Malnutrition, not sugar: the surprising truth about type 5 diabetes
Image: Polina Tankilevitch /pexels
Type 5 Diabetes is real - and it's tied to malnutrition, not sugar.
Here's what you need to know:
For years, diabetes has been framed as a lifestyle condition linked to poor diet and weight gain, but that's not the full story.
A new type of diabetes, now officially recognised by the International Diabetes Federation (IDF) as Type 5 diabetes, is turning that belief on its head.
And it's hitting the world's poorest communities hardest.
On April 9, Type 5 diabetes was formally added to the global classification system, the first new entry of its kind in decades.
What makes this type different? It's caused not by overnutrition, but by chronic undernutrition and the people most at risk aren't those with excess fat, but those without enough food during critical early stages of development.
'Malnutrition‑related diabetes has historically been vastly under‑diagnosed and poorly understood,' said Dr Meredith Hawkins, endocrinologist at Albert Einstein College of Medicine and founding director of the Global Diabetes Institute (GDI), in an interview with Earth.com.
Video Player is loading.
Play Video
Play
Unmute
Current Time
0:00
/
Duration
-:-
Loaded :
0%
Stream Type LIVE
Seek to live, currently behind live
LIVE
Remaining Time
-
0:00
This is a modal window.
Beginning of dialog window. Escape will cancel and close the window.
Text Color White Black Red Green Blue Yellow Magenta Cyan
Transparency Opaque Semi-Transparent Background Color Black White Red Green Blue Yellow Magenta Cyan
Transparency Opaque Semi-Transparent Transparent Window Color Black White Red Green Blue Yellow Magenta Cyan
Transparency Transparent Semi-Transparent Opaque
Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Proportional Sans-Serif Monospace Sans-Serif Proportional Serif Monospace Serif Casual Script Small Caps
Reset
restore all settings to the default values Done
Close Modal Dialog
End of dialog window.
Advertisement
Next
Stay
Close ✕
Type 5 diabetes is caused by malnutrition during early development, not overeating common in lean people.
Image: Lagos Food Bank Initiative/pexels
What is Type 5 diabetes?
Type 5 diabetes primarily affects people in Asia and Africa, especially lean adolescents and young adults who experienced poor nutrition during childhood.
According to the IDF Diabetes Atlas (11th edition), about 20 to 25 million people are already living with this type a number that rivals HIV infection rates in the same regions.
Unlike the familiar Type 2 diabetes, which is often linked to high-calorie diets and obesity, Type 5 develops when the pancreas fails to develop fully in childhood due to nutrient deficiencies particularly low protein intake during pregnancy or adolescence.
An article cited in "The Conversation" explains that rodent models have shown a clear connection between a low-protein diet and underdeveloped pancreases, which translates to reduced insulin production capacity.
Simply put: if your body never built enough insulin-producing cells as a child, you're at higher risk for developing diabetes later even if you stay lean and active.
This newly recognised condition is more than a medical milestone it's a call to rethink global health narratives.
Most public awareness campaigns around diabetes centre on obesity, sugar, and sedentary lifestyles, often overlooking the fact that millions of people face a very different risk one rooted in poverty and food insecurity.
This also exposes the health gap in countries battling undernutrition and limited access to healthcare. Type 5 diabetes often goes undiagnosed or misdiagnosed, as it doesn't fit the typical profile healthcare workers are trained to look for.
As Hawkins noted, expanding our understanding of diabetes types is not just about labels; it's about making sure the right people get the right treatment.
Recognising Type 5 diabetes is just the beginning.
Image: Nataliya Vaitkevich/pexels
Types of diabetes
Here's a simplified breakdown of the major types of diabetes to better understand where Type 5 fits in:
Type 1 Diabetes: An autoimmune condition where the body attacks insulin-producing cells. Usually appears early in life. Not linked to diet or weight. Treated with lifelong insulin therapy
Type 2 Diabetes: The most common type, often linked to obesity but not exclusively
This can be reversed with diet, exercise, and medication (like Metformin)
Ethnic background and genetics also play a role
Managed through lifestyle changes, tablets or insulin
Gestational Diabetes Temporary condition during pregnancy due to hormonal shifts.
Increases the future risk of Type 2 diabetes.
Treated with dietary changes, insulin or tablets.
Type 5 Diabetes Caused by malnutrition during early development, not overeating.
Common in lean people, especially in resource-poor countries.
Requires a new clinical approach to diagnosis and treatment.
Still under-recognised in mainstream health systems.
Why nutritional equity is keyType 5 diabetes shines a spotlight on how early-life nutrition or the lack thereof can leave permanent damage.
It also challenges the global focus on obesity as the face of diabetes, urging health systems to prioritise food security and maternal nutrition as long-term investments in public health.
