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

A Distinct New Type of Diabetes Is Now Officially Recognized

From sciencealert.com

The International Diabetes Federation (IDF) officially recognized a fifth form of diabetes in 2025, after decades of controversy.

It's now urging other health authorities, like the World Health Organization (WHO), to follow suit.

Type 5 diabetes is rarely discussed or researched, and yet it is thought to impact up to 25 million people worldwide, especially those in low- and middle-income nations where access to medical care is limited.

It was first described in 1955 in Jamaica, then forgotten about for many years. Even once it was acknowledged by the WHO in the 1980s, the diagnosis created controversy.

For going on seven decades, scientists have debated whether type 5 diabetes exists at all, and in 1999, WHO withdrew the classification due to a lack of evidence. There has been little agreement on how to diagnose type 5 diabetes or how to treat it.

                                                                                    (Nataliya Vaitkevich/Pexels/Canva)

Type 1 diabetes is an autoimmune condition that destroys the pancreas's ability to produce insulin. Type 2 diabetes is an insensitivity to insulin due to diet and lifestyle. Type 3c diabetes is commonly caused by damage to the pancreas. Gestational diabetes is triggered by hormonal changes during pregnancy.

Type 5 diabetes seems to stem from nutrient deficiency. Previously known as malnutrition-related diabetes mellitus (MRDM), this form of diabetes is commonly misdiagnosed as other types.

And yet, because insulin resistance does not seem to be the primary cause of type 5 diabetes, existing treatments may not help. In fact, they may even harm.

"Understanding the specific types of diabetes someone has is crucial to providing the right treatment," Craig Beall, a diabetes researcher at the University of Exeter, explained in May 2025.

For years now, Meredith Hawkins, an endocrinologist at the Albert Einstein College of Medicine's Global Diabetes Institute, has called for global recognition of type 5 diabetes, which typically impacts people in Asia and Africa who are experiencing severe food insecurity.

"Malnutrition-related diabetes is more common than tuberculosis and nearly as common as HIV/ AIDS, but the lack of an official name has hindered efforts to diagnose patients or find effective therapies," Hawkins said in 2025.

"I'm hopeful that this formal recognition as type 5 diabetes will lead to progress against this long-neglected disease that severely debilitates people and is often fatal."

                     The pancreas produces insulin, which helps cells absorb glucose from the blood. (Science Photo Library/Canva)

In recent years, numerous animal and human studies have shown that chronic nutrient deficiencies can have lifelong impacts on the pancreas, disrupting its ability to secrete insulin and balance blood sugar levels.

Hawkins' own work, published in 2022, was the first to establish a unique metabolic profile for this with malnutrition-related diabetes.

She and her colleagues ran a small trial in south India, which showed people with MRDM are insulin-deficient like people with type 1 diabetes, but not to the same degree, and still sensitive to insulin, unlike people with type 2 diabetes who develop resistance.

"Type 5 diabetes stands apart with its unique pathogenesis, theorized to involve compromised pancreatic development resulting from extended periods of nutritional insufficiency," Rahul Garg, a physician at F.H. Medical College and Hospital in India, wrote in a recent review.

In light of this evidence, the IDF is making a concerted effort to at last recognize type 5 diabetes.

Some researchers have said the move is "long overdue", while others argue that it is "unwarranted" due to "diagnostic uncertainty" stemming from the variety of diabetes cases seemingly related to malnutrition.

Some say the number of patients with type 5 diabetes is growing; others say its prevalence is receding. Either way, it's all tied up in whether the condition is properly diagnosed and recognized.

Without a formal name and recognition, it's challenging to fund research, and without further evidence, it's impossible to know enough about a condition to formulate a standard diagnosis or to say how many people it affects.

In 2025, the IDF established a type 5 diabetes working group, with Hawkins as chair, to develop formal diagnostic criteria and therapeutic guidelines for type 5 diabetes; establish a global research registry; and create training for healthcare professionals.

The distinct metabolic profile of type 5 diabetes means treating doctors need to tread a fine line when managing patients' insulin levels.

People with type 5 diabetes might only need minimal amounts of supplementary insulin or require alternative approaches to stimulate insulin secretion, to avoid insulin levels plummeting or spiking dangerously.

Undernutrition in infancy and early childhood can lead to diabetes. (Wadivkar et al., The Lancet Global Health, 2025)

"Inappropriate insulin treatment could induce hypoglycaemia [low blood sugar levels], which can be a particular risk in settings with food insecurity and where glucose monitoring might not be affordable," Hawkins and colleagues explained, in a review published after type 5 diabetes was formally recognized.

The issue isn't confined to Asia and Africa, either. Undernourishment is a growing problem in parts of Latin America and the Caribbean, where a complicated mix of environmental, political, and economic factors is magnifying health inequalities and extreme poverty.

"There is no quick fix, and so we expect the fight against this disease to require substantial further research and advocacy," said Hawkins in an interview.

"Once you have seen young patients dying from inappropriate treatment of a neglected form of diabetes, there's no turning back."

https://www.sciencealert.com/a-distinct-new-type-of-diabetes-is-now-officially-recognized