At the International Diabetes Federation’s (IDF) World Diabetes Congress held in Bangkok in April 2025, a new Type 5 Diabetes Working Group was launched.
What is Diabetes?
Diabetes is a chronic condition where the body cannot properly produce or use insulin, resulting in elevated blood sugar levels. It has several types based on causes and characteristics.
What is Type 5 Diabetes?
- Type 5 diabetes, also known as malnutrition-induced diabetes, is associated with undernutrition and low body weight, in contrast to other forms which are often linked to obesity or autoimmune issues.
About the International Diabetes Federation (IDF)
- The IDF is an umbrella organisation of over 240 national diabetes associations in 160 countries and territories
- Established: 1950
- Objective: To promote diabetes care, prevention, and a cure worldwide.
- Activities: Hosts the World Diabetes Congress and leads global initiatives on all forms of diabetes.
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- Historical Background: First described in Jamaica in 1955 as J-type diabetes.
- In 1985, WHO classified it as malnutrition-related diabetes mellitus but removed the classification in 1999 due to lack of conclusive evidence.
- Current Status: Today, over 25 million people are estimated to be living with this form of diabetes, especially in low-income regions such as India, Sri Lanka, Bangladesh, Ethiopia, and Uganda.
Comparison: Types of Diabetes and Their Causes
Type |
Cause |
Common Features |
Type 1 |
Autoimmune destruction of insulin-producing cells |
Typically diagnosed in youth; insulin-dependent |
Type 2 |
Lifestyle-related (poor diet, obesity, inactivity) |
Most common; managed with lifestyle or medication |
Type 3 |
Insulin resistance in the brain (Alzheimer’s-linked) |
Still under research |
Type 4 |
Age-related insulin resistance |
Seen in elderly patients |
Type 5 |
Early-life undernutrition and low BMI |
“Lean diabetes”; poorly responsive to standard treatment |
- Gestational diabetes is a form of diabetes that develops during pregnancy due to hormonal interference with insulin’s effectiveness and usually disappears after childbirth.
- It causes high blood sugar levels that can affect both the mother and the baby’s health.
Why is type 5 Condition Back in Focus?
- Persistent Global Burden: Despite its removal from classifications in 1999, growing evidence from developing countries indicates that Type 5 diabetes is widespread and distinct, especially among younger, undernourished adults.
- Scientific Advances: A 2022 study at CMC Vellore confirmed Type 5 diabetes as a unique metabolic condition.
- The patients showed a ‘thin-fat’ phenotype, with low BMI but abnormal fat accumulation due to in utero malnutrition, supporting the thrifty gene theory.
Type 5 Diabetes Working Group
- Chaired by Nihal Thomas (CMC Vellore) and Meredith Hawkins (Einstein College of Medicine, New York), the group aims to:
- Define diagnostic criteria and guidelines
- Establish a global registry to enable collaborative research
- Promote research into the disease’s mechanisms and treatment
- Create educational modules to train healthcare professionals globally
- The Vellore Declaration: It emphasized the need for urgent research and awareness about Type 5 diabetes.
Conclusion
- The formation of the Type 5 Diabetes Working Group represents a pivotal step in recognising and tackling malnutrition-induced diabetes. With targeted global collaboration, education, and research, the initiative hopes to improve diagnosis, treatment, and awareness of this silent and deadly condition.