TYPE DIABETES: SCIENCE &
TECHNOLOGY
NEWS: New working group on
malnutrition-induced diabetes formed at recent World Diabetes Congress
WHAT’S IN THE NEWS?
Type 5 diabetes, also called
malnutrition-induced diabetes, affects undernourished individuals with low BMI
and is gaining renewed global attention. The formation of a Type 5 Diabetes
Working Group aims to develop diagnostic criteria, promote research, and
address this neglected public health issue.
Overview of Diabetes
- Diabetes is a chronic metabolic disorder where the
body fails to produce or effectively use insulin, a hormone that regulates
blood glucose levels.
- Uncontrolled diabetes leads to consistently high
blood sugar, which can cause damage to organs including the eyes, kidneys,
heart, and nerves.
- Several types of diabetes exist, classified based on
their underlying causes—ranging from autoimmune damage (Type 1) to insulin
resistance (Type 2) or other less common mechanisms.
What is Type 5 Diabetes?
- Type 5 diabetes, also referred to as malnutrition-related
diabetes mellitus, is linked to undernutrition, low body weight,
and poor nutritional status during early life.
- Unlike most other types of diabetes that are
associated with obesity or autoimmune factors, Type 5 primarily affects
lean individuals from resource-constrained regions.
- Patients typically exhibit a "thin-fat"
phenotype—low body mass index (BMI) but disproportionately high fat
deposition due to early-life nutritional deprivation.
Historical Context of Type 5 Diabetes
- This condition was first described in Jamaica in
1955 and was initially named J-type diabetes.
- The World Health Organization (WHO)
recognized it in 1985 under the term malnutrition-related diabetes
mellitus.
- However, the classification was withdrawn in 1999
due to a lack of standardized global evidence and consensus.
- Despite this, observational data continued to emerge
from countries with high undernutrition prevalence, especially in South
Asia and Sub-Saharan Africa.
Why Type 5 Diabetes Is Back in Focus
- Rising Evidence from Developing Countries:
Millions of undernourished individuals in low-income regions—especially
India, Bangladesh, Sri Lanka, Ethiopia, and Uganda—show symptoms of Type 5
diabetes.
- Undiagnosed Burden: Type 5 often goes unrecognized or is
misdiagnosed as Type 1 or Type 2 diabetes, leading to ineffective
treatments.
- Scientific Advances: A
major 2022 study by Christian Medical College (CMC), Vellore,
confirmed that Type 5 has unique pathophysiological features, including
abnormal fat storage despite lean body frames.
- Support for Thrifty Gene Hypothesis:
Evidence suggests that fetal malnutrition may program the body to store
fat more efficiently, increasing diabetes risk in adulthood even in lean
individuals.
Comparison: Different Types of Diabetes and Their
Features
- Type 1: Autoimmune destruction of pancreatic
β-cells; insulin-dependent; typically seen in children and young adults.
- Type 2: Associated with lifestyle factors such as
poor diet, obesity, and physical inactivity; treated with lifestyle
modifications and medications.
- Type 3: Experimental category linked to insulin
resistance in the brain, possibly associated with Alzheimer's disease.
- Type 4: Age-related insulin resistance; occurs in
elderly individuals due to aging-related hormonal and metabolic changes.
- Type 5: Result of early-life malnutrition and low
BMI; poorly responsive to conventional diabetes treatments; needs
customized therapeutic protocols.
- Gestational Diabetes:
Occurs during pregnancy due to hormonal interference with insulin
function; usually resolves after childbirth but increases future risk of
Type 2 diabetes in both mother and child.
Launch of the Type 5 Diabetes Working Group
- Announced at the International Diabetes
Federation’s (IDF) World Diabetes Congress held in Bangkok in April
2025.
- Aimed at formally recognizing and tackling
malnutrition-induced diabetes on a global level.
- Co-chaired by Dr. Nihal Thomas (CMC Vellore)
and Dr. Meredith Hawkins (Einstein College of Medicine, New York)—two
global leaders in metabolic and endocrinological research.
Objectives of the Working Group
- Define Clinical Guidelines:
Establish diagnostic criteria for Type 5 diabetes to aid clinicians in
accurate identification and treatment.
- Create a Global Patient Registry:
Facilitate data collection and cross-country collaboration in research and
policymaking.
- Advance Research: Encourage studies into the unique biology,
genetic, and environmental mechanisms underlying Type 5 diabetes.
- Educate Healthcare Providers:
Develop global training modules for doctors, nurses, and health workers to
improve awareness and case management.
- Advocacy and Policy Influence:
Promote inclusion of Type 5 in national diabetes frameworks and global
non-communicable disease agendas.
The Vellore Declaration
- Issued during the Congress as a formal call to
action on Type 5 diabetes.
- Urged health ministries, researchers, and
international health organizations to prioritize research funding, policy
integration, and data tracking.
- Stressed the need for sustainable nutritional
support systems to prevent early-life undernutrition, which is at the root
of Type 5 diabetes.
Role of the International Diabetes Federation (IDF)
- Founded in 1950, IDF is a leading global
organization working to promote diabetes awareness, care, prevention, and
a cure.
- It connects over 240 diabetes associations from 160+
countries, offering a platform for collaborative initiatives.
- The IDF hosts the World Diabetes Congress, a
biennial global conference to foster exchange of research and policy
innovation.
Conclusion
- The launch of the Type 5 Diabetes Working Group
is a crucial turning point in acknowledging a long-ignored form of
diabetes tied to poverty and malnutrition.
- By promoting global collaboration in research,
education, and diagnosis, this initiative offers hope for millions living
with “lean diabetes” in the world’s poorest regions.
- Moving forward, targeted nutritional interventions,
early-life healthcare, and diagnostic clarity will be essential to address
this silent but widespread metabolic crisis.
Source: https://www.thehindu.com/sci-tech/health/new-working-group-on-malnutrition-induced-diabetes-formed-at-recent-world-diabetes-congress/article69443849.ece