New Diabetes Classification, ‘Type 5,’ Recognized as Distinct Condition Linked to malnutrition
Researchers have formally identified and are advocating for recognition of “Type 5” diabetes, a form of the disease physiologically distinct from Type 1 and Type 2 and strongly linked to chronic malnutrition. The effort, spurred by observing patients who weren’t responding to typical diabetes treatments, aims to improve diagnosis and treatment for a growing population at risk.
Dr. Laura Hawkins, a researcher involved in the classification, stated, “As they weren’t being appropriately treated really motivated our research.” Studies, including research published in PubMed (https://pubmed.ncbi.nlm.nih.gov/35522035/), demonstrate physiological differences between individuals with Type 5 diabetes and those with other types.
Unlike Type 2 diabetes, where cells often resist insulin, people with Type 5 diabetes can respond to insulin, but their pancreas struggles to produce enough.”These individuals have generally had malnutrition from the time they were in utero,” Hawkins explains.”They’re malnourished as toddlers, as children, as adolescents and as adults. These are the ones that don’t catch up. They just stay very thin.” Dr. William Boyne bluntly described the condition of the pancreas in these patients: “Their pancreas is crap. ItS not as bad as Type 1, but it’s really crappy.”
The International Diabetes Federation has launched a working group to develop diagnostic criteria and treatment guidelines (https://idf.org/news/new-type-5-diabetes-working-group/). The name “Type 5” was chosen as it was considered uncontested, with “Types 3 and 4” currently under consideration for other diabetes forms.
However, not all researchers are convinced. Anoop Misra, an endocrinologist at the Center of Nutrition & Metabolic Research in New Delhi, argues, “formal classification risks codifying what might potentially be a spectrum of poorly characterized Type 2 diabetes rather than a discrete entity,” stating the current data is insufficient to confirm a distinct form of diabetes.
Advocates fear rising cases globally, particularly in regions experiencing food crises.Current conflicts and famine conditions in Gaza, Sudan, the Democratic Republic of Congo, Nigeria, and Yemen could lead to increased risk for future generations, according to Boyne. “It’s really heart-rending,” he says. “This is something that’s preventable - it’s preventable by food.”