This is more than a medical discovery, it's a wake-up call. With nearly one in nine adults living with diabetes worldwide, and more than 250 million people undiagnosed (International Diabetes Federation, IDF), it's time to think of diabetes in a new light, one that looks at inequality, not just indulgence.
Whether it's rooted in excess or scarcity, diabetes is a growing global crisis. Recognising Type 5 diabetes is just the beginning.
Now, the challenge is making sure people in affected communities are seen, heard, and treated starting with redefining the narrative around who is at risk and why.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Citizen
14 hours ago
- The Citizen
Rooibos and broccoli protect the heart
Biochemist Sinenhlanhla Mthembu reveals how rooibos and broccoli can help combat heart disease, a leading cause of death in South Africa. Broccoli and rooibos, common food items in South Africa, have been found to help protect against the leading cause of death: heart disease. This significant finding has emerged from research conducted by a young biochemist at North-West University's (NWU) Mahikeng campus, Sinenhlanhla Mthembu. She embarked on a mission to explore the potential role of plant-based compounds in combating heart damage associated with metabolic disorders. After dedicated research for her PhD degree, for which she graduated in July, Mthembu successfully demonstrated that both broccoli and rooibos possess the ability to protect the heart. Broccoli and rooibos can protect heart KwaZulu-Natal-born Mthembu, 27, had set herself on a research journey with a special focus. She had people in mind and how this lifestyle disease had now begun to devastate rural communities due to changing lifestyles. 'I was motivated by a desire to tackle real health challenges that affect people's lives,' Mthembu says. ALSO READ: [REVIEW] Huawei's Watch Fit 4 Pro an Apple watch killer? 'Heart disease and lipid-related disorders are major concerns, especially in South Africa, and I wanted to explore how everyday foods like rooibos and broccoli, foods many of us enjoy daily, can protect the heart.' Mthembu's study addressed the question why cardiovascular complications continue to rise, despite the availability of conventional therapies. The findings point to affordable, plant-based interventions as a potential solution. Affordable, plant-based interventions While the body naturally produces disease-fighting antioxidants such as coenzyme Q10, which is critical for heart health, metabolic complications such as dyslipidemia can disrupt these molecules, she says. 'Natural compounds such as aspalathin from rooibos and sulforaphane from broccoli can restore antioxidants, improve energy metabolism and shield heart cells from oxidative damage. 'This could improve outcomes for patients facing cardiovascular complications.' ALSO READ: Lifesaving heart surgery gives baby Oaheng a second chance to shine Mthembu is grateful to the South African Medical Research Council that supported her during her studies. But she reserved special thanks to her mentor and supervisor, Prof Sithandiwe Mazibuko-Mbeje from the biochemistry department 'who supported not only my lab work but also my dreams'. NWU vice-chancellor and principal Prof Bismark Tyobeka spoke about the young scientist's research work and how it would put NWU on the world map. Noting Mthembu's excellent research outcomes and alluding to her humble rural background, Tyobeka said, 'one's origins do not dictate one's potential and destination'. Cardiovascular disease top 3 causes of death in SA According to Discovery, cardiovascular disease is one of the top three causes of death in South Africa, ahead of HIV/Aids and TB combined in terms of mortality. The South African Heart Association said the disease was among the top three causes of death in sub-Saharan Africa. Discovery said approximately 78 475 people die from heart disease annually, or about 215 deaths per day in South Africa. NOW READ: The silent threat of hyperlipidaemia lurking in everyday joys
The Citizen
2 days ago
- The Citizen
University jumps in to fight SA's GBV
The president has declared GBV as a pandemic in South Africa. Activists fighting against gender-based violence and femicide (GBVF) and crime experts are welcoming North-West University's (NWU) launch of a GBVF Empowerment Centre. It was recently launched at the NWU Vanderbijlpark campus to serve as a one-stop hub offering psychosocial support, legal case navigation and proactive advocacy. Key partners include the Gauteng department of Community Safety, Sonke Gender Justice, Higher Health, Ikhaya le Themba Empowerment Centre and international collaborators such as University College Dublin and Dublin Rape Crisis Centre. Dr Vedhna Dayanand-Lalla from NWU said, 'The president has noted that South Africa is facing a GBVF pandemic. ' Like other institutions of higher learning, we have encountered cases of GBVF. Through the centre, we aim to address all GBVF matters effectively and efficiently. 'The centre will adhere to a strict professional and confidential process. Social workers from Ikhaya le Themba will be at the centre twice a week to provide professional services. 'Vereeniging SA Police Service members will work closely with us to ensure a smooth and qualified process for all cases. 'We plan to train student leaders to respond to trauma in a supportive manner, especially as first responders within the residences. 'We hope to include social work students and honours psychology students as interns at the centre in the near future. 'We envision a focus on research alongside community service. We hope the centre will generate quality research that will serve as the foundation for our interventions while contributing to preventative processes and programmes.' The centre will be open to the surrounding community. To kick-start community education, they partnered with Ubuntu Evolution Hub, which will train 52 school principals on GBVF, handling and reporting statutory rape, HIV/Aids and pupil pregnancy. GBV activist Prince Ntsikelelo Soga, executive director of the organisation I Am That Man, said the centre would bridge critical gaps in offering psychosocial care, legal guidance and proactive advocacy under one roof. Willem Els of the Institute for Security Studies said it was part of the bigger strategy needed, as government and law enforcement agencies do not have enough impact. – [email protected]
