What Is Type 5 Diabetes?

Although Type 1 and Type 2 diabetes may be commonly known, Type 5 is a recently classified, unique form of malnutrition-related diabetes. This type of diabetes more frequently impacts people in low-to-middle income countries and is increasingly acknowledged as a significant contributor to global diabetes. It is estimated that up to 25 million people worldwide may be affected.

What Is Type 5 Diabetes?

Type 5 diabetes typically develops in underweight young adults living in resource-limited settings, such as rural communities or areas with shortages of food and essential supplies. Unlike other types of diabetes, chronic protein deficiency, especially during childhood and adolescence, impairs the pancreas’s ability to make insulin. Insulin is a hormone made by the pancreas that helps move glucose (sugar) from the blood into the body’s cells, where it’s used for energy. Without enough insulin, glucose builds up in the bloodstream and cells can’t get the energy they need. Other potential contributors to Type 5 diabetes include repeat infections and poor maternal nutrition during pregnancy.

Although malnutrition-related diabetes was first documented in 1955, it has been under-recognized to date. By classifying Type 5 diabetes, the hope is to increase attention on how this condition develops and to discover improved treatment options.

How Does Type 5 Diabetes Compare to Other Types of Diabetes?

Type 5 diabetes is different than other forms of diabetes. In Type 1 diabetes, the insulin-producing cells in the pancreas are attacked by the body’s immune system, stopping insulin production. The most common form of diabetes, Type 2, happens when the body is not able to use insulin properly. While Type 2 is linked to being overweight, it can occur in people at any weight. Gestational diabetes develops during pregnancy and usually goes away after delivery, though it increases the risk of developing Type 2 diabetes later in life.

Because Type 5 diabetes is triggered by chronic undernutrition rather than immune dysfunction, excess body weight, or pregnancy-related hormone changes, it requires a unique approach to diagnosis and management.

How Is Type 5 Diabetes Diagnosed and Managed?

Type 5 diabetes may be misdiagnosed as either Type 1 or Type 2 diabetes. Type 5 diabetes should be suspected in undernourished young adults who meet all five of these criteria:

• A body mass index (BMI) below 18.5 (underweight)
• High blood sugars
• Impaired insulin production
• Lower body fat
• No markers of autoimmune diabetes or signs of insulin resistance

Recognizing and accurately diagnosing Type 5 diabetes is critical to ensure appropriate treatment. Management of Type 5 Diabetes should focus on improving blood glucose and correcting malnutrition.

The best way to treat Type 5 diabetes is not fully known at this time. Insulin may be needed in smaller doses than for those with Type 1 diabetes to avoid low blood sugars. In some cases, oral diabetes medications may be used to stimulate insulin production. Because pills are less costly than insulin and easier to take, they may be useful when resources are limited.

Nutrition Considerations and Key Takeaways about Type 5 Diabetes

Addressing social, cultural and educational needs are essential steps in Type 5 diabetes treatment and prevention. Because this type of diabetes is linked to long-term undernutrition, access to food is both part of the problem and the solution. Nutrition concerns include balancing carbohydrates while improving intake of protein, calories, vitamins and minerals. Encouraging the use of affordable, locally available foods may make healthier eating more sustainable. Nutrition supplements and fortified foods may also be needed to meet nutritional needs. The recognition of this condition underscores the importance of nutrition and the vital role registered dietitian nutritionists play in the management and prevention of chronic diseases.