Type 5 Diabetes Has Officially Been Recognized — Here's How It Differs From Other Types

From huffingtonpost.co.uk 

By Ashley Broadwater

Doctors and researchers are learning more about this often-misdiagnosed health issue

You’ve probably already heard of Type 1 diabetes and Type 2 diabetes. More than 38 million Americans have diabetes, and 90% to 95% of those individuals have Type 2. While the two types are notably different, diabetes is essentially a disease in which the body struggles to regulate blood sugar levels.

Unlike Type 1 and Type 2, a Type 5 diabetes diagnosis is new. The International Diabetes Federation officially recognized Type 5 diabetes in 2025, and research estimates that up to 25 million people have it.

So what is this condition that so many people have, and that so many of us don’t know about?

“Type 5 diabetes is a newly recognized form of diabetes that emerges primarily from chronic undernutrition, especially during early life, rather than autoimmune destruction like Type 1 or insulin resistance driven by obesity like Type 2,” said Dr. Ken Berry, a family physician who helps patients with obesity, insulin resistance and Type 2 diabetes.

Dr. Yoon Kook Kim, a board-certified endocrinologist at UM St. Joseph Medical Group, explained how it develops: “It is thought that a long-term, early exposure to undernutrition leads to underdevelopment of the pancreas, which is crucial to insulin delivery and production,” he said. “This leads to a state of inadequate insulin production, which in turn leads to uncontrolled and high blood sugar levels.”

Yana Iskayeva via Getty Images

Type 5 diabetes is an under-recognized issue, but millions likely are living with it.

Ahead, these two doctors explain more about how Type 5 diabetes differs from Type 1 and Type 2, as well as other need-to-know information about the condition.

How Does Type 5 Diabetes Differ From Type 1 And Type 2?

As mentioned, Type 5 diabetes stems from long-term undernutrition, particularly in a person’s formative years. That’s what makes it different from Type 1 and Type 2.

“In Type 1 diabetes, the immune system attacks the pancreatic beta cells, and insulin production collapses,” Berry said. “In Type 2 diabetes, the body becomes resistant to insulin and, over time, the pancreas cannot keep up.”

He added to his explanation of Type 5 diabetes, saying, “Type 5 diabetes, by contrast, involves a defect in insulin production, too, but the trigger is undernutrition impairing the pancreas early on rather than autoimmunity or obesity.”

So all types of diabetes involve a pancreatic issue, but the difference is how it starts.

While the differences are clear, they’re also, well, not — or at least weren’t in the past. “Many people with Type 5 diabetes have historically been misclassified as Type 1 or Type 2, and that misclassification can lead to poor treatment outcomes,” Berry said.

Who Typically Has Type 5 Diabetes?

As with many health conditions, and due to the causes and risk factors, some people are more likely than others to have Type 5 diabetes.

“As the condition is largely due to undernutrition during early stages of life, Type 5 diabetes is found more commonly in patients who had chronic significant malnutrition during childhood or adolescence,” Kim said.

“It is most commonly seen in low- and middle-income countries, especially in parts of Asia and Africa,” Berry added. “Because awareness is still emerging, it may also affect marginalized or food-insecure populations in higher-income countries, though this is less well-documented at this time.”

What Are The Signs Of Type 5 Diabetes?

Type 5 diabetes symptoms aren’t much different from the symptoms of Type 1 and Type 2, including increased thirst, frequent urination, elevated blood glucose levels, fatigue and weight loss.

Kim explained that diabetes symptoms are tied to blood sugar levels.

There are distinguishing features between the three types, however. “The individual may be underweight and may have had poor early nutrition,” Berry said. “Because the insulin-secretion defect is the primary issue, rather than insulin resistance, the pattern of disease is different, with less likelihood of ketosis (unlike classic Type 1) despite high blood sugar.”

Ketosis is when your body uses its fat (instead of blood sugar) as fuel and energy. Symptoms include an upset stomach, headache, fatigue, bad breath, insomnia, dehydration, low bone density, high cholesterol and kidney stones.

When To See A Doctor About Type 5 Diabetes

Some of the signs mentioned above come and go by themselves (aka aren’t necessarily a case of diabetes) or are caused by other factors. So, is seeing a doctor all that crucial? At what point?

