Emerging Type 5 Diabetes Demands Specialized Treatment Approaches

Emerging Type 5 Diabetes Demands Specialized Treatment Approaches

Current data reveals that over 588 million American adults are living with diabetes, with type 2 diabetes accounting for 90% to 95% of these cases. In contrast, type 1 diabetes, though constituting 5% to 10% of cases, remains widely recognized. Recently, researchers have brought attention to a lesser-known variant known as type 5 diabetes or malnutrition-related diabetes mellitus (MRDM), advocating for its unique classification and tailored treatment.

Understanding the Different Types of Diabetes

Type 2 diabetes is prevalent among adults, yet it can also manifest in children. The Centers for Disease Control and Prevention identifies key risk factors, including family history, advancing age, obesity, and unhealthy lifestyle choices. Dr. Jeffrey Hockings, founder and CEO of the Diabetes Reversal Group in Texas, explains that type 2 diabetes occurs due to insulin resistance. A long-standing diet high in sugars and carbohydrates leads the body to misinterpret its own insulin, resulting in resistance.

This insulin resistance maintains high blood sugar levels, often necessitating either oral medications or insulin therapy to manage the condition. Fortunately, Dr. Hockings notes that with significant lifestyle changes, type 2 diabetes can be reversed.

Type 1 Diabetes: A Different Challenge

Type 1 diabetes presents a metabolic condition in which the body either becomes resistant to insulin or fails to produce sufficient insulin. This form of diabetes is not reversible. Typically diagnosed in children, adolescents, and young adults, adults can also become affected. Dr. Hockings clarifies that type 1 diabetes is often associated with genetic factors or autoimmune diseases that hinder the pancreas from producing enough insulin. Patients must rely on daily insulin injections or pumps throughout their lives.

Other Types of Diabetes

In addition to type 1 and type 2, other established categories include type 3c, which arises from conditions such as chronic pancreatitis and pancreatic cancer, and gestational diabetes, which can develop during pregnancy. Maintaining awareness of these variants is crucial for healthcare providers and patients alike.

Introducing Type 5 Diabetes

Type 5 diabetes or MRDM results from chronic undernutrition and existing health disparities, according to the International Diabetes Federation (IDF). This condition often presents with significant weight loss, fatigue, an increased susceptibility to infections, frequent urination, and excessive thirst.

Tanya Freirich, a registered dietitian nutritionist based in Charlotte, North Carolina, explains that type 5 diabetes primarily develops in individuals with a low body mass index (BMI) who experienced chronic malnutrition during both their developmental and adult years. Notably, these individuals do not exhibit the same insulin resistance characteristics as those diagnosed with type 2 diabetes.

The Debate Among Medical Professionals

While type 5 diabetes shares certain similarities with both types 1 and 2, it possesses distinct features that justify its separate diagnostic criteria, according to Freirich. In January 2025, at an international expert meeting in India, MRDM was formally classified as type 5 diabetes. Subsequently, in April 2025, type 5 diabetes received official recognition at the IDF World Diabetes Congress 2025 held in Bangkok.

As part of this acknowledgment, IDF President Peter Schwarz announced the formation of a specialized type 5 diabetes working group. This initiative aims to establish clear diagnostic criteria and appropriate treatment protocols for this emerging form of diabetes. Nonetheless, there remains contention within the medical community about whether type 5 diabetes adequately merits a distinctive classification, as indicated by Dr. Bronwyn Holmes, a board-certified physician on Eden’s Medical Advisory Board in New York.

Dr. Holmes argues that understanding the unique biological mechanisms, public health implications, and clinical presentations associated with type 5 diabetes supports its separate classification.

Diagnosis and Treatment Protocols

At present, type 5 diabetes has not been formally recognized by prominent health organizations, such as the American Diabetes Association or the World Health Organization. Diagnosing this condition requires evaluating a history of malnutrition, a low BMI, and typically an age of onset under 30. Blood glucose tests are also essential for confirming the diagnosis.

Effective treatment for type 5 diabetes focuses on nutritional rehabilitation to address any deficiencies while optimizing pancreatic function. Though some individuals may require insulin, Hocking emphasizes the importance of careful dosage control to prevent potentially dangerous drops in blood sugar levels.

A management plan may also incorporate oral medications and a high-protein diet. Freirich highlights that taking into account the metabolic disparities in type 5 diabetes is crucial for successful treatment strategies.

Proactive Management and Empowerment

For individuals with type 5 diabetes, proper dietary management is essential for addressing malnutrition as well as maintaining optimal blood sugar levels. Freirich explains that patients in this category tend to be more susceptible to low blood sugars due to heightened insulin sensitivity and their ability to produce some insulin naturally.

Anyone experiencing symptoms associated with type 5 diabetes or any type of diabetes should seek guidance from a qualified healthcare professional for appropriate testing, diagnosis, and tailored treatment strategies. As research into type 5 diabetes evolves, growing recognition may lead to better management for those affected by this unique form of the disease.