This common condition just got a fresh diagnosis—and docs say new guidelines are coming soon
Key Takeaways
Industry Buzz
“The recognition of type 5 diabetes is a step forward in understanding and addressing the complex interplay of factors that contribute to diabetes development, especially in populations facing nutritional challenges.” — Raj Dasgupta, MD, internal medicine physician
"Since this is a newly recognized type of diabetes, more research needs to be done. And it's expected that guidelines as far as management treatment should be coming out in future years." — Endocrinologist @mad_endo on TikTok
Find more of your peers' perspectives and insights below.
The International Diabetes Federation (IDF) recently announced that a group of physicians are officially developing diagnostic criteria and therapeutic guidelines for a new category of diabetes formally classified as “type 5 diabetes.”
According to IDF’s statement, roughly 20 to 25 million people around the globe, largely in Asia and Africa, suffer from this form of diabetes, which is related to malnutrition.[] Malnutrition-related diabetes has been recognized for close to 70 years. However, it wasn’t formally defined as a distinct category until now. In the past, it was often misdiagnosed as type 1 or type 2 diabetes.
Researchers only recently decided that its unique features—specifically, insulin deficiency without insulin resistance—were sufficient to classify it as a new type. “The recognition of type 5 diabetes is a step forward in understanding and addressing the complex interplay of factors that contribute to diabetes development, especially in populations facing nutritional challenges,” Raj Dasgupta, MD, an internal medicine physician and Chief Medical Officer of Sleepopolis, tells MDLinx.
TD5 explainer
The disease is caused by chronic undernutrition, especially in childhood and adolescence. Experts conclude it is likely a result of impaired pancreatic function caused by long-term nutrient deficiencies.
Austin Shuxiao, MD, an internal medicine practitioner at UHS Wilson Medical Center in Johnson City, NY, and founder of Peach IV, says type 5 diabetes is similar to type 1 diabetes in that they both stem from a lack of insulin secretion. “However, the cause of type 5 diabetes is not from the destruction of pancreatic cells, but from the underdevelopment of those cells due to chronic malnutrition,” Dr. Shuxiao explains.
In a TikTok video, an endocrinologist under the handle @mad_endo discusses everything we know so far: ‘It's more common in men, especially from lower to medium-income countries. They will often have a BMI under 19. They're often mistaken for having type 1 diabetes, but these patients do not go into ketoacidosis, even if they don't have insulin.
But these patients do develop a defect in their ability to secrete insulin that is unrelated to any autoimmunity, such as the one that's present in type 1 diabetes. Since this is a newly recognized type of diabetes, more research needs to be done. And it's expected that guidelines as far as management treatment should be coming out in future years,” she adds.
Potential treatment avenues
There’s currently no known cure for type 5 diabetes. This is understandable, “especially given how recently it’s been discovered, and meaningful breakthroughs take time,” says Dr. Shuxiao.
While there is no cure, many people with type 5 diabetes may not need regular insulin injections, notes Dr. Dasgupta.
Those with type 5 diabetes are deficient in insulin—but not resistant. As such, they may be able to manage their symptoms with oral medication (and not insulin injections). “That’s a major benefit in low-resource settings where insulin is hard to access,” Dr. Dasgupta says.
Blood sugar levels in people with type 5 diabetes may also be monitored to prevent hyper- and hypoglycemia, adds Dr. Shuxiao. Ultimately, protecting and building access to healthy foods and proper nutrition will support the development of various organs and bodily functions in children, he notes.
People most affected by type 5 diabetes are those who reside in low-income areas that typically aren’t prioritized in medical research and drug development, Dr. Shuxiao says. Typically, strong incentives are needed to drive pharmaceutical companies and academic institutions to uncover cures for diseases. The new classification is the first step to raising awareness and attention to this frequently misdiagnosed condition, says Dr. Shuxiao.
"This could change the lives of millions of people," says Dr. Dasgupta. "Malnutrition-related diabetes is finally being taken seriously and studied the way it deserves to be."
“That means we could see more personalized treatment options, better-informed doctors, and more affordable care, all of which can make a real difference and save lives,” he says.
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