In a groundbreaking development for global health, the International Diabetes Federation (IDF) has officially recognized Type 5 diabetes as a distinct form of diabetes, marking a significant milestone in addressing a long-overlooked condition.
This recognition, formalized at the IDF World Diabetes Congress in Bangkok in April 2025, shines a spotlight on a form of diabetes linked to malnutrition, primarily affecting lean, undernourished individuals in low- and middle-income countries (LMICs).
Unlike the more commonly known Type 1 and Type 2 diabetes, Type 5 diabetes presents unique challenges and characteristics, necessitating tailored approaches to diagnosis, treatment, and research. This blog explores the significance of this recognition, the science behind Type 5 diabetes, and its implications for millions worldwide.
The Journey to Recognition: A Historical Perspective
The story of Type 5 diabetes is one of persistence and rediscovery. First documented in Jamaica in 1955 as “J-type diabetes,” this condition was observed in young, lean adults who were malnourished. By the 1960s, similar cases emerged in undernourished populations across India, Pakistan, and sub-Saharan Africa, hinting at a pattern tied to nutritional deficiencies.
In 1985, the World Health Organization (WHO) acknowledged malnutrition-related diabetes as a distinct entity, but this designation was retracted in 1999 due to insufficient follow-up studies and evidence to differentiate it clearly from other diabetes types.
The tide began to turn with renewed scientific interest in the 21st century. A pivotal 2022 study published in Diabetes Care by researchers at Christian Medical College in Vellore, India, led by Meredith Hawkins, demonstrated that malnutrition-related diabetes is fundamentally distinct from both Type 1 diabetes (an autoimmune condition) and Type 2 diabetes (often linked to obesity and insulin resistance).
This research highlighted a unique metabolic profile in affected individuals, characterized by a profound insulin secretion defect rather than the insulin resistance typical of Type 2 diabetes. These findings reignited global attention and set the stage for advocacy efforts to reclassify the condition.
The IDF’s decision to designate Type 5 diabetes was not made lightly. At the 2025 World Diabetes Congress, attendees unanimously voted to recognize malnutrition-related diabetes as a distinct form of the disease, a decision endorsed by IDF President Peter Schwarz.
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This landmark move was bolstered by decades of research, particularly from institutions like the Albert Einstein College of Medicine, where Hawkins serves as the founding director of the Global Diabetes Institute. The recognition addresses a critical gap in diabetes classification, ensuring that millions affected by this condition are no longer overlooked by healthcare systems designed primarily for Type 1 and Type 2 diabetes.
Understanding Type 5 Diabetes: Characteristics and Causes
Type 5 diabetes stands apart from other forms of diabetes due to its unique etiology and patient demographic. Unlike Type 1 diabetes, which results from the immune system attacking insulin-producing beta cells, or Type 2 diabetes, which is often associated with lifestyle factors and obesity, Type 5 diabetes is closely tied to chronic malnutrition.
It predominantly affects lean teenagers and young adults in LMICs, particularly in regions like Asia and Africa, where an estimated 20 to 25 million people may be living with the condition.
The condition is believed to stem from a combination of genetic and environmental factors. Research suggests that a mutation in a single gene may play a role, impairing the pancreas’s ability to secrete insulin effectively. This defect is exacerbated by prolonged malnutrition, which deprives the body of essential nutrients needed for proper metabolic function.
Unlike Type 2 diabetes, where insulin resistance is the primary issue, Type 5 diabetes patients often exhibit low insulin production, making standard treatments less effective.
The symptoms of Type 5 diabetes can be subtle and easily misdiagnosed. Patients may experience typical diabetes symptoms such as excessive thirst, frequent urination, and fatigue, but their lean body mass and lack of obesity-related risk factors often lead clinicians to rule out Type 2 diabetes.
Without proper diagnostic tools, these individuals may be misclassified or left untreated, increasing the risk of complications like kidney failure, nerve damage, and cardiovascular disease. The IDF’s recognition aims to address this diagnostic challenge by encouraging the development of specific guidelines and testing protocols tailored to Type 5 diabetes.
The global burden of Type 5 diabetes is significant yet underreported. Its prevalence in impoverished nations mirrors the distribution of malnutrition, with countries in South Asia and sub-Saharan Africa bearing the brunt.
