On April 9, 2025, the International Diabetes Federation officially recognised “type 5 diabetes,” a form of malnutrition-related diabetes affecting millions of young, lean individuals in impoverished regions. Unlike type 2 diabetes, this variant is caused by chronic undernutrition rather than excessive calorie intake, and has historically gone underdiagnosed and misunderstood.
Medical researchers have linked early-life protein deficiency to impaired pancreatic development. Studies in humans and animals show that poor maternal nutrition or childhood hunger can stunt the growth of insulin-producing beta cells, leaving individuals unable to regulate blood sugar later in life. In communities across South India, type 5 patients—often with a BMI around 18—have shown signs of fetal undernutrition.
Physiologically, type 5 diabetes exhibits low insulin production alongside preserved or even enhanced insulin sensitivity, distinguishing it from the obesity-linked type 2 and the autoimmune-driven type 1. These patients typically lack excess visceral or liver fat and test negative for autoimmune markers, placing them in the category of “severe insulin-deficient diabetes”.
Clinically, misdiagnosis is common: lean individuals from food-insecure settings may be erroneously labelled as type 1 and prescribed high insulin doses, which can induce dangerous hypoglycaemia. Experts recommend low-dose insulin or oral medications like sulfonylureas, combined with improved nutrition, to better suit these patients and reduce both cost and health risk.
After formal adoption, the IDF quickly formed a working group to establish diagnostic guidelines, treatment protocols, and an international registry by 2027. Field trials will test low-dose insulin, oral agents, and nutritional interventions. Analysts predict that shifting misdiagnosed cases from insulin to oral drugs could save tens of millions annually—funds that could better support maternal and early-life nutrition programs.