The answer: earlier than you might think.

“Anyone experiencing classic diabetes symptoms such as thirst, increased urination, unexplained weight loss or failure to gain weight should see a doctor,” Berry said.

With Type 5 diabetes, he also believed there are extra reasons to act early, such as:

• Having a history of undernutrition or chronic food insecurity, particularly during childhood or adolescence
• Being at a “healthy” or low weight, and showing signs of elevated blood sugar
• Being treated for Type 1 or Type 2 diabetes, and that treatment not working as expected (such as needing very low doses of insulin or not following the usual pattern)

“Misdiagnosis is common,” Berry added. “Early evaluation is key because correct diagnosis helps tailor treatment, and misclassification can lead to overtreatment or undertreatment.”

Kim largely agreed and spoke to certain risk factors. For example, a history of significant and long-term malnutrition at a young age makes a Type 5 diabetes diagnosis more likely.

“Of those patients, if you have been diagnosed with diabetes already, but have had significant challenges in getting better control of the blood sugars despite being on a relatively healthy diet with lower carbohydrate intake and [on] medications typically used for Type 2 diabetes, [you] should consider this,” he continued.

What Treatment Looks Like For Type 5 Diabetes

What exactly does treatment entail for Type 5 diabetes? The answer isn’t crystal clear — yet. “Treatment is still evolving because the formal guidelines for Type 5 are in development,” Berry said.

At least currently, it can look similar to Type 1 and Type 2 treatment, though. “As Type 5 diabetes is in some ways closer to early-stage Type 1 diabetes in that there is an underproduction of insulin rather than resistance to insulin, insulin therapy can be quite helpful,” Kim said. “Some medications traditionally used in Type 2 diabetes can also be helpful in helping the lower amounts of insulin ‘work more efficiently.’”

Precautions have to be taken, however, and differences do exist. Right now, Berry said treatment also includes the following:

• Addressing underlying nutritional deficits by improving protein intake, correcting micronutrient deficiencies and supporting overall metabolic health
• Tailoring glucose-lowering therapy carefully — using too much or too little insulin can be dangerous, and the “right” amount will look different for Type 5 cases
• Considering the use of oral medications or other therapies that target beta-cell function rather than just insulin resistance

Treatment is advancing, too, as research continues. Berry has seen diagnostic criteria and treatment protocols for Type 5 specifically, global health efforts to raise awareness and an emerging interest in precision medicine that tailors diabetes support.

Kim felt encouraged about these advancements and also noted that the International Diabetes Federation had launched a new work group for Type 5 diabetes.

“With this increased awareness and studies, we can also hope for more targeted treatment options for Type 5 diabetes in the future,” he said.

https://www.huffingtonpost.co.uk/entry/type-5-diabetes-signs-symptoms_l_69406860e4b043da371d2a3a

How Quickly Can You Lower Your A1C if You Have Type 2 Diabetes?

From everydayhealth.com

It can take time to reduce your average blood glucose levels and, as a result, get a lower haemoglobin A1C test result when you have type 2 diabetes. An A1C test measures your average blood sugar level, generally reflecting the prior three months before your test.

“This three-month interval is based on the average lifespan of a red blood cell,” says Bethany Gottesman, MD, an endocrinologist at Phoenix Children’s Hospital in Arizona. The A1C test gives clues to how much glucose in the blood is “sticking” to haemoglobin molecules (proteins) in your red blood cells, says Dr. Gottesman.

So as your blood sugar improves and your body replaces red blood cells, your A1C drops. Here, find out how long it may take to lower your average blood glucose and, in turn, reduce your A1C level.

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How Soon Can You Lower Your A1C?

Guidelines for measuring A1C suggest having this test every three to six months, so it’s hard to know how A1C levels behave before the three-month mark. Red blood cells don't get replaced all at once — some fraction are getting recycled all the time, says Gillian Goddard, MD, an endocrinologist and an adjunct assistant professor of medicine at the NYU Grossman School of Medicine in New York City.

Medications for type 2 diabetes can lower blood sugar quickly; some may even work within days.

