The International Diabetes Federation has officially recognised a new form of diabetes, Type 5, linked to chronic undernutrition, which could transform diagnosis and treatment, particularly in low-income countries.
The International Diabetes Federation has formally recognised a new category, Type 5 diabetes, in a move that diabetes specialists say could reshape diagnosis and care for people whose illness has long been linked to malnutrition rather than obesity. Sun Ming-tsung, deputy secretary-general of the Taiwan Obesity Society’s eastern branch, said on his website and Facebook page that the condition, previously called malnutrition-related diabetes mellitus, was acknowledged by the federation in 2025 as a distinct classification.
According to the federation, Type 5 diabetes is associated with chronic undernutrition, particularly during adolescence and young adulthood, and is most common in low- and middle-income countries, especially in South-East Asia and sub-Saharan Africa. The organisation said the recognition is an important step towards better global understanding of a form of diabetes that has often been overlooked. Cleveland Clinic says the condition is thought to arise when long-term nutritional deficiency prevents the pancreas from developing properly, leaving patients unable to make enough insulin.
Sun said the new classification matters because Type 5 diabetes is neither Type 1, which is driven by autoimmunity, nor Type 2, which is typically linked to insulin resistance. He said patients are often very lean, with body mass index below 19, and do not show autoimmune antibodies. In his view, that has left some people misdiagnosed and treated in ways that do not fit the underlying problem. The federation launched a working group in April 2025 to draw up diagnostic criteria and treatment guidance, with experts including Meredith Hawkins and Nihal Thomas leading the effort.
For clinicians, the practical message is to look more closely at younger, undernourished patients who show signs of insulin deficiency. Sun said nutrition support should be central to care, alongside carefully considered use of insulin or other medicines. The federation has said the new category is intended not only to improve diagnosis, but also to support research and education for health professionals dealing with a condition that may affect millions of people worldwide.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
