Once overlooked, type 5 diabetes is now considered a unique condition, mainly in low-income areas with underweight and malnourished people. Unlike Type 1 or Type 2, it usually responds to tablets instead of insulin and can be affected by millions.
The little-known form of diabetes was originally determined 75 years ago and is now making a comeback in global medical discussions. Now known as type 5 diabetes, the condition was formally recognized by International Diabetes Federation President Professor Peter Schwartz earlier this week and was held in Bangkok in 2025. A global task force was also set up to study its spread and potential causes.
According to experts, type 5 diabetes does not meet the common characteristics of type 1 or type 2 diabetes. “People with type 5 diabetes are usually underweight, have no family history of diabetes, and show symptoms that are not exactly matched with type 1 or 2 diabetes,” said Dr. Nihal Thomas, professor of the Department of Endocrinology at the Vellore (CMC) of the Christian Medical School.
This was first observed in the 1960s in parts of the population of India, Pakistan and sub-Saharan Africa. Originally known as type J diabetes, as initially detected in Jamaica, it was briefly included in the 1985 World Health Organization classification. However, it was deleted in 1998 due to the lack of reliable physiological evidence and has long been considered an insane form of existing types of diabetes.
In 2022, a study conducted by Dr. Thomas and Dr. Riddhi Dasgupta of CMC, as well as Professor Meredith Hawkins of Albert Einstein School of Medicine in New York, and Dr. Riddhi Dasgupta of CMC caught the attention. Their research shows that type 5 diabetes is indeed physiologically different from type 1 and type 2 diabetes. ‘Diabetes type 5 diabetes is insulin deficiency but insulin resistance. This is a key difference from type 2 diabetes, and despite the production of insulin, the body is still resistant to the effects of insulin. ” said Dr. Thomas.
Patients diagnosed with this disease usually have an extremely low body mass index (BMI), usually less than 18.5 kg/m2. While past studies have shown that babies born later born with overborn babies may have type 2 diabetes, researchers have found that those who are malnourished after birth may develop type 5 diabetes.
Another major difference is that type 5 patients do not have antibodies that are commonly seen in type 1 diabetes. Additionally, only half of the affected individuals can be managed with oral medications alone. ‘In addition, about 50% of these can be managed with a tablet instead of insulin. This is important because the 5 types are visible in low-resource fields. Dr Thomas added. For example, in India, cases are more common in regions with lower GDP.
The results of the study were published in the 2022 journal Diabetes Care. Since then, Scientific Americans have published a detailed review in 2023, which has helped bring more international focus to this long-standing state.
Dr. Thomas also clarified that type 5 should not be confused with Mody-5 (mature diabetes with young or HNF1-beta mutations), a rare genetic form of diabetes. He added that there are approximately 25 to 30 million cases of type 5 diabetes worldwide.
