Recognition of Type 5 Diabetes

Type 5 diabetes, affecting lean and undernourished young adults in low- and middle-income countries, has been recognized by the International Diabetes Federation (IDF) as a distinct form of diabetes. This form has historically been neglected and frequently misdiagnosed due to a lack of research.

Characteristics of Type 5 Diabetes

• Type 5 diabetes primarily affects lean and malnourished teenagers and young adults.
• Causes abnormal function of pancreatic beta cells, leading to insufficient insulin production.
• Unlike Type 2 diabetes, this type is not characterized by insulin resistance.

Historical Context

• First reported in Jamaica in 1955 as J-type diabetes.
• Classified by WHO in 1985 as "malnutrition-related diabetes mellitus," later dismissed in 1999 due to insufficient evidence.
• Affects an estimated 25 million people globally, mostly in countries like India, Sri Lanka, and Uganda.

Markers and Causes

• No autoimmune or genetic causes detected.
• Affected individuals have a lower body-mass index (BMI) of less than 18.5 kg/m2.
• Substantially lower insulin secretion and body fat percentage compared to Type 2 diabetes.
• Low dietary intake of proteins, fiber, and essential micronutrients.
• Caused by malnutrition beginning in the womb, potentially exacerbated by post-natal nutritional deficiencies.

Treatment Considerations

• Specific diagnostic and therapeutic guidelines are yet to be developed.
• A high protein diet is essential, alongside adequate intake of carbohydrates and fats to ensure weight gain.
• Treatment may include anti-diabetic medication or insulin based on glucose levels and individual response.