 “But to see the full effect of a new [treatment], you need to wait the 90 days it will take for all the red blood cells to get recycled and replaced with new ones,” Dr. Goddard says.

“However, the good news is that A1C is influenced more heavily by recent blood sugar levels,” says the endocrinologist Betul Hatipoglu, MD, a professor at the School of Medicine at Case Western Reserve University and the director of Case Center for Diabetes, Obesity, and Metabolism in Cleveland. “With consistent changes in treatment and lifestyle, improvement can begin within a few weeks, although we typically wait about three months to see the full effect.”

Factors That Affect How Quickly You Can Lower Your A1C

Your average blood sugar is the main driving factor in how fast your A1C drops, says Gottesman. Less sugar in your bloodstream means less to attach to the red blood cells over time and add to the A1C measure, she says.

According to Dr. Hatipoglu, these factors also play a role in how fast your A1C can drop:

• Your A1C level when treatment starts
• Diabetes severity
• How long you have had diabetes
• How much insulin your body still makes
• The treatment you’re on
• How consistently blood sugar levels improve

“Someone with a higher starting A1C may see a larger initial reduction, particularly when effective medications are combined with changes in nutrition, physical activity, and weight management,” says Hatipoglu.

Lots of factors cause individual variation, including stress and hormones. And other health conditions, like anaemia, blood disorders that affect haemoglobin, and chronic kidney disease can also push your A1C results lower or higher. “In these situations, glucose monitoring provides additional information,” says Hatipoglu.

Tips for Lowering Your A1C as Quickly as Possible

The best method to lower your A1C uses a combination of medication, exercise, and good nutrition.

Take Your Medications as Prescribed

Your provider may prescribe oral medications like metformin (Glucophage XR, Glumetza, Fortamet), insulin injections, GLP-1 receptor agonists (Ozempic, Trulicity), or SGLT-2 inhibitors (Jardiance, Brenzavvy) to help you manage your blood sugar. “The fastest way to lower A1C is with insulin,” says Goddard. “However, insulin has some drawbacks, including that it can cause low blood sugars and weight gain.”

The best approach combines medication with nutrition, physical activity, and consistent follow-up with your provider, says Hatipoglu.

Adjust Your Diet

The food you eat has a huge impact on your blood sugar levels. Focus on eating a healthy diabetic diet that is rich in whole grains as well as fibre and protein, and avoid processed sugars that tend to raise blood sugar quickly, says Gottesman.

Your provider or dietitian may give you a few tools to help you balance your diet. These may include:

Carbohydrate counting: Carbs are broken down into sugar in your blood, so keeping detailed track of how many you eat and drink can help you limit yourself and give the right dose of insulin.

Plate method: Using a nine-inch-diameter plate, fill half with low-starch vegetables, a quarter with lean protein, and a quarter with healthy carbohydrates. Here are some examples of each:

Low-starch or nonstarchy vegetables

Lean protein

Healthy carbs

Leafy greens


Fish, shellfish


Whole-grain bread, pasta, and rice


Zucchini, yellow squash


Beans, lentils, tofu


Fruits

Broccoli, cauliflower


Eggs

Low-fat yogurt


Tomatoes, eggplant


Low-fat meats


Starchy vegetables (sweet potatoes, green peas, or acorn squash)


Green beans, snow peas


Poultry

Beans

Learn what healthy portion sizes look like for your favourite foods, and follow those guidelines. Avoid soda, juice, and other high-sugar drinks. “Reducing sugary drinks and refined carbohydrates can improve blood sugar within days,” says Hatipoglu.

Alcohol can also make your blood sugar fluctuate, so it’s best to stick with a maximum of one drink a day for women, two for men.

Add Exercise to Your Day

Exercise increases your insulin sensitivity, which means the insulin in your body works better to use the sugar in your blood for energy. “The activity part is particularly important after meals to help the body more effectively utilize the glucose in the food,” says Gottesman.

Research suggests that even a 10-minute walk after lunch may prevent your blood sugar from spiking. And consistent exercise can lower your A1C.

Regular exercise can also help you lose weight, which can make it easier to manage blood sugar levels. Try for 30 minutes a day of moderate-intensity aerobic exercise like walking or cycling most days, plus muscle-strengthening exercises two to three times a week. Your provider can help you develop a safe and effective exercise plan.

