10/06/2025
At the recent International Diabetes Federation (IDF) World Diabetes Congress 2025 in Bangkok, Thailand, IDF President Professor Peter Schwarz announced the launch of a working group to develop formal diagnostic criteria and therapeutic guidelines for a type of diabetes linked to malnutrition that was formally classified as “type 5 diabetes” during an international meeting of experts in India earlier this year. The working group will also establish a global research registry and develop education modules to train healthcare professionals.
Type 5 diabetes is estimated to affect between 20 to 25 million people worldwide, primarily in regions such as Asia and Africa. This recognition marks a pivotal moment in the understanding of diabetes and how the condition affects lean and malnourished teens and young adults in low- and middle-income countries (LMICs).
The concept of type 5 diabetes refers to severe insulin-deficient diabetes (SIDD), characterized by elevated levels of insulin deficiency and poor metabolic control. Unlike type 2 diabetes, type 5 diabetes, also known as malnutrition-related diabetes, is primarily caused by chronic undernutrition, especially during childhood or adolescence. Type 1 diabetes is the result of autoimmune destruction of insulin-producing cells. Type 2 diabetes is characterized by the body’s inability to use the insulin it produces. Type 5 diabetes is distinct. It is believed to stem from impaired pancreatic development due to long-term nutrient deficiencies.
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. Previously, prevailing theories suggested that the condition developed due to insulin resistance. In recent years, renewed research—led by Dr Hawkins—confirmed its distinct metabolic profile.
People with type 5 diabetes are insulin deficient, but not insulin resistant. Many may be able to manage their diabetes with oral medication rather than with injections of insulin. Given that type 5 diabetes is mostly found in low-resource settings, this cost-effective approach could prove important in regions already struggling to tackle the rising number of people living with the condition.
