A new recognized form of diabetes, known as type 5 diabetes, is now attracting global attention in the way it silently affects lean and young people, especially in lower and moderate-or-countries such as India. The International Diabetes Federation (IDF) has officially accepted type 5 diabetes as a separate category of disease. The announcement was made at the 75th World Congress for diabetes held in Bangkok on 75 April 2025.

What is type 5 diabetes?

Unlike more commonly known type 1 and type 2 diabetes, type 5 diabetes is not caused by autoimmune issues or lifestyle factors such as obesity or poor diet. Instead, it stems from a genetic mutation that disrupts the ability of the pancreas to produce insulin. This form of diabetes is mainly seen in lean and malnourished teenagers and young adults, which makes it difficult to detect and often make incorrect diagnosis.

Professor of Endocrinology at Christian Medical College (CMC), Dr. Nihal Thomas, Vellore and a member of the IDF Working Group say the situation has been around for decades, but was never formally recognized. “It was once called J-Type diabetes when it was first seen in Jamaica in 1955, and later in 1985, WHO called it ‘diabetes mellitus’ related to malnutrition. However, this category was dropped in 1999 due to lack of adequate evidence,” he says.

Now, with the clinical observation and years of study, the link between this unique form of malnutrition and diabetes is more clear than ever.

How is this different from other types?

Dr. Thomas explains that individuals with type 5 diabetes often have very low body mass index (BMI) – usually less than 18.5. Their insulin production is very low, even lower than many types of types of diabetes cases, and slightly higher than type 1. Unlike type 2 patients, these individuals also show liver glucose output.

The scan shows that their body fat is much less than typical diabetic patients, and their diet has a severe decrease in protein, fiber and essential nutrients. Type 5 makes it hard to catch diabetes, is the absence of general risk factors such as high weight, family history or autoimmune.

It starts in the womb

Dr, Director of Diabetes Unit at KEM Hospital in Pune. The CS Yajnik and another main member of the working group explains how the disease often starts even before birth. “If a baby does not get proper nutrition in the womb, it later increases the risk of diabetes,” they say.

He says that India’s long history plays a role due to factors like colonial difficulty and poverty. “When a child decreases before birth and lives in that way after birth, it can give rise to this form of diabetes. Unlike type 2 diabetes, which is often associated with obesity and overranteration, type 5 diabetes is the result of malnutrition.”

What is treatment?

Treatment for type 5 diabetes requires a comprehensive nutritional approach. Dr. Thomas explain the importance of a high-protein diet with enough carbs and healthy fats to promote healthy weight gain.

Because each case is different, the use of insulin or oral medicine depends on how much the patient’s blood sugar levels improve with diet and lifestyle changes. “This is not a size-fit-all scheme. We treat the person’s needs,” they explain.

What will happen next?

The work group of experts now focuses on setting up global clinical criteria to effectively recognize and treat type 5 diabetes in various population. They also aim to develop standard treatment guidelines to suit this unique group of patients.

This recognition marks a large innings in diabetes care, which often attracts attention to the ignored group – younger young people remain silently with a disease that was not yet considered real.

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