Global Focus on Type 5 Diabetes

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.

• 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

• 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.