What is Type 5 diabetes? IDF recognises malnutrition-linked condition

Long overlooked and often misdiagnosed, Type 5 diabetes, caused by malnutrition-linked reduced insulin production, has finally gained official recognition

A form of diabetes associated with malnutrition rather than obesity has received official recognition, several decades after it was first identified in developing nations.

 

The International Diabetes Federation (IDF), earlier this month, formally classified the condition as "Type 5 diabetes", also known as Maturity Onset Diabetes of the Young (MODY).

 

"Although Type 5 diabetes has been observed for over 70 years, it has been largely overlooked in global health discussions. The condition was first noted in the mid-20th century and often misclassified as Type 1 or 2 diabetes," said the IDF in a statement.

 

According to the IDF, a network of over 250 national diabetes associations in more than 160 countries, this uncommon form of diabetes is estimated to affect around 25 million people worldwide—mainly undernourished young men in Asia and Africa. 

 

What is Type 5 diabetes and how does it develop? 

Type 5 diabetes is a rare, inherited form of the condition that typically occurs in undernourished adolescents and young adults from low- and middle-income households. It is characterised by reduced insulin production resulting from prolonged malnutrition.

 

According to the IDF, the concept of Type 5 diabetes refers to severe insulin-deficient diabetes (SIDD), marked by extreme insulin deficiency and poor metabolic control.

 

The condition usually emerges during adolescence or early adulthood in individuals with a genetic mutation passed down from a parent. If one parent carries the affected gene, there is a 50 per cent likelihood that their children will inherit it.

Where was Type 5 diabetes first discovered? 

MODY was first identified in Jamaica in 1955. Nearly three decades later, the World Health Organization (WHO) recognised “malnutrition-related diabetes mellitus” as a separate form of diabetes, but discontinued the classification in 1999 due to insufficient evidence. Cases have since been reported in India, Sri Lanka, Bangladesh, Uganda, Ethiopia, Rwanda, and Korea—primarily across the Global South. 

How is Type 5 diabetes different from Type 1 and Type 2? 

According to the IDF, unlike Type 2 diabetes, which is driven by insulin resistance and lifestyle factors, Type 5 diabetes is primarily caused by chronic undernutrition, particularly during childhood or adolescence.

 

While Type 1 diabetes results from autoimmune destruction of insulin-producing cells, and Type 2 diabetes is marked by the body’s inability to use insulin efficiently, Type 5 diabetes stems from impaired pancreatic development due to prolonged nutrient deficiencies.

Is there a treatment for Type 5 diabetes? 

As Type 5 diabetes has only recently been officially recognised, formal diagnostic criteria and treatment protocols are still under development. The IDF has formed a dedicated working group that will spend the next two years developing guidelines based on research in low-income and resource-constrained settings.

What is the IDF doing next? 

The group will establish a global research registry and create educational modules for healthcare professionals.

 

The initiative is co-chaired by Dr Meredith Hawkins, endocrinologist and founding director of the Global Diabetes Institute at the Albert Einstein College of Medicine, New York, and Dr Nihal Thomas, professor of endocrinology at Christian Medical College (CMC), Vellore. The Type 5 Diabetes Working Group brings together international experts to address this long-overlooked public health challenge.  For more health updates and wellness insights, follow #HealthWithBS