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Arab Times
19-05-2025
- Health
- Arab Times
The link between malnutrition and type 5 diabetes: What you need to know
NEW YORK, May 19: After years of debate, the International Diabetes Federation (IDF) has officially recognized type 5 diabetes as a distinct diagnosis. This new classification highlights a form of the condition linked to childhood malnutrition, which primarily affects millions of teens and young adults, particularly in regions like Asia and Africa. Dr. Meredith Hawkins, the founding director of the Global Diabetes Institute at Albert Einstein College of Medicine and co-chair of the IDF working group on type 5 diabetes, noted that type 5 diabetes could also impact certain populations in the United States, including children in foster care or migrants who have faced food insecurity. Diabetes in all its forms impacts the body's ability to process glucose, a critical energy source for cells. Without proper regulation, glucose accumulates in the bloodstream, potentially causing damage to vital organs, including the eyes, kidneys, nerves, and heart. Type 1 diabetes occurs when the immune system destroys the insulin-producing cells in the pancreas, resulting in little or no insulin to help cells absorb glucose. In type 2 diabetes, the body either does not use insulin effectively or doesn't produce enough, and obesity is a significant risk factor. However, type 5 diabetes arises from childhood undernutrition, which can impair pancreatic development and reduce insulin production, according to Dr. Hawkins. Although experts have recognized type 5 diabetes for decades, it was often misclassified as either type 1 or type 2 diabetes. Dr. Hawkins explained that individuals with type 5 diabetes typically require very small amounts of insulin or oral medication, as standard insulin doses can dangerously lower blood sugar and lead to severe complications, even death. She first noticed these treatment failures while treating young patients in Africa years ago. Currently, the American Diabetes Association (ADA) recognizes type 1, type 2, and gestational diabetes, as well as other types that are caused by specific conditions such as cystic fibrosis, pancreatic disease, organ transplant, steroid therapy, or genetic factors. Other medical organizations acknowledge additional forms of diabetes, such as type 3, which links insulin resistance to Alzheimer's disease, and type 4, which is age-related and found in lean, older adults. Despite advances in diabetes classification, there is no specific blood test to diagnose type 5 diabetes. Dr. Hawkins explained that the diagnosis is largely based on assessing the clinical picture, particularly the patient's history of childhood malnutrition. While malnutrition is the primary factor defining type 5 diabetes, Dr. Hawkins believes that awareness of this condition may also benefit individuals in higher-income countries who experience significant weight loss, such as those who undergo bariatric surgery or use GLP-1 medications. Concerns about this issue were raised by colleagues in Japan, who observed young women intentionally starving themselves and displaying a clinical profile similar to that of individuals with type 5 diabetes. However, Dr. Hawkins emphasized that more research is needed to understand whether extreme weight loss can actually lead to type 5 diabetes. Significant weight loss can reduce muscle mass, which, in turn, affects how the body processes glucose. As skeletal muscle is the body's largest insulin-sensitive tissue and accounts for much of its glucose uptake, losing muscle mass can result in insulin resistance—a condition where cells do not properly respond to insulin, leading to elevated blood sugar levels. While the American Diabetes Association has not yet classified type 5 diabetes, experts believe that the delay is likely due to the time required for internal review and consensus within the organization. Dr. Hawkins anticipates that the ADA will formally address the condition soon. Dr. Rozalina McCoy, an associate professor of medicine at the University of Maryland School of Medicine, suggested that there may already be cases of type 5 diabetes in the US that have gone unrecognized by healthcare providers. "It is important to consider this unique type of diabetes and treat it carefully, not only in those who have a childhood history of malnutrition, but also in those who have lost significant weight or are malnourished for other reasons, such as an eating disorder or weight loss treatment, either surgical or medical," McCoy said. As more attention is brought to type 5 diabetes, healthcare providers are urged to recognize and properly treat this condition, especially for individuals with a history of childhood malnutrition or significant weight loss.