The condition’s designation as Type 5 diabetes is a call to action for healthcare systems to prioritize these underserved populations, ensuring that diagnostic and treatment resources reach those who need them most.
Implications for Global Health: Moving Forward
The IDF’s recognition of Type 5 diabetes as a distinct disease has far-reaching implications for global health policy, research, and patient care. One immediate outcome is the formation of a Type 5 diabetes working group, co-chaired by experts like Meredith Hawkins, tasked with developing diagnostic criteria and treatment strategies.
This initiative aims to equip healthcare professionals with the tools to accurately identify and manage the condition, reducing misdiagnoses and improving patient outcomes.
From a research perspective, the designation opens doors to targeted studies. Scientists can now focus on unraveling the genetic and nutritional underpinnings of Type 5 diabetes, potentially identifying therapies that address its unique insulin secretion defect.
Hawkins has suggested that dietary interventions, such as higher protein and lower carbohydrate intake, along with supplementation of deficient micronutrients, could be critical. However, these approaches require rigorous clinical trials to establish efficacy and safety, a process now supported by the IDF’s global mandate.
For patients, the recognition brings hope for better care and visibility. In LMICs, where healthcare resources are often stretched thin, Type 5 diabetes has historically been sidelined in favor of more prevalent conditions like tuberculosis or HIV/AIDS.
The IDF’s announcement signals a shift, urging governments and organizations to allocate resources to address this “silent epidemic.” Improved diagnosis could lead to earlier interventions, preventing the debilitating complications that disproportionately affect young adults in their prime.
Public health campaigns will also play a crucial role. Raising awareness about Type 5 diabetes among clinicians and communities is essential to overcome the stigma and misunderstanding surrounding diabetes in malnourished populations.
In many regions, diabetes is stereotyped as a disease of excess, making it harder for lean individuals to receive appropriate care. Educational efforts can bridge this gap, ensuring that Type 5 diabetes is understood as a legitimate and urgent health concern.
The recognition also underscores the broader link between nutrition and chronic disease. Type 5 diabetes serves as a stark reminder that malnutrition, often associated with hunger and wasting, can have complex metabolic consequences.
Addressing this condition requires not only medical interventions but also systemic efforts to combat poverty, improve food security, and ensure access to nutritious diets. The IDF’s move aligns with global health goals, such as the United Nations’ Sustainable Development Goals, which prioritize ending hunger and promoting well-being.
Economically, the burden of Type 5 diabetes cannot be ignored. In LMICs, where healthcare spending is already limited, untreated diabetes can lead to significant productivity losses and healthcare costs.
By investing in early diagnosis and management, countries can mitigate these impacts, fostering healthier and more resilient populations. International partnerships, including collaborations with organizations like the WHO, will be key to scaling up these efforts.
The road ahead is not without challenges. Developing affordable diagnostic tools and treatments for Type 5 diabetes in resource-constrained settings will require innovation and commitment.
Additionally, cultural and logistical barriers, such as limited healthcare access in rural areas, must be addressed to ensure equitable care. However, the IDF’s recognition provides a strong foundation, galvanizing stakeholders to tackle these issues collectively.
The official recognition of Type 5 diabetes by the International Diabetes Federation marks a turning point in the fight against a long-neglected global health challenge. By acknowledging malnutrition-related diabetes as a distinct disease, the IDF has paved the way for improved diagnosis, treatment, and research, offering hope to millions in low- and middle-income countries. The journey to this milestone reflects decades of scientific perseverance, culminating in a unified call to action at the 2025 World Diabetes Congress.
Understanding Type 5 diabetes—its unique characteristics, causes, and implications—is critical to addressing its global burden. As researchers, clinicians, and policymakers rally to develop targeted strategies, the focus must remain on the patients: young, lean individuals whose lives are disrupted by a condition rooted in malnutrition. This recognition is not just a scientific achievement but a moral imperative, urging the world to confront the inequities that fuel diseases like Type 5 diabetes.
As we move forward, the global health community has an opportunity to rewrite the narrative for millions. By combining cutting-edge research with compassionate care and systemic change, we can ensure that Type 5 diabetes is no longer a hidden epidemic but a manageable condition, allowing those affected to live healthier, fuller lives.
The IDF’s bold step is a beacon of progress, illuminating the path toward a more inclusive and equitable approach to diabetes care worldwide.