Get Better Sleep

Your body may have a harder time managing blood sugar when you don’t get enough sleep. Set yourself up for sleep success by adopting these healthy sleep habits.

• Avoid screens and intense activity an hour or so before bed.
• Eat only light snacks (no heavy meals) near bedtime.
• Follow a calming bedtime routine to prepare your mind for sleep.
• Stop drinking caffeine and alcohol several hours before you want to go to bed.
• Make your sleep space comfortable, cool, and dark.

How to Manage A1C Goals and Expectations

Hatipoglu encourages people not to focus exclusively on how quickly they can lower their A1C. “The goal is to improve blood sugar safely and maintain those improvements over time,” she says.

Goddard agrees, and says it’s often better to lower A1C over several months with your doctor’s adjustments to one or two medications that don't cause low blood sugars, like metformin or GLP-1s, which are medications that help you lose weight and increase the release of insulin to manage diabetes.

“I also want people to understand that progress doesn't have to wait for the next A1C test,” says Hatipoglu. She sees improvements in daily glucose levels, energy, and healthy habits as meaningful steps toward better metabolic health.

“The goal isn't simply to achieve a lower number,” says Hatipoglu. “It's to understand what works for your body and build changes you can sustain.”

The Takeaway

• A haemoglobin A1C blood test shows your average blood sugar over the past two to three months, and you can expect to have this test every three to six months.
• Your blood sugar levels can decrease within days of starting a new treatment, but healthcare providers typically wait 90 days to check your A1C, to get a more accurate picture of your progress.
• You can promote lower blood sugar by following your treatment plan, eating a healthy diabetes-friendly diet, and exercising regularly.

https://www.everydayhealth.com/type-2-diabetes/how-quickly-can-you-lower-your-a1c/

Low-fat vegan diet can cut liver fat by a third and improve insulin function in adults with type 2 diabetes

From medicalxpress.com

By Physicians Committee for Responsible Medicine 

Adults with type 2 diabetes who followed a low-fat vegan diet for 16 weeks, eating as much as they wanted, with no calorie counting or portion control, lost weight, reduced fat build-up in the liver and abdomen and improved insulin sensitivity and beta-cell function, according to a new clinical trial published in BMJ Open Diabetes Research & Care.

The study, led by researchers at the Physicians Committee for Responsible Medicine in collaboration with the Yale School of Medicine, is the first to simultaneously measure liver fat, muscle fat, visceral fat and tissue advanced glycation end products (AGEs) in a single plant-based dietary intervention in people with type 2 diabetes, offering a more complete picture of how diet reverses the underlying mechanisms that drive the disease.

Credit: Unsplash/CC0 Public Domain

"For years, people with diabetes have been told to count calories and measure portions. This study shows that a simple shift in what you eat—toward vegetables, whole grains, legumes and fruit—can reduce the fat clogging the liver by a third and improve how the pancreas makes insulin, without anyone having to count a single calorie," said Hana Kahleova, M.D., Ph.D., the lead author of the study and director of clinical research at the Physicians Committee for Responsible Medicine.

Key findings include:

• Body weight fell by an average of 6.0 kg (13.2 pounds) (6.6%), driven mainly by loss of fat mass (-4.2 kg (-9.3 pounds)); visceral (abdominal) fat volume dropped by 290 cm³.
• Hepatocellular (liver) lipid content, a key driver of insulin resistance, fell by 33%.
• Tissue accumulation of advanced glycation end products (AGEs), which contribute to insulin resistance and beta-cell damage, decreased significantly.
• Insulin resistance (HOMA-IR) improved, and insulin sensitivity (OGIS and PREDIM) increased.
• Multiple markers of pancreatic beta-cell function improved, including glucose-stimulated insulin secretion, beta-cell glucose sensitivity, rate sensitivity and potentiation factor.
• HbA1c fell by 1.0 percentage point, and total and LDL cholesterol both decreased significantly.
• These changes occurred without a prescribed calorie target; participants were counselled to eat to satiety on a low-fat, plant-based diet (about 75% of calories from carbohydrates, 15% from protein and 10% from fat).