Express Tribune
22-04-2025
- Health
- Express Tribune
New Type 5 diabetes officially recognised, impacts 25m people worldwide
Previously misunderstood and often misdiagnosed, Type 5 diabetes – also known as malnutrition-related diabetes or Maturity Onset Diabetes of the Young (MODY) – disproportionately affects lean adolescents and young adults, especially in low and middle-income countries across Asia and PEXELS Listen to article A rare and long-overlooked form of diabetes, linked not to obesity but to malnutrition, has been formally recognised by the International Diabetes Federation (IDF) as 'Type 5 diabetes' — a landmark moment for global health experts and patients alike. Previously misunderstood and often misdiagnosed, Type 5 diabetes – also known as malnutrition-related diabetes or Maturity Onset Diabetes of the Young (MODY) – disproportionately affects lean adolescents and young adults, especially in low and middle-income countries across Asia and Africa. The IDF's official recognition came via a formal vote at the World Diabetes Congress in Bangkok on 8 April, marking decades of medical debate. Experts say this rare form of diabetes, which develops in teenagers and young adults due to prolonged nutritional deficiencies, affects an estimated 25 million people worldwide. Unlike the more widely known types of diabetes, which are typically linked to obesity, genetics, or autoimmune responses, Type 5 stems from long-term malnutrition. It leads to poor insulin production due to pancreatic beta cell dysfunction, making standard insulin-based treatments risky and potentially fatal. Professor Meredith Hawkins of the Albert Einstein College of Medicine, who has long advocated for its recognition, welcomed the IDF's decision, saying: 'The IDF's recognition of Type 5 diabetes is an important step toward raising awareness of a health problem that is so devastating to so many people.' She added that the disease had been 'vastly underdiagnosed and poorly understood' for decades. Her research has shown that insulin therapy, often misapplied in these patients, can cause dangerous drops in blood sugar due to the unique metabolic characteristics of the disease. The condition was first observed in Jamaica in the 1950s and was temporarily included in the World Health Organization's diabetes classifications in the 1980s before being removed in 1999 due to insufficient data. However, over the past two decades, physicians across developing countries have increasingly reported seeing young, underweight patients who do not respond to typical insulin treatments. Many of these cases were initially misdiagnosed as Type 1 diabetes. Dr Nihal Thomas of India's Christian Medical College, and a member of the Type 5 Diabetes Working Group, said the disease is 'largely inherited' and requires more targeted research and diagnosis protocols. 'Due to the lack of formal recognition, this condition has been understudied and misdiagnosed. Recognition by the IDF opens the door to better diagnosis and more tailored therapies,' Dr Thomas added. Experts emphasise that Type 5 diabetes is more common than tuberculosis and nearly as widespread as HIV/AIDS in some regions. However, the absence of an official classification until now has limited research funding, public awareness, and therapeutic innovation. With formal recognition now in place, health organisations hope the spotlight on Type 5 diabetes will drive efforts to develop diagnostic tools, train healthcare providers, and ensure effective, non-insulin-based treatment strategies for affected populations. The next steps, researchers say, involve increasing global awareness, particularly among health professionals in high-prevalence areas, and pushing for investment into research and public health solutions tailored to the condition.


The Sun
21-04-2025
- Health
- The Sun
New ‘Diabetes type 5' discovered by scientists who say it's ‘vastly undiagnosed' – do you have the signs?
A NEW form of diabetes linked to malnutrition, not obesity, has been officially recognised. 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.'


Scottish Sun
21-04-2025
- Health
- Scottish Sun
New ‘Diabetes type 5' discovered by scientists who say it's ‘vastly undiagnosed' – do you have the signs?