The Citizen
2 days ago
- The Citizen
Inside SA's multi-million rand plan to fill US funding void
The current tranche of money comes from Treasury's contingency reserve. Health Minister Aaron Motsoaledi recently announced that National Treasury had released roughly R753 million to help plug the gap left by US funding cuts to South Africa's health system. Another R268 million is also being released in the following two years for researchers that lost their US grants. But this may only constitute the first round of emergency funds from government, according to sources we spoke to. ALSO READ: Treasury allocates R750m to offset Pepfar funding withdrawal as Motsoaledi tables health budget The health department is planning to submit a bid for an additional allocation later on, which will be considered by Treasury. But this will likely only be approved if the first tranche of funding is appropriately used. So how is the money supposed to be used? To find out, we spoke with officials from the National Treasury, the National Department of Health and the South African Medical Research Council (SAMRC). Money for provinces is for saving jobs at government clinics The current tranche of money comes from Treasury's contingency reserve, which exists partially to deal with unforeseen funding shortfalls. It was released in terms of Section 16 of the Public Finance Management Act. Of the R753 million that's been announced for this year, Motsoaledi stated that R590 million would be going to provincial health departments via the District Health Programme Grant – a conditional grant for funding the country's public health efforts, particularly HIV, TB, and other communicable diseases. Such conditional grants typically give the National Health Department more say over how provincial departments spend money than is the case with most other health funding in provinces.. To explain how government officials arrived at this figure, it's worth recapping what services the US previously supported within provinces. Prior to Donald Trump becoming US president on 20 January, the US Agency for International Development (USAID) had financed health programmes in specific districts with high rates of HIV. These districts were scattered across all South Africa's provinces, save for the Northern Cape. The funds were typically channelled by USAID to non-governmental organisations (NGOs), which used the money to assist the districts in two ways. The first is that NGOs would hire and deploy health workers at government clinics. The second is that the NGOs would run independent mobile clinics and drop-in centres, which assisted so-called key populations, such as men who have sex with men, sex workers, transgender people, and people who inject drugs. Following the US funding cuts, thousands of NGO-funded health workers lost their jobs at government clinics, while many of the health centres catering to key populations were forced to close. In response, the health department began negotiations with Treasury to get emergency funding to restore some of these services. As part of its application, the health department submitted proposals for each province, which specified how much money was needed and how it would be used. (Though this only took place after significant delay and confusion). Since Treasury couldn't afford to plug the entire gap left by the US funding cuts, the provincial-level proposals only requested money for some of the services that had been terminated. For instance, funding was not requested for the key populations health centres. Instead, the priority was to secure the jobs that had been lost at government health facilities. READ MORE: Over 8 000 SA healthcare jobs lost – and more could follow – after US Pepfar aid cuts As such, the total amount that was requested from Treasury for each province was largely calculated by taking the total number of health workers that NGOs had hired at clinics and working out how much it would cost to rehire them for 12 months. Rather than paying the NGOs a grant to deploy these workers as was done by USAID, the health department proposed hiring them directly. This meant that they calculated their wages according to standard government pay scales which is less than what these workers would have earned from the NGOs. The total came to just under R1.2 billion for all the provinces combined. Treasury awarded roughly half of this on the basis that the money would be used to finance these wages for six months, rather than 12. This amounts to the R590 million for provinces that was announced by Motsoaledi. If all goes smoothly and this money is used effectively to hire these staff over the next six months, then a new tranche of Section 16 funding could be released in order to continue hiring them. Funds might also be released to fund the key populations health sites. A concern, however, is that the money may just be used by provinces to augment their ordinary budgets. If the funds aren't actually earmarked to respond to the US cuts, then it is much less likely that more emergency funding will be released. At this stage, it is too early to tell how provinces will use the money, particularly given that it appears that at least some of them haven't gotten it yet. Spotlight and GroundUp sent questions to several provincial health departments. Only the Western Cape responded. The province's MEC for Health and Wellness, Mireille Wenger, said that the funds have not yet been received by her department, but that once they were, they would be directed to several key priority areas, including digitisation of health records, and the strengthening of the primary healthcare system. It's thus not clear whether the province will be earmarking any of the funds to employ health staff axed by US-funded NGOs. In response to a question about this, Wenger stated that 'further clarity is still required from the National Department