A long-overlooked form of diabetes that affects millions of undernourished young people in low- and middle-income countries has finally been officially recognized as a distinct type of the disease. The International Diabetes Federation (IDF) has named it type 5 diabetes, marking a turning point in global efforts to understand and treat this deadly condition.
Type 5 diabetes, also known as malnutrition-related diabetes, mostly affects lean teenagers and young adults in regions such as Asia and Africa where food insecurity and poverty are widespread.
Unlike type 2 diabetes, which is linked to obesity and accounts for most diabetes cases in developing countries, type 5 diabetes is caused by chronic undernutrition. Despite being described as far back as 70 years ago, it has often gone unrecognized or misunderstood by health professionals.
Dr. Meredith Hawkins, a professor of medicine and founding director of the Global Diabetes Institute at Albert Einstein College of Medicine, has been a leading force behind this recognition.
“Malnutrition-related diabetes has historically been vastly under-diagnosed and poorly understood,” she said. “The IDF’s recognition of it as type 5 diabetes is an important step toward raising awareness of a health problem that is so devastating to so many people.”
It’s estimated that 20 to 25 million people globally may be living with this condition. Many of them go untreated or are misdiagnosed, often dying within a year of diagnosis because traditional diabetes treatments don’t work—and can even be harmful.
For instance, some patients are given insulin assuming they have type 1 diabetes, but insulin doesn’t help and may cause life-threatening drops in blood sugar.
Dr. Hawkins first encountered reports of this unusual form of diabetes in 2005 during global health meetings. Doctors from several countries were describing young, thin patients with diabetes who didn’t fit the usual profiles for type 1 or type 2. Their symptoms didn’t improve with standard treatments, leaving many physicians confused and concerned.
Determined to investigate further, Dr. Hawkins established the Global Diabetes Institute in 2010. Her team partnered with Christian Medical College in Vellore, India, to lead studies into the condition’s biological causes.
In a 2022 study published in Diabetes Care, they found that people with malnutrition-related diabetes don’t suffer from insulin resistance, as previously believed. Instead, they have an impaired ability to produce insulin in the first place—a key discovery that changed how scientists view the disease and its treatment.
To build global momentum, Dr. Hawkins and her colleagues hosted an international meeting in India in January 2025. Researchers from several countries presented evidence to a panel of experts, including leaders from the IDF and the American Diabetes Association.
The group voted unanimously to recognize malnutrition-related diabetes as a distinct condition. This decision was formally endorsed at the IDF World Diabetes Congress in Bangkok, Thailand.
Following the announcement, IDF President Dr. Peter Schwarz confirmed the formation of a dedicated working group for type 5 diabetes. Co-chaired by Dr. Hawkins, the group will spend the next two years developing clear diagnostic criteria and treatment guidelines for health professionals worldwide.
Dr. Hawkins believes this new designation will finally give the condition the attention it deserves. “Malnutrition-related diabetes is more common than tuberculosis and nearly as common as HIV/AIDS,” she said, “but the lack of an official name has hindered efforts to diagnose patients or find effective therapies.”
She hopes that naming it type 5 diabetes will not only help doctors correctly identify and treat it but also boost funding for research and support for the millions of people suffering silently from this overlooked condition. For the first time, there’s hope that type 5 diabetes will be addressed with the urgency it demands.
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The research findings can be found in Diabetes Care.
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