Click to share on X/Twitter (Opens in new window) Click to share on Facebook (Opens in new window) A NEW form of diabetes linked to malnutrition, not obesity, has been officially recognised. Named Type 5 diabetes, the disease is estimated to affect 25million people worldwide. Sign up for Scottish Sun newsletter Sign up 1 A new form of diabetes has been recognised Credit: Getty - Contributor 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. Type 5 Diabetes: Do you have the signs? Type 5 diabetes is a newly recognised form of diabetes linked to malnutrition, not obesity. It mostly affects young, undernourished people in low- and middle-income countries — and is often misdiagnosed. Common symptoms include: Very low body weight or trouble gaining weight Constant tiredness or weakness Excessive thirst Frequent urination Blurred vision Muscle loss Poor appetite or trouble digesting food No response — or bad reactions — to insulin treatment The condition is often inherited — if one parent carries the gene, their child has a 50 per cent chance of developing it. Source: International Diabetes Federation (IDF), Albert Einstein College of Medicine, Christian Medical College India '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.'


The Independent
17-04-2025
- Health
- The Independent
What is Type 5 diabetes? New form of disease recognised after decades of debate
A new type of diabetes that's linked not to obesity but to malnutrition has been officially recognised, decades after it was first observed in developing countries. The International Diabetes Federation (IDF) this month officially recognised the disease as "Type 5 diabetes" or Maturity Onset Diabetes of the Young (Mody). The rare form of diabetes is believed to affect about 25 million people globally, and is caused by malnutrition-induced low insulin production among lean and malnourished teenagers and young adults in low and middle-income households, according to reports. The new disease, distinct from Type 1 and 2 diabetes, was officially recognised through a vote on 8 April at the IDF's World Diabetes Congress in Bangkok, Thailand following years of debate over its identification. Meredith Hawkins, professor of medicine at Albert Einstein College of Medicine, said malnutrition-related diabetes 'has historically been vastly underdiagnosed and poorly understood'. "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." Type 5 diabetes is a rare, inherited form of the disease that develops in the early teens or 20s in people who have a genetic mutation passed from parent to child. If a parent has the affected gene, their children have a 50 per cent chance of also being carriers. It is not caused by being obese or through lifestyle choices. Mody is estimated to affect up to 25 million people globally, mainly young men in Asia and Africa with a body mass index less than 19kg/m2, according to experts. Nihal Thomas, professor of endocrinology at Christian Medical College in India and a member of the Type 5 Diabetes Working Group, said 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,' he was quoted by The Indian Express as saying. Mody was first described in Jamaica in 1955. Three decades later, the World Health Organization officially classified 'malnutrition-related diabetes mellitus' as a distinct diabetes type, before dropping the category in 1999 due to a lack of evidence. Patients are often misdiagnosed as having Type 1 diabetes despite the fact that providing them too much insulin can rapidly prove fatal, Dr Hawkins told Medscape Medical News. "Malnutrition-related diabetes is more common than tuberculosis and nearly as common as HIV/AIDS, but the lack of an official name has hindered efforts to diagnose patients or find effective therapies," Dr Hawkins said. Dr Hawkins said she first learned of malnutrition-related diabetes in 2005 while teaching at global health meeting, when doctors from multiple countries told her they were seeing patients with "an unusual 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, with is typically associated with obesity, she said, adding: "It was very confusing." Dr Hawkins founded Einstein's Global Diabetes Institute in 2010, which began leading international efforts to uncover the underlying metabolic defects that leads to malnutrition-related diabetes. More than a decade later in 2022, Dr 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 this form of diabetes have a profound defect in the capacity to secrete insulin, which wasn't recognised before. "This finding has revolutionised how we think about this condition and how we should treat it." Doctors worldwide are still unsure how to treat these patients, who often don't live for more than a year after diagnosis, according to Dr Hawkins. She added that to manage Type 5 diabetes, the patients should include much higher amounts of protein and lower amounts of carbohydrates in their diet, while paying attention to deficient micronutrients. "But this needs to be carefully studied now that there is global will and an official mandate from [IDF] to do so.'