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Malnutrition related diabetes designated as 'Type 5 Diabetes'

The International Diabetes Federation (IDF) based on a research at Albert Einstein College of Medicine Tuesday April 08, 2025 officially designated Malnutrition related diabetes as Type 5 Diabetes

Wednesday April 9, 2025 4:55 PM, ummid.com News Network

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Bronx (New York): The International Diabetes Federation (IDF) based on a research at Albert Einstein College of Medicine Tuesday April 08, 2025 officially designated Malnutrition related diabetes as Type 5 Diabetes.

Malnutrition-related diabetes typically affects lean, malnourished teens and young adults in low- and middle-income countries.

The new designation, made Tuesday by the International Diabetes Federation (IDF), stems largely from the research and advocacy of Meredith Hawkins (M.D., M.S.) - Professor of Medicine, Harold and Muriel Block Chair in Medicine, and Founding Director of Global Diabetes Institute at Albert Einstein College of Medicine.

"Malnutrition-related diabetes has historically been vastly under-diagnosed and poorly understood," said Dr. Hawkins.

"The IDF's recognition of it as Type 5 diabetes is an important step toward raising awareness of a health problem that is so devastating to so many people”, she added.

Who are affected by Type 2 Diabetes

Diabetes normally caused by obesity, known as Type 2 diabetes, accounts for the majority of diabetes cases in developing countries.

“But increasingly, young people are being diagnosed with diabetes caused not by too much food but by too little — by malnutrition, in other words”, Dr. Hawkins said.

Type 5 diabetes is estimated to affect 20 to 25 million people worldwide, mainly in Asia and Africa.

"Doctors are still unsure how to treat these patients, who often don't live for more than a year after diagnosis," she said.

Malnutrition-related diabetes was first described 70 years ago, with several studies later finding a high incidence of the disease in impoverished nations.

Responding to those reports, the World Health Organization (WHO) recognized malnutrition-related diabetes as a distinct form of the disease in 1985.

However, WHO removed this designation in 1999, due to a lack of follow-up studies and supporting evidence.

Dr. Hawkins first learned of malnutrition-related diabetes in 2005 while teaching at global health meetings.

"Doctors from various countries told me they were seeing many patients with an unusual form of diabetes," she said.

"The patients were young and thin, which suggested that they had Type 1 diabetes, which can be managed with insulin injections to regulate blood sugar levels. But insulin didn't help these patients and in some cases caused dangerously low blood sugar. Nor did these patients seem to have Type 2 diabetes, which is typically associated with obesity. It was very confusing”, she observed.

A Brief Timeline

In 2010, Dr. Hawkins founded Einstein's Global Diabetes Institute, which began leading international efforts to uncover the underlying metabolic defects that lead to malnutrition-related diabetes—a crucial step towards finding effective treatments.

In a 2022 study published in Diabetes Care, Dr. Hawkins and her colleagues at Christian Medical College in Vellore, India, demonstrated that malnutrition-related diabetes is fundamentally different from types 1 and 2. Earlier findings had suggested that malnutrition-related diabetes stemmed from insulin resistance.

"But it turns out that people with this form of diabetes have a profound defect in the capacity to secrete insulin, which wasn't recognized before. This finding has revolutionized how we think about this condition and how we should treat it," said Dr. Hawkins.

In January this year, Dr. Hawkins and her colleagues at Christian Medical College convened an international meeting in India to discuss the classification, diagnosis, and management of malnutrition-related diabetes as well as to advocate for global awareness and research.

Investigators from several countries presented findings to a panel of diabetes experts, including the heads of the IDF and the American Diabetes Association.

The attendees voted unanimously that malnutrition-related diabetes should be considered a distinct form of the disease - a decision that was endorsed Tuesday April 08, 2025 at the IDF World Diabetes Congress 2025, in Bangkok, Thailand.

While announcing the organization's formal recognition of type 5 diabetes, IDF president Peter Schwarz, Ph.D., also noted the formation of a Type 5 diabetes working group, to be co-chaired by Dr. Hawkins.

The group has been tasked to develop formal diagnostic and therapeutic guidelines for type 5 diabetes over the next two years.

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