Type 5 Diabetes Officially Recognized by International Diabetes Federation (IDF)

(Source – Indian Express, Section – Explained, Page – 11)

Analysis of the news

Recognition of a Long-Ignored Diabetes Type

• Type 5 diabetes, a condition affecting lean and malnourished youth in low- and middle-income countries, has finally been recognized as a distinct form by the International Diabetes Federation (IDF).

• Though reported as early as 1955 (J-type diabetes), and later termed “malnutrition-related diabetes” by the WHO in 1985, it was delisted in 1999 due to insufficient evidence.

• Its official recognition in April 2025 marks a significant step in understanding diabetes in undernourished populations.

Understanding Type 5 Diabetes

• Type 5 diabetes arises from malnutrition-induced damage to pancreatic beta cells, resulting in poor insulin production.

• Unlike Type 2 diabetes, where insulin resistance is the issue, Type 5 involves inadequate insulin secretion due to developmental deficiencies often stemming from childhood or prenatal malnutrition.

• It affects young adults with extremely low body mass index (BMI <18.5), and has largely been misdiagnosed due to lack of formal classification.

Distinct Markers and Characteristics

• Patients with Type 5 diabetes show no autoimmune or genetic markers, very low insulin secretion, and lower hepatic glucose production compared to Type 2 diabetes.

• Body scans reveal significantly less fat, and diets are typically low in protein, fibre, and essential nutrients.

• These characteristics set it apart clinically and metabolically from other diabetes types.

Origins Traced to the Womb

• Malnutrition often begins during fetal development. According to experts, inadequate maternal nutrition during pregnancy hampers fetal pancreatic development, increasing diabetes risk.

• Historical factors like colonization, famine, and labour-intensive livelihoods contributed to chronic undernutrition in populations like India, compounding risk over generations.

Treatment and Future Directions

• Management of Type 5 diabetes requires nutritional rehabilitation, particularly high-protein diets, and careful monitoring of carbohydrate and fat intake to promote healthy weight gain.

• Medication or insulin is prescribed case-by-case. The IDF working group now aims to establish diagnostic criteria and treatment protocols tailored to diverse, under-resourced settings.