Premium

Type 5 diabetes recognised as distinct form of disease: why is this significant?

Neglected for decades in research, and frequently misdiagnosed, it has taken a long time for Type 5 diabetes, caused by malnutrition-induced lowering of insulin production, to gain official recognition.

4 min readPuneUpdated: Apr 17, 2025 05:40 PM IST

Type 5 diabetes, diabetes, International Diabetes Federation, malnourished teenagers, Type 5 diabetes treatment, Indian express explained, explained news, current affairs

Type 5 diabetes is a form of diabetes affecting lean and malnourished teenagers and young adults in low- and middle-income countries.

Type 5 diabetes, which affects lean and undernourished young adults in low- and middle-income countries, has at last been officially recognised as a distinct form of the disease by the International Diabetes Federation (IDF).

Neglected for decades in research, and frequently misdiagnosed, it has taken a long time for Type 5 diabetes, caused by malnutrition-induced lowering of insulin production, to gain official recognition.

What is Type 5 diabetes?

Type 5 diabetes is a form of diabetes affecting lean and malnourished teenagers and young adults in low- and middle-income countries.

Dr Nihal Thomas, professor of endocrinology at Christian Medical College, Vellore, is among the members of the Type 5 Diabetes Working Group. He told The Indian Express that the disease causes pancreatic beta cells to function abnormally, leading to insufficient production of insulin.

This is unlike Type 2 diabetes, the most prevalent form of the disease, where the main problem is insulin resistance — while the pancreas continues to produce insulin, the body does not respond properly to the hormone.

The term ‘Type 5’ diabetes was introduced and endorsed by Prof Peter Schwarz, president of the IDF, in January this year. On April 7, it was officially recognised at the 75th World Congress for Diabetes in Bangkok.

However, this is not a new disease. It was first reported in Jamaica as early as 1955 under the moniker J-type diabetes. In 1985, the World Health Organization (WHO) classified the condition as “malnutrition-related diabetes mellitus”. But this classification was done away with in 1999 for the want of evidence of a causal link to malnutrition, which is among the definitive features of what is now known as Type 5 diabetes.

Story continues below this ad

It was subsequently reported in many countries, such as India, Sri Lanka, Bangladesh, Uganda, Ethiopia, Rwanda, and Korea, mostly in the Global South. It currently affects an estimated 25 million people globally.

Its official recognition comes on the back of recent research, which has brought renewed attention to the impact of malnutrition on pancreatic development and insulin function, particularly in individuals with poor nutrition in childhood and early adulthood.

What are markers of Type 5 diabetes?

According to Dr Thomas, this unique form of diabetes, observed in Asian Indians, has no evidence of autoimmune or genetic causes.

“Affected individuals have a significantly lower body-mass index (BMI) — of less than 18.5 kg/m2 — than those reported in previous Indian studies. Insulin secretion is severely reduced, much lower than typical Type 2 diabetes and just above levels seen in Type 1 Diabetes,” he said.

Story continues below this ad

“Body scans also reveal a substantially lower percentage of body fat compared to Type 2 diabetes cases. Additionally, dietary intake of proteins, fibre and essential micronutrients is significantly low,” Dr Thomas added.

So, what causes Type 5 diabetes?

Malnutrition. And it all begins in the womb.

Dr C S Yajnik, director, Diabetes Unit, KEM Hospital Pune, and a key member of the Type 5 Diabetes Working Group, explained how malnutrition begins in the mother’s womb.

“If a baby does not get the right amount of nutrition while growing in the womb, it can increase the risk of diabetes later in life. For a long time, many Indians were undernourished due to hard labour, colonisation, and famines. But in the past 50 years, with rapid urban growth and development, overeating has also become a problem. When a baby is under or over nourished before birth and then gains too much weight later, it can lead to Type 2 diabetes. But if the baby stays undernourished both before and after birth, it can lead to this malnutrition-related diabetes, or as now christened, Type 5 diabetes,” he said.

Story continues below this ad

How can Type 5 diabetes be treated?

Given it has only now been officially recognised, specific diagnostic criteria and therapeutic guidelines are yet to be finalised. This is what the aforementioned Working Group will be doing over the next two years, by looking at diverse populations, especially in low-income, low-resource settings.

According to Dr Thomas, a high protein diet is important. Depending on the person’s low BMI and physical activity levels, an adequate amount of carbs and fats are also needed to ensure weight gain.

“Anti-diabetic medicine or insulin is considered based on the level of glucose and the therapeutic response on a case-by-case basis,” he said.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More

Tags:
diabetes

Loading Recommendations...

Mar 06: Latest News

Live Blog