Malnutrition-related diabetes mellitus, or type 5 diabetes, is a specific variety of diabetes that afflicts millions of people worldwide.
It was officially recognised by the International Diabetes Federation (IDF) in 2025 and affects about 25 million individuals across the globe, with the majority not being diagnosed at all.
This is in contrast to Type 1 diabetes, which is autoimmune, or Type 2 insulin-resistant diabetes; the condition is caused by chronic malnutrition during early development stages.
Formerly known as MRDM, Type 5 diabetes is a disease that is caused by long-term deficiencies of nutrients that affect the functional development of the pancreas and insulin secretion.
The patients usually look young, skinny, or thin, which makes it difficult to diagnose, and they are often mistaken for other types of diabetes.
Proper diagnosis, safe treatment, and improving the health outcomes of individuals affected by Type 5 diabetes requires proper recognition of Type 5 diabetes.
Type 5 Diabetes History and Recognition
Early Discovery
Dr. Philip Hugh-Jones reported the first cases of this fifth form of diabetes in Jamaica in 1955, when he saw 13 unusual cases.
Such patients showed symptoms that were not typical of Type 1 or Type 2 diabetes, and the doctors were not sure how to categorize them.
It was first referred to as Type J diabetes, but was quickly forgotten and was part of unknown diabetes for many years to come, about world awareness.
WHO Classification and Withdrawal
To recognize its unique features, the World Health Organization had briefly categorized it as malnutrition-related diabetes mellitus in the 1980s.
The classification was revoked in 1999 owing to the lack of sufficient evidence that supported it, and a long time was spent arguing whether it existed or not.
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Formal Recognition by IDF
In 2025, Type 5 diabetes was formally recognized as an independent type of diabetes by the International Diabetes Federation and requires specific research and management.
This appreciation guarantees more awareness, standard diagnostic criteria, and encourages research into effective treatment options in the world.
Causes of Type 5 Diabetes
Malnutrition as the Major Cause
Chronic undernutrition in childhood or adolescence is the primary cause behind Type 5 diabetes as it disrupts the development of the pancreas and insulin secretion.
Protein, zinc, magnesium, and B vitamins deficiencies over long periods cause the pancreatic beta cells to mature partially, decreasing insulin production throughout life.
Other Risk Factors
Such high-risk groups as refugees, migrants, and people with eating disorders or years of food insecurity in the early stages of life are at risk.
In contrast to autoimmune Type 1 or insulin-resistant Type 2 diabetes, nutritional deprivation in early life causes underdevelopment of pancreatic functions and malfunctioning metabolism.
Effects on the Pancreatic Effect
Malnutrition occurring early interferes with the growth and functioning of the beta-cells, resulting in insulin deficiency and a distinct metabolic profile when compared to other types of diabetes.
The mechanism distinguishes Type 5 diabetes, but not other subtypes such as MODY Type 5, Type 1.5 diabetes, and infrequent subtypes such as Type 3 or Type 4 diabetes.
Symptoms of Type 5 Diabetes
Overlapping Symptoms
The symptoms include the overlap with other types of diabetes, such as frequent urination, excessive thirst, fatigue, unexplained weight loss, blurred vision, and slow-healing wounds.
Unique Indicators
The effects of malnutrition are manifested by patients who seem to be underweight, experience stunted growth, delayed puberty, frequent infections, and anemia.
In contrast to Type 1 diabetes, ketoacidosis is not common, and insulin resistance is low in comparison with Type 2 diabetes, which is mainly associated with the mechanisms of obesity.
Age of Onset
The symptoms normally manifest prior to the age of 30 years, and hence they affect the adolescents and young adults; therefore, early detection is essential to avoid wrong diagnosis and complications.
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Diagnosis of Type 5 Diabetes
Key Diagnostic Criteria
The diagnosis is realized through insulin production measurement, insulin sensitivity, nutrition history, BMI, growth curves, and showing no autoimmune-related indicators.
Distinction between Other Types
This fifth type of diabetes is commonly misclassified by the standard diagnostic tests, and it can only be differentiated from Type 1, Type 2, Type 1.5, and the MODY Type 5 by taking care in the evaluation.
Proper differentiation is important in the treatment of patients who have pancreatic underdevelopment, towards proper treatment and avoiding fruitless treatment.
International Guidelines Role
At IDF, metabolic and nutritional evaluation is promoted to guarantee the right diagnosis and minimize misclassification as treatment plans are developed on a global basis.
Prevalence of Type 5 Diabetes all over the World
Estimated Numbers
Whereas there are no precise statistics available, it has been estimated that Type 5 diabetes affects approximately 25 million people in the world, and most of the victims are in underdeveloped countries.
Geographic Distribution
It is widespread mostly in Asia, Africa, and some parts of Latin America, where food insecurity and long-term malnutrition are prevalent and widespread.
