New ‘Diabetes type 5' discovered by scientists who say it's ‘vastly undiagnosed' – do you have the signs?
Named Type 5 diabetes, the disease is estimated to affect 25million people worldwide.
It mainly strikes malnourished, lean teens and young adults in low and middle-income countries.
The International Diabetes Federation (IDF) voted to classify the condition previously known as Maturity Onset Diabetes of the Young (MODY) at its World Diabetes Congress in Bangkok on April 8th.
'It has historically been vastly underdiagnosed and poorly understood,' said Professor Meredith Hawkins of Albert Einstein College of Medicine, said.
'The IDF's recognition of it as 'Type 5 diabetes' is an important step toward raising awareness of a health problem that is so devastating to so many people," she added.
Globally, around 830 million adults are living with diabetes, mostly Type 1 and Type 2, according to a 2022 study.
Both types affect the body's ability to control blood sugar levels.
In Type 1 diabetes, the body can't produce insulin - a hormone that helps move sugar from the blood into cells for energy. This causes high blood sugar, which can damage organs.
In Type 2 diabetes, the body still makes insulin but becomes resistant to it, so sugar stays in the blood instead of entering the cells. Over time, this also leads to high blood sugar levels.
Type 5 diabetes is different. It's caused by malnutrition, which leads to low insulin production. The leaves the body unable to make enough insulin to manage blood sugar properly.
It's not due to a total lack of insulin like Type 1, or insulin resistance like Type 2 - rather the body doesn't produce enough, often because of poor nutrition.
40 Day Health Challenge GP Dr Sumi Dunne on signs and symptoms of diabetes to watch out for
Unlike Types 1 and 2, Type 5 is also usually inherited. If a parent carries the gene, their child has a 50 per cent chance of developing it, as the gene makes them more vulnerable to the condition.
Type 5 diabetes typically appears in early teens or 20s, especially in young men in Asia and Africa with a body mass index (BMI) of 19.
A healthy BMI is between 18 and 24.9, suggesting that those with Type 5 diabetes tend to be on the thinner side of healthy.
Professor Nihal Thomas, of Christian Medical College in India, told The Indian Express: 'The disease causes pancreatic beta cells to function abnormally, which leads to insufficient production of insulin.
"Due to the lack of formal recognition, this condition has been understudied and misdiagnosed.'
Doctors often mistake it for Type 1 diabetes - but giving insulin can be dangerous, Prof Hawkins told Medscape Medical News.
'Malnutrition-related diabetes is more common than tuberculosis and nearly as common as HIV/AIDS,' Prof Hawkins said.
'But the lack of an official name has hindered efforts to diagnose patients or find effective therapies.'
She first heard about the condition in 2005 when doctors from several countries described a strange form of diabetes.
"The patients were young and thin, which suggested that they had Type 1 diabetes, which can be managed with insulin injections to regulate blood sugar levels.
"But insulin didn't help these patients and in some cases caused dangerously low blood sugar," she said, according to Medical Express.
The patients did not seem to have Type 2 diabetes either, as it is typically associated with obesity, which the doctor said "was very confusing."
In 2010, Prof Hawkins founded Einstein's Global Diabetes Institute.
More than a decade later in 2022, Prof Hawkins and her colleagues at the Christian Medical College demonstrated that this form of diabetes was fundamentally different from Type 1 and 2.
She said people with Type 5 diabetes have a profound defect in the capacity to secrete insulin which wasn't recognised before.
This means their bodies can't properly absorb and store nutrients, especially sugar and fat to put on any weight, or store muscle.
As a result, they often stay very thin, even if they're eating enough.
'This finding has revolutionised how we think about this condition and how we should treat it," she said.
But there's still no standard treatment, with many patients dying within a year of diagnosis.
Prof Hawkins said diets high in protein and low in carbohydrates, along with targeted micronutrients, may help.
But she warned: 'This needs to be carefully studied now that there is global will and an official mandate from [IDF] to do so.'
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