in low- and middle-income countries (LMICs) across Asia and Africa.
Those affected are often teens and young adults, lean or underweight individuals and those living in resource-limited settings.
Because of its unique characteristics, it has often been misclassified as either Type 1 or Type 2 diabetes in clinical settings, leading to inappropriate treatment strategies.
A major focus of the new IDF Working Group on Type 5 Diabetes, led by Dr. Meredith Hawkins (Albert Einstein College of Medicine, USA) and Dr. Nihal Thomas (Christian Medical College, India), is to: Develop formal diagnostic criteria
Establish a global patient registry
Create educational materials for health workers in LMICs
Explore cost-effective therapies
Here's a breakdown of all types of diabetes
Type 1 diabetes Cause: Autoimmune destruction of insulin-producing beta cells
Onset: Typically in children and young adults
Insulin resistance: Absent
Treatment: Lifelong insulin therapy
Prevalence: 5–10% of all diabetes cases
Type 2 diabetes Cause: Insulin resistance and eventual insulin production decline
Onset: Usually adulthood, but increasingly seen in youth
Risk factors: Obesity, sedentary lifestyle, genetics
Treatment: Diet, exercise, oral meds, sometimes insulin
Prevalence: ~90% of all diabetes cases
Gestational diabetes Cause: Hormonal changes during pregnancy leading to insulin resistance
Onset: During pregnancy
Risk: Increased future risk of Type 2 diabetes for both mother and child
Treatment: Diet, exercise, insulin if needed
Monogenic diabetes Cause: Single gene mutations affecting insulin production
Onset: Often in childhood or young adulthood
Treatment: Varies because some forms are responsive to sulfonylureas
Type 3c diabetes Cause: Damage to the pancreas (e.g., pancreatitis, cancer, surgery)
Onset: Variable, depending on pancreatic disease
Treatment: Insulin and enzyme replacement
Type 5 diabetes (new) Cause: Chronic malnutrition impairs pancreatic development
Onset: Teens and young adults, especially in LMICs
Insulin resistance: Low
Treatment: Often oral medications; tailored to resource availability
Prevalence: 20–25 million globally (mostly unrecognised)
The recognition of Type 5 Diabetes is more than just a medical milestone, it is a step toward health equity for the millions of people in developing regions who have lacked proper diagnosis and care.
The evolution of diabetes classification reflects the growing understanding that diabetes is not a one-size-fits-all disease.
With Type 5 diabetes now formally recognised, global healthcare systems have an opportunity, and a responsibility, to adapt diabetes care to diverse populations and unique socioeconomic contexts.
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