Type 5 diabetes is a recently recognised form of diabetes linked to long-term undernutrition. Unlike Type 1 and Type 2 diabetes, it primarily affects individuals in low-income regions where malnutrition is widespread. Also called malnutrition-related diabetes mellitus (MRDM), Type 5 diabetes occurs when chronic nutrient deficiencies during childhood or early development impair the pancreas, reducing insulin production. This insufficiency leads to elevated blood sugar levels, a hallmark of diabetes. People with Type 5 diabetes often have low body weight and may show physical signs of prolonged undernutrition. Management typically involves insulin therapy, although researchers are investigating alternative treatments, including oral medications, to improve patient outcomes and offer more accessible options for those living in resource-limited areas.







Understanding Type 5 diabetes







Type 5 diabetes occurs when chronic malnutrition during childhood or early development hampers proper pancreatic growth. The pancreas is the organ responsible for producing insulin, a hormone essential for regulating blood sugar levels. When pancreatic development is impaired, insulin production is insufficient, resulting in elevated blood sugar levels, a hallmark of diabetes.



Officially recognised by the International Diabetes Federation in 2025, Type 5 diabetes affects an estimated 20 to 25 million people worldwide. The condition is most common in regions with high rates of malnutrition, particularly parts of Asia and Africa. Scientists are actively investigating ways to improve the diagnosis and treatment of this unique form of diabetes.





Symptoms and signs of Type 5 diabetes

• Increased thirst


• Frequent urination


• Blurred vision


• Persistent fatigue


• Headaches


• Slow-healing cuts and wounds


• Low body mass index (BMI below 18.5)


• Impaired skeletal growth


• Enlarged salivary glands


• Changes in skin or hair texture

Type 5 diabetes causes and risk factors







The primary cause of Type 5 diabetes is believed to be chronic undernutrition during critical periods of growth. Inadequate intake of essential nutrients during childhood or in utero can interfere with pancreatic development, leading to lifelong insulin insufficiency.



People at risk often have a documented history of malnutrition and present with low BMI at a young age. Researchers continue to study the mechanisms linking nutrient deficiency to pancreatic dysfunction and subsequent diabetes.





How Type 5 diabetes is different from other types







Type 5 diabetes is distinct from Types 1 and 2 in several key ways. Unlike Type 1, which is an autoimmune condition where the body attacks insulin-producing cells, Type 5 arises from chronic undernutrition that prevents the pancreas from developing fully. Unlike Type 2, which is often linked to obesity and insulin resistance, Type 5 typically affects individuals who are underweight and have a history of malnutrition.



Another major difference is the age of onset. Type 5 usually develops before the age of 30, whereas Type 2 commonly appears in adulthood, and Type 1 can occur at any age. Additionally, people with Type 5 often do not have ketones in their urine at diagnosis, a feature commonly seen in Type 1 diabetes.





Complications and diagnosis of Type 5 Diabetes







Type 5 diabetes carries risks similar to other diabetes types, including cardiovascular disease, kidney damage, nerve damage, and eye complications. Early detection and proper management are crucial to prevent these long-term health consequences. Blood glucose testing remains the cornerstone of diabetes diagnosis, with readings above 200 mg/dL typically indicating diabetes. In higher-income countries, healthcare providers use additional tests such as glycated haemoglobin (A1C), urinalysis, and antibody screening to differentiate between diabetes types.



In low- and middle-income regions, limited access to these advanced tests often leads to misdiagnosis, with Type 5 diabetes frequently mistaken for Type 1. Key distinguishing factors include a history of malnutrition, age under 30 at diagnosis, low BMI, and the absence of ketones in urine at the time of diagnosis.










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