The At-Risk Populations of Richer Counties.
This fifth type of diabetes can develop even in developed countries, when marginalized populations and chronically malnourished refugees have access to superior healthcare.
Treatment of Type 5 Diabetes
Nutritional Interventions
The treatment will start with better nutrition by using high-protein food and adding zinc, magnesium, and B vitamins that will help restore pancreatic function.
Insulin Therapy
Insulin therapy may have to be in a low dosage form to achieve a stable level of blood glucose; however, close observation is needed to prevent potentially fatal hypoglycemia or spikes.
Medication Approaches
There are some drugs that are used in Type 2 diabetes that make insulin more effective, and new methods of precision medicine enable the individual treatment of patients.
Lifestyle and Supportive Measures
Blood glucose, dietary modifications, and treatment of malnutrition make a good base for long-term management of Type 5 diabetes.
Can Type 5 Diabetes Be Cured?
Type 5 diabetes is not completely curable at the moment, as in most cases, malnutrition at an early age leads to the underdevelopment of the pancreas, which cannot be reversed.
Nevertheless, the level of blood glucose can be brought to normal with the help of nutritional therapy, low-dose insulin, and lifestyle changes, which can help to avoid severe complications.
Current studies, such as Type 5 diabetes research papers, are looking into regenerative therapy that would be able to restore the functionality of the pancreas in the future.
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Long-Term Health Risks
Unchecked Type 5 diabetes may result in chronic hyperglycemia, frequent infections, retarded growth, and wounds that take a long time to heal.
Risks from Misdiagnosis
Patients diagnosed with Type 1 or Type 2 diabetes fail to get the correct treatment, are exposed to either hypoglycemia or hyperglycemia, or experience metabolic complications.
These risks are essential, and early identification and personalized care are vital in terms of minimizing the risk in a population with low access to healthcare.
Research and Global Initiatives
Key Studies
Studies such as the Young-Onset Diabetes in Sub-Saharan Africa (YODA) study have proved that most misdiagnosed Type 1 patients are actually Type 5 diabetes.
Such patients did not have autoimmune markers, yet secreted insufficient insulin, which is why the condition is a clear example of a metabolic disease.
International Diabetes Federation Interventions
To enhance management of Type 5 Diabetes, the IDF has formed the Type 5 Diabetes Working Group that is to establish diagnostic standards, treatment standards, and international patient registries.
Future Research Directions
Research is centered on precision medicine, nutritional interventions, and pharmacological approaches to enhance the results and quality of living of the affected people.
Incidence and Control of T5DM
Nutritional Prevention
Prevention aims at proper nutrition in children, where they should have sufficient protein, vitamins, and other minerals in order to prevent the risk of contracting Type 5 diabetes.
Managing Diagnosed Cases
In patients with the diagnosis, personalized nutrition programs with low insulin in a strictly controlled dose stabilize the level of glucose in the blood and enhance long-term health.
The early warnings should be monitored to avoid complications of metabolism, frequent infections, and growth retardation.
Diabetes Type 5 vs. Other Diabetes Type Comparisons
Differentiated Type 1 and Type 2
Type 1 diabetes is an autoimmune one, Type 2 is associated with insulin resistance, and Type 5 is developed due to malnutrition that hinders the development of the pancreas.
Distinction of Rare Types
Type 1.5, Type 3, Type 4, and MODY Type 5 diabetes, and proper diagnosis to treat and provide appropriate care.
Conclusion: Diabetes Type 5 Care in the Future
The fifth type of diabetes is a unique condition that is brought by malnutrition and not by autoimmunity or insulin resistance due to obesity, and requires special treatment.
Effective management and better results are safe and require early diagnosis, nutritional support, and the individualization of insulin therapy.
Accurate medicine, nutritional interventions, and new treatment regimes provide a glimmer of hope for the quality of life around the world.
The identification of Type 5 diabetes by the IDF has guaranteed continued research, awareness, and better management approaches in the management of Type 5 diabetes in all populations of the world.
Frequently Asked Questions (FAQs)
What is Type 5 diabetes?
Type 5 diabetes, also called malnutrition-related diabetes, is a distinct form caused by chronic undernutrition affecting pancreatic development.
What is the difference between Type 2 and Type 5 diabetes?
Type 2 diabetes is insulin-resistant and often linked to obesity, while Type 5 diabetes arises from malnutrition, with low insulin production but preserved sensitivity.
Is there Type 6 diabetes?
Currently, there is no officially recognized Type 6 diabetes, though research continues on rare or emerging forms of diabetes.
What is the difference between Type 1 and Type 5 diabetes?
Type 1 diabetes is autoimmune, destroying insulin-producing cells, whereas Type 5 diabetes results from an underdeveloped pancreas due to early-life malnutrition.
