In 2019, nearly 77 million people were diagnosed with diabetes. By 2045, that number is expected to rise to 134 million. And let’s be honest even managing the existing types of diabetes isn’t easy. Just when we thought diabetes only came in two types: Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) something unexpected has come into focus. The International Diabetes Federation (IDF) has recently shed light on a lesser-known variant called Type 5 diabetes. While some are calling it new, it’s actually not. It was first described way back in the 1950s, and the World Health Organization (WHO) officially recognized it in the 1980s. But after that? It faded into the background with very little research or attention, until now. Recent findings have uncovered a key link that makes this type stand out. And unlike Type 1 or Type 2, it’s a different kind of condition altogether. So if you are curious about this overlooked form of diabetes and what makes it unique, keep reading. It might just be something new to bring up the next time you are talking health with your friends or family.
What is Type 5 Diabetes?
For the longest time, the most common forms of diabetes were Type 1 and Type 2, one tied to autoimmune issues, the other mostly linked to obesity and lifestyle. But now there is a lesser-known type getting some attention: Type 5 diabetes, also known as Malnutrition-Related Diabetes Mellitus (MRDM). In 2025, the International Diabetes Federation (IDF) highlighted that this type is often found in people who were malnourished during childhood or even before birth. What is surprising is that we used to assume lean individuals especially those with a BMI around 19 kg/m² were either healthy or just undernourished. But Type 5 flips that idea. Even with a low BMI, someone can still develop diabetes.
Cause
The main cause of Type 5 diabetes in adolescents and young adults is chronic malnutrition during early life, either in childhood or even before birth. Because of this, the pancreas does not fully develop. And when the pancreas does not grow properly, the beta cells, which are responsible for producing insulin, also stay underdeveloped. That means the body ends up making less insulin. One unique feature of Type 5 diabetes is something called resistance to ketosis – a state where the body usually burns fat and produces ketones for energy. But in people with Type 5, this process doesn’t happen easily. Even with low insulin, their bodies struggle to break down ketone-producing nutrients, so insulin levels often stay unusually high.
Who Is at Risk?
The group most at risk for Type 5 diabetes includes:
- Undernutrition kids or fetus: Young adults who were malnourished or undernourished during childhood or even during the fetal stage may face a higher risk of developing Type 5 diabetes. Long-term nutrient deficiencies in those early stages can interfere with normal organ development, especially the pancreas. And when the pancreas does not fully develop, it affects insulin production later on. People who continued to experience poor nutrition into adolescence or early adulthood are especially vulnerable, as their bodies never got the nutrients needed for proper growth and function.
- Low Body Mass Index (BMI): A BMI below 19 kg/m² in adolescents or young adults is a notable risk factor. Unlike Type 2 diabetes, which is commonly associated with obesity and sedentary lifestyle, Type 5 diabetes is linked to underweight individuals.
- Low- and Middle-Income Countries (LMICs): People living in LMICs are more exposed to risk due to resource constraints such as food insecurity, housing instability, and limited access to diverse, nutrient-rich foods.
- Refugees and Asylum Seekers: Populations who have experienced displacement such as refugees or asylum seekers often endure food scarcity during early life, focusing on survival rather than nutrition. This places them at increased risk of developing Type 5 diabetes later in life.
Symptoms of Type 5 Diabetes
The symptoms of Type 5 diabetes are often similar to those seen in other forms of diabetes but may present with added complexity due to the individual’s nutritional background. Common signs include:
- Increased thirst
- Frequent need to pee
- Headache
- Blurry vision
- Lethargic/ fatigue
- Slow healing of wounds
Diagnosis
Since the link and risk factors for Type 5 diabetes have only recently come to light, awareness among healthcare professionals is still limited. Because of this, some individuals may have already been misdiagnosed or are still being misdiagnosed today. There is also no official diagnostic criteria yet, as research and treatment development are still in early stages. For now, blood glucose testing remains the standard method for detection. But blood sugar alone does not tell the whole story. If your blood sugar levels are unusually low, think back: were you undernourished as a child? Is your BMI below 19 kg/m²? Do you have ketones in your urine? If these signs match, it is worth sharing them with your doctor during diagnosis.
Management and Treatment
As stated in the above section the management and treatment of Type 5 diabetes remains an emerging area of research. While there is no specific protocol yet, injectable insulin is currently being used as a provisional treatment option. Researchers are also actively exploring the effectiveness of oral diabetes medications to help manage this condition in the future. Based on current findings, here are some practical management strategies for individuals living with Type 5 diabetes:
- Ensure Adequate Nutrition: Since the condition is closely linked to malnutrition, maintaining a nutrient-rich, balanced diet is essential for improving pancreatic health and overall glucose control.
- Limit Ketone-Rich Foods: Reducing the intake of foods that may elevate ketone levels can help prevent complications, particularly since individuals with Type 5 diabetes may exhibit resistance to ketosis.
Given its association with underdevelopment of the pancreas, management should focus on lifestyle choices that avoid further pancreatic damage. Here are some key lifestyle tips:
- Avoid Smoking: Cigarettes contain compounds that interfere with insulin use and cause inflammation of the pancreas, potentially worsening pancreatic function.
- Quit Alcohol: Alcohol can impair how insulin functions in the liver and peripheral tissues, increasing insulin resistance and further complicating diabetes management.
- Manage Stress: Chronic stress triggers the production of free radicals, damaging internal organs and disrupting blood sugar control. Simple practices like yoga, meditation, spending time in nature, or regular physical activity can significantly reduce stress levels.
- Get Adequate Sleep: Poor or inadequate sleep increases oxidative stress in the body, causing insulin level fluctuations and worsening blood glucose control. Maintaining a consistent and healthy sleep routine is vital.
Conclusion
Type 5 diabetes may not be entirely new, but the scientist is only now beginning to understand it better. Unlike the more familiar forms of diabetes, Type 5 is rooted in early-life malnutrition, and this variant of diabetes does not only affect those who are overweight or living with autoimmune issues. Even lean individuals, especially those who faced undernutrition during childhood or fetal development, may be at risk. Since research is still ongoing, there is currently no well-established treatment plan and diagnosis. Progress takes time and scientific breakthroughs don’t happen overnight. If you or your acquaintance gets diagnosed with Type 5 diabetes, consider participating in a clinical trial. Your participation could play a vital role in advancing the research and helping future generations live healthier and hassle-free lives. Talk to your healthcare provider about your symptoms and available options.