"This research adds to a growing body of evidence that food can work like medicine for people with diabetes. When patients don't have to weigh their portions or track every calorie, healthy eating becomes something they can actually sustain, and that is when we see real, lasting metabolic change," said Kahleova.

More information

Hana Kahleova et al, Changes in ectopic lipids, insulin sensitivity, and beta cell function after a low-fat vegan diet in adults with type 2 diabetes: a 16-week single-arm clinical trial, BMJ Open Diabetes Research & Care (2026). DOI: 10.1136/bmjdrc-2026-006472

https://medicalxpress.com/news/2026-10-fat-vegan-diet-liver-insulin.html

What is ‘Type 3 Diabetes’? Who’s Most at Risk

From newsweek.com

By Claire Dodds

Type 1 and Type 2 diabetes have long been studied by medical experts and are known as the most common types of diabetes.

However, research shows that there may be a third strain of diabetes, one that is particularly affecting certain groups.

In general, diabetes occurs when the body does not produce enough insulin or cells do not respond properly to insulin, leading to high blood sugar levels.

According to experts, patients with Alzheimer's disease may, actually, be experiencing a similar phenomenon, with some medical professionals referring to it as Type 3 diabetes.

"The term 'Type 3 diabetes' reflects the idea that Alzheimer's disease may involve a form of insulin resistance or impaired insulin signalling in the brain," Suzanne Craft, Ph.D., professor of gerontology and geriatric medicine and director of the Alzheimer’s Disease Research Center at Wake Forest University School of Medicine, told Newsweek.

"This differs from Type 1 diabetes, in which an autoimmune process prevents the pancreas from producing sufficient insulin, and Type 2 diabetes, in which the body becomes resistant to insulin and has difficulty regulating glucose metabolism." 

According to the Alzheimer's Society, patients with the condition may become resistant to insulin as their brains change.

"Nerve cells in the brain may become resistant to the effect of insulin. This may lead to the build-up of amyloid and tau proteins in the brain," the society explains.

Seemingly, this risk goes both ways, as diabetes has been suggested to put patients at a higher risk of developing dementia. 

"Some of the strongest evidence comes from large, long-term observational studies showing that adults with Type 2 diabetes have an increased risk of cognitive decline and dementia, including Alzheimer’s disease," Craft told Newsweek.

"There is also growing evidence that the risk begins before diabetes develops: people with prediabetes, insulin resistance and other forms of metabolic dysfunction also appear to be at increased risk."

However, according to the Alzheimer's Society, "it is important to note that diabetes is only a risk factor and does not mean that a person with diabetes will go on to develop dementia."

Jacob Wackerhausen

Often Misdiagnosed

Type 3 diabetes is not a new notion. A 2017 Newsweek article identified Type 3c diabetes as one caused by various types of damage to the pancreas.

"Type 3c diabetes is caused by damage to the pancreas from inflammation of the pancreas (pancreatitis), tumours of the pancreas, or pancreatic surgery," Newsweek reported at the time.

"This type of damage to the pancreas not only impairs the organ's ability to produce insulin, but also to produce the proteins needed to digest food (digestive enzymes) and other hormones."

The research noted that Type 3c diabetes was often misdiagnosed as Type 2 diabetes. However, this diagnosis is unrelated to the presentation of evidence for Type 3 diabetes relating to Alzheimer's disease.

Mitigating Risk

As scientific interest in this phenomenon develops, medical experts advise on a number of ways to mitigate diabetes risk.

"Regular physical activity is one of the most promising lifestyle interventions for reducing the risk of cognitive decline and dementia," Craft continues.

"Maintaining a healthy weight, eating a healthy diet and controlling cardiovascular risk factors such as blood pressure and cholesterol are also important.

"These approaches may be particularly powerful when combined rather than pursued individually."

Diabetes research is constantly changing, bringing to light new information on the treatment and management of this disease.

The idea of a third type of diabetes may have just been getting off the ground a decade ago, but continued research is helping doctors and patients alike learn more about what makes their insulin production systems tick.

https://www.newsweek.com/what-is-type-3-diabetes-whos-most-at-risk-12524607