New Classification of Diabetes: Type 5 Diabetes Emerges as a Distinct Condition
Recent research has unveiled a significant development in the understanding of diabetes, with experts advocating for the recognition of a lesser-known variant: Type 5 diabetes, also known as malnutrition-related diabetes mellitus (MRDM). This emerging classification highlights the need for tailored treatment approaches for individuals affected by this condition, which is distinct from the more commonly known Type 1 and Type 2 diabetes.
The Diabetes Landscape
Diabetes has become a pressing public health issue, with over 588 million adults in the United States currently diagnosed with the condition. The Centers for Disease Control and Prevention (CDC) reports that between 90% and 95% of these cases are Type 2 diabetes, a condition primarily linked to lifestyle factors such as obesity, poor diet, and lack of physical activity. Type 1 diabetes, which accounts for only 5% to 10% of cases, is an autoimmune disorder that typically manifests in childhood and requires lifelong insulin therapy.
Understanding Type 1 and Type 2 Diabetes
Type 2 diabetes is characterized by insulin resistance, where the body fails to respond effectively to insulin, leading to elevated blood sugar levels. Dr. Jeffrey Hockings, founder of the Diabetes Reversal Group in Texas, explains that this condition often results from a long-term diet high in sugars and carbohydrates. In contrast, Type 1 diabetes arises from a genetic predisposition or autoimmune response that impairs insulin production in the pancreas. Unlike Type 2, Type 1 diabetes is not reversible and necessitates daily insulin administration.
Introducing Type 5 Diabetes
Type 5 diabetes, or MRDM, has recently gained attention for its unique characteristics and the specific health challenges it presents. According to the International Diabetes Federation (IDF), this form of diabetes is primarily the result of chronic undernutrition and health disparities. It is often diagnosed in individuals with a low body mass index (BMI) who have experienced malnutrition during critical developmental periods.
Symptoms and Diagnosis
Common symptoms of Type 5 diabetes include significant weight loss, fatigue, increased susceptibility to infections, frequent urination, and excessive thirst. Diagnosis typically involves assessing a patient’s nutritional history, BMI, and age, particularly if diagnosed before the age of 30. Blood glucose tests are also employed to confirm the condition.
Dr. Hockings emphasizes that while Type 5 diabetes shares some features with Type 1 and Type 2 diabetes, it is distinct enough to warrant its own classification. “Individuals with Type 5 diabetes do not exhibit the same insulin resistance seen in Type 2 diabetes,” he notes.
Historical Context and Recognition
The formal classification of MRDM as Type 5 diabetes occurred during an international meeting of diabetes experts in India in January 2025. This recognition was further solidified at the IDF World Diabetes Congress in Bangkok later that year. IDF President Peter Schwarz announced the formation of a working group dedicated to defining diagnostic criteria and treatment protocols for this new classification.
Despite this progress, the medical community remains divided on whether Type 5 diabetes should be categorized separately. Dr. Bronwyn Holmes, a board-certified physician, argues that the unique biological mechanisms and public health implications of Type 5 diabetes justify its distinct classification. However, it has yet to receive formal recognition from major organizations such as the American Diabetes Association or the World Health Organization.
Treatment Approaches
The treatment of Type 5 diabetes focuses on nutritional rehabilitation to address deficiencies and enhance pancreatic function. Dr. Hockings explains that while some patients may require insulin, careful management is essential to prevent dangerously low blood sugar levels. A high-protein diet and oral medications are also integral components of the treatment plan.
Tanya Freirich, a registered dietitian specializing in diabetes, highlights the importance of considering the metabolic differences associated with Type 5 diabetes. “Individuals with this condition are more prone to low blood sugars due to their insulin sensitivity and ability to produce some insulin,” she states. A tailored diet can help manage malnutrition and maintain optimal blood sugar levels.
The Broader Implications
The emergence of Type 5 diabetes underscores the need for a more nuanced understanding of diabetes as a spectrum of conditions rather than a one-size-fits-all diagnosis. This perspective is particularly relevant in light of the increasing prevalence of diabetes globally, which has been exacerbated by factors such as urbanization, dietary changes, and socioeconomic disparities.
Historically, diabetes has been categorized primarily into Type 1 and Type 2, with limited recognition of the diverse factors that contribute to its development. The introduction of Type 5 diabetes may pave the way for more personalized treatment strategies that address the specific needs of individuals affected by malnutrition and related health issues.
Conclusion
As the medical community continues to explore the complexities of diabetes, the recognition of Type 5 diabetes represents a significant step forward in understanding and treating this multifaceted condition. With over half a billion adults living with diabetes, the need for tailored interventions has never been more critical. As research progresses, it is essential for healthcare professionals to remain informed about emerging classifications and treatment options to provide the best care for their patients. Individuals experiencing symptoms of any form of diabetes are encouraged to consult qualified healthcare professionals for accurate diagnosis and effective treatment plans.
