Type 2 vs Type 5. A new diabetes type is official where eating less does not help

At the International Diabetes Federation (IDF) World Diabetes Congress 2025, IDF President Professor Peter Schwarz announced the creation of a special team to set official guidelines for type 5 diabetes, a form of diabetes linked to malnutrition. This condition was formally classified earlier this year during an expert meeting in India. The newly formed Type 5 Diabetes Working Group will focus on diagnosing, treating, and researching the disease while also training healthcare professionals.

The group is co-led by Dr Meredith Hawkins, founder of the Global Diabetes Institute at Albert Einstein College of Medicine, and Dr Nihal Thomas, professor of endocrinology at Christian Medical College in Vellore, India. Their goal is to bring attention to this lesser-known type of diabetes, which affects 20 to 25 million people worldwide, mostly in Asia and Africa.

Diabetes is becoming more common worldwide. According to the latest IDF Diabetes Atlas (2025), 1 in 9 adults (ages 20-79) has diabetes, and more than 40% of them don’t even know they have it. By 2050, the IDF estimates that 1 in 8 adults—around 853 million people—will be living with diabetes, a 46% increase from today’s numbers. Over 90% of all cases are type 2 diabetes, which is mainly linked to poor diet and lifestyle.

While type 2 diabetes is the most widespread, type 5 diabetes is a growing concern in low- and middle-income countries (LMICs), where undernutrition plays a bigger role. This type of diabetes has often been misunderstood, but experts are now pushing for better recognition and care.

Unlike type 1 or type 2 diabetes, type 5 diabetes—also called malnutrition-related diabetes—is triggered by long-term undernutrition, especially during childhood or adolescence. Scientists believe that a lack of proper nutrients can stop the pancreas from developing properly, leading to severe insulin-deficient diabetes (SIDD).

Speaking at the IDF Congress, Professor Schwarz highlighted the importance of recognizing type 5 diabetes: “The recognition of type 5 diabetes marks a historic shift in how we approach diabetes globally. For too long, this condition has gone unrecognised, affecting millions of people and depriving them of access to adapted care. With the launch of the Type 5 Diabetes Working Group, we are taking decisive steps to correct this. This is about equity, science, and saving lives.”

For many years, doctors incorrectly thought this condition was similar to type 2 diabetes, linking it to insulin resistance. Because of this misunderstanding, treatments often didn’t work. However, Dr Hawkins and her team have shown that type 5 diabetes has a unique metabolic profile, meaning it needs a different approach.

A key discovery is that people with type 5 diabetes are insulin deficient but not insulin resistant. This means they may not always need insulin injections—many can manage their condition with oral medication instead. This is especially important in low-resource settings, where insulin can be expensive or hard to access.

With the new guidelines, doctors will have a clearer understanding of how to diagnose and treat this condition properly. A global research registry will also help track cases and improve scientific knowledge. The working group hopes to push research forward and shape global healthcare policies to ensure those affected by type 5 diabetes get the care they need.

Source: International Diabetes Federation (link1, link2)

This article was generated with some help from AI and reviewed by an editor.

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