Type 5 Diabetes: IDF Recognizes Malnutrition-Linked Diabetes as Distinct Disease
Thailand: In a landmark move at the World Diabetes Congress 2025 in Bangkok, the International Diabetes Federation (IDF) formally recognized malnutrition-related diabetes as a distinct type of diabetes—now designated as Type 5 diabetes. This decision marks a pivotal moment in diabetes research, bringing long-overdue attention to a form of the disease that affects millions in low- and middle-income countries yet remains largely underdiagnosed and poorly understood.
The newly coined “Type 5 diabetes” primarily affects lean adolescents and young adults with a history of early-life undernutrition. Unlike type 2 diabetes, which is commonly linked to obesity, this form stems from malnutrition and disproportionately impacts populations in countries such as India, Bangladesh, Uganda, Ethiopia, and Sri Lanka. Current estimates suggest that as many as 25 million people may be living with this condition globally.
The push for official recognition was led by Dr. Meredith Hawkins, professor of medicine at Albert Einstein College of Medicine and director of its Global Diabetes Institute, in collaboration with Dr. Nihal Thomas and colleagues at Christian Medical College (CMC), Vellore. Their research has played a crucial role in distinguishing Type 5 from other forms of diabetes.
Dr. Hawkins first encountered this unusual presentation nearly two decades ago while engaging with clinicians from across the globe. Many described young, thin patients diagnosed with diabetes who did not respond to insulin—ruling out type 1—and lacked the characteristics of type 2 diabetes. It was a mystery that needed urgent investigation.
In 2022, a breakthrough study led by Dr. Hawkins and her team in India confirmed that this condition stems not from insulin resistance, as previously thought, but from a severe inability to produce insulin. This finding reshaped the understanding of malnutrition-related diabetes and prompted a call for global consensus.
That call was answered in January 2025 when 42 global experts gathered at CMC Vellore and signed the “Vellore Declaration,” advocating for international recognition and focused research. During this meeting, IDF President Professor Peter Schwarz proposed the name “Type 5 diabetes” and announced the formation of a dedicated working group to develop formal diagnostic criteria, treatment guidelines, and awareness programs.
According to Dr. Hawkins, "This condition is more widespread than tuberculosis and nearly as prevalent as HIV/AIDS."
“But the absence of a proper classification has long hindered both diagnosis and research.”
Experts say the formal naming of Type 5 diabetes will not only boost clinical awareness but also pave the way for inclusive healthcare strategies in under-resourced settings. The IDF’s working group is expected to release official guidelines within two years.
By recognizing Type 5 diabetes, the global medical community is taking a vital step toward addressing a serious, life-limiting disease that has remained in the shadows for decades—bringing hope to millions for better diagnosis, care, and survival.
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