of Health and National Treasury regarding the precise provincial allocations and conditions tied to the additional funding'. What about research? Of the R753 million that's been released for this year, R132 million has been allocated to mitigate the funding cuts for research by US federal institutions, primarily the National Institutes for Health (NIH). Unlike USAID, the NIH is not an aid body. It provides grants to researchers who are testing new treatments and medical interventions that ultimately benefit everyone. These grants can be awarded to researchers in the US or abroad as part of a highly competitive application process. Researchers in South Africa are awarded a few billion rands worth of grants from the NIH each year, largely due to their expertise in HIV and TB. But over the last few months, much of this funding has been terminated or left in limbo. (See a detailed explanation of the situation here). The R132 million issued by Treasury is supposed to assist some of these researchers. It will be followed by another R268 million over the following two years. The Gates Foundation and Wellcome Trust are chipping in an additional R100 million each – though in their case, the funds are being provided upfront. All of this money – R600 million in total – is being channelled to the SAMRC, which will release it to researchers via a competitive grant allocation system. According to SAMRC spokesperson Tendani Tsedu, they have already received the R132 million from Treasury, though they are still 'finalising the processes with the Gates Foundation and Wellcome Trust for receipt of [their donations]'. The SAMRC is also in negotiation with a French research body about securing more funds, though these talks are ongoing. In the meantime, the SAMRC has sent out a request for grant applications from researchers who have lost their US money. The memo states: 'Applicants may apply for funding support for up to 12 months to continue, wind down or complete critical research activities and sustain the projects until U.S. funding is resumed or alternative funds are sourced.' 'The plan,' Tsedu said, 'is to award these grants as soon as possible this year.' READ MORE: Health experts warn of 'huge disaster' as USAID terminates Pepfar HIV funding in SA Professor Linda-Gail Bekker, CEO of the Desmond Tutu Health Foundation, told us that the hope is that the grants could fill some of the gaps. 'This is a bridge and it is certainly going to save some people's jobs, and some research,' she said, but 'it isn't going to completely fill the gap'. Indeed, the SAMRC has made clear that its grants aren't intended to replace the US funding awards entirely. This is unsurprising given that the money that's being made available is a tiny fraction of the total grant funding awarded by the NIH. It's unlikely that research projects will continue to operate as before, and will instead be pared down, said Bekker. 'It's going to be about getting the absolute minimum done so you either save the outcome, or get an outcome rather than no outcome,' she said. In other cases, the funds may simply 'allow you to more ethically close [the research project] down,' Bekker added. For some, this funding may also have come too late. Many researchers have already had to lay off staff. Additionally, patients who had been on experimental treatments may have already been transitioned back into routine care. It's unclear how such projects could be resumed months later. In response, Tsedu stated: 'For projects that have already closed as a result of the funding cuts, the principal investigator will need to motivate whether the study can be appropriately resurrected if new funds are secured.' The SAMRC has established a steering committee which will adjudicate bids. They will be considering a range of criteria, Tsedu said, including how beneficial the research might be for the South African health system, and how heavily the project was impacted by the US funding cuts. They will also consider how an SAMRC grant could 'be leveraged for future sustainability of the project, personnel or unit,' he said. An endless back and forth The job of the SAMRC steering committee will likely be made a lot more complicated by the erratic policy changes within the NIH. On 25 March, the body sent a memo to staff, – leaked to Nature and Bhekisisa – instructing them to hold all funding awards to researchers in South Africa. After this, numerous researchers in the country said they couldn't renew their grants. However, last month, Science reported that a new memo had been sent to NIH staff which said that while South African researchers still couldn't get new grants, active awards could be resumed. Since then, some funds appear to be trickling back into the country, but certainly not all. For instance, Spotlight and GroundUp spoke to one researcher who had two active NIH awards before the cuts. He stated that one of these was resumed last month, while the other is still paused. READ MORE: SA funds 90% of its HIV/Aids ARV programme, Motsoaledi reveals amid Pepfar uncertainty Bekker also told us that she had heard of one or two research grants being resumed in the last week, though she said the bulk of active awards to South Africa are still pending. 'Where people are the prime recipients [of an NIH grant] without a subawardee, there seems to be a queue and backlog but some [of those awards] are coming through,' said Bekker. 'But how long this is going to take and when it might come through we're waiting to hear.' She said a strategy might be to apply for the SAMRC bridging funding and 'if by some miracle the [NIH funding is resumed]' then researchers could then presumably retract their SAMRC application. In the meantime, health researchers will have to continue spending their time working out how to respond to the abrupt and increasingly confusing changes to funding guidelines that have dogged them since Trump assumed office. 'It's such a dreadful waste of energy,' said Bekker. 'If we were just getting on with the research, it would be so much better.' This article was republished from GroundUp under a Creative Commons license. Read the original article here.
