Type 5 Diabetes: The Rising Link Between Malnutrition and Blood Sugar
The medical community is currently divided over a category of diabetes that experts believe affects millions of patients worldwide. Known as type 5 diabetes, this condition is linked to chronic malnutrition during childhood and adolescence, often leading to a misdiagnosis of more common forms of the disease.
For Noella Mukumbi, a 30-year-old hairdresser living in Uganda, the journey to a correct diagnosis was harrowing. Initially diagnosed with type 1 diabetes in 2023, she began standard insulin injections that left her dizzy, unstable, and eventually caused her to collapse. It was only three years later that specialists identified her condition as likely being type 5 diabetes.
The Challenge of Classification
The International Diabetes Federation (FID) formally recognised type 5 diabetes in April 2025, following a study published in Lancet involving over 50 scientists. Despite this, the World Health Organization (OMS) does not currently recognise the condition as a separate category, citing a lack of sufficient scientific evidence to distinguish it from other forms of diabetes.
The stakes for patients are high. Because type 5 diabetes often presents in individuals with very low body weight and high blood sugar, We see frequently mistaken for type 1. However, these patients may be unusually sensitive to insulin, meaning standard treatments can lead to life-threatening hypoglycemia.
Clinical Implications and Future Outlook
Dr. Meredith Hawkins, director of the Global Diabetes Institute at Albert Einstein College of Medicine, characterizes the misclassification of this condition as a widespread issue. She notes that without proper identification, patients are at risk of severe complications, including kidney failure, nerve damage, and amputations. Researchers are concerned that as global food insecurity persists, this form of the disease could become increasingly prevalent.
As the FID establishes a working group to develop formal diagnostic and treatment guidelines, the medical community remains at a crossroads. A primary hurdle remains the lack of a standardized diagnostic test, leading some experts, such as Dr. V. Mohan, to question whether the condition is truly distinct or a variant of existing types. For patients like Noella Mukumbi, who has seen her health improve after shifting from insulin to metformin, the focus is on the tangible benefits of personalized care.
Frequently Asked Questions
What is type 5 diabetes?
It is a form of diabetes believed to result from long-term malnutrition during childhood and adolescence, affecting the pancreas’s ability to produce sufficient insulin.
Why is it often misdiagnosed?
Because it commonly affects young, thin individuals with high blood sugar, it shares clinical symptoms with type 1 diabetes, leading doctors to prescribe insulin treatments that may be harmful to these specific patients.
Is there a cure or a formal test?
There is currently no formal diagnostic test recognised internationally. Treatment often involves careful medication management and addressing nutritional needs, though clinical guidelines are still being developed by a dedicated task force.
How might the formal recognition of new medical categories change the way healthcare providers approach patients in resource-limited settings?