I am an Endocrinologist and Diabetologist, and today I will be exploring Type 5 Diabetes, a recently recognised form of diabetes that is helpful in understanding this complex metabolic disorder. 

For decades, we have classified diabetes into familiar types, type 1, type 2, gestational diabetes during pregnancy and the rarer monogenic forms like MODY. But recent research has revealed a 5th type with unique characteristics and treatment implications.  

In April 2025, the International Diabetes Federation officially recognised type 5 diabetes as a distinct category. This condition primarily affects young, undernourished individuals in low and middle-income countries like Asia and Africa. 

Unlike type 1 diabetes, which is autoimmune, or type 2, which is often linked to obesity and insulin resistance, type 5 diabetes stems from chronic undernutrition during critical developmental periods in childhood and adolescence. This undernutrition impairs pancreatic development, leading to reduced insulin production. 

Individuals with type 5 diabetes often present with symptoms similar to other forms of diabetes: increased thirst and urination, unexplained weight loss, fatigue, blurred vision, and slow-healing wounds. However, they are typically young and thin, leading to frequent misclassification as type 1 diabetes. Standard insulin treatments can be ineffective or even harmful, sometimes causing dangerously low blood glucose levels.

This was recognised by Dr Meredith Hawkins, her studies revealed that this form of diabetes is characterised by severe insulin deficiency without the autoimmune markers of type 1 or type 2.

Currently, there is no standardised treatment for type 5 diabetes. Management strategies focus on nutritional interventions, including high-protein, low-carbohydrate diets with micronutrient supplementation. Some patients may respond to oral medications, but more research is needed to establish effective treatment protocols.

The formal recognition of type 5 diabetes marks a pivotal moment in our understanding of this disease. It underscores the importance of considering socioeconomic factors in health and the need for tailored medical approaches. As awareness grows, I hope to see improved diagnosis, treatment, and outcomes for those affected by this condition.