Latest news with #WorldDiabetesCongress
Time of India
02-05-2025
- Health
- Time of India
Access to more tests needed to identify type 5 or lean diabetes
It has for long been conjectured to be a malnutrition-related form of diabetes, but has only now been officially recognized as 'Type 5' diabetes at the World Diabetes Congress in Bangkok last week. This comes 70 years after this type of diabetes was first reported. One of the lead authors of the path-breaking physiological study which established that lean diabetes is different from other kinds of the condition, Dr Nihal Thomas , professor of endocrinology at CMC Vellore , explains the implications for the efforts to prevent and treat diabetes in India and the world. What is the prevalence of this kind of diabetes? It is estimated that there are 25 million cases across the world. However, considering that a significant proportion of populations in sub-Saharan Africa, South and Southeast Asia belong to the lower socioeconomic category, the number could be much higher. What is happening in war-torn areas of Africa like Sudan and parts of the Congo? We really do not know. Right now, Type 2 is the most prevalent. A lower prevalence of Type 5 could be because of these cases being wrongly identified as Type 1 and Type 2 diabetes, not having the criteria and access to tests to identify Type 5, and a survey bias. We need to do at least two tests to establish it is Type 5, an ultrasound scan of the pancreas to rule out chronic pancreatitis and c-peptide test to measure the level of c-peptide in the blood, which can tell you how much insulin the body is producing. C-peptide is a by-product of insulin production from the pancreas. And GAD antibodies to rule out Type 1 diabetes. We will have to make these tests widely available so that Type 5 can be correctly diagnosed to help patients better. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Free P2,000 GCash eGift UnionBank Credit Card Apply Now Undo How would the treatment differ? Unlike Type 2 diabetes, which involves resistance to insulin, in Type 5 diabetes insulin resistance is not a feature. When the body cannot produce enough insulin it can lead to ketoacidosis, a condition where the body starts burning fat for energy, instead of sugars, which happens in Type 1 diabetes However, ketoacidosis does not happen in Type 5 diabetes. It appears that at least 50% of Type 5 diabetes patients can be treated with tablets and might not need insulin. But a lot of research is needed to determine what works best for managing and treating Type 5 patients. Some of them do need insulin therapy. Is that a subset of Type 5 diabetes? These are research questions that need to be taken up. The usual advice for diabetes patients is to cut down consumption and increase physical exercise. What would be the recommendations for a person with malnutrition-related diabetes? Insulin secretion is not just dependent on carbohydrates or glucose for stimulating it. It is also dependent on amino acids, which are the building blocks for proteins, and can also stimulate insulin production. So, will a high protein diet help? We do not know. In our study we found that many with Type 5 diabetes were habituated to a low-protein diet. We prescribed them standard diets but found that they gained some weight, but never really became obese. They improved but remained underweight. We recommend a high calorie diet . How high is something we need to find out. Though most people from lower socioeconomic sections are into physical labour, not everyone is. So, we recommend some amount of resistance exercise. We need much more research on the ground in clinical settings to determine what works for them. If it was identified 70 years back, why was it retracted from the WHO classification as a distinct form of diabetes? The first case was identified in Jamaica in 1955. In India, Dr BB Tripathy in Cuttack also documented cases of individuals with low BMI and diabetes from 1963 onwards. Such cases were documented in many countries including Bangladesh, Nigeria, Ethiopia Uganda, and India. It was formally recognized by the WHO in 1985, promoted by Prof Jasbir Bajaj , as a distinct form of diabetes called malnutrition related diabetes mellitus (MDRM). However, with a lack of proper physiological studies over the next 10-15 years to establish it as a distinct type, in 1999 MDRM was omitted from the classification. The people affected by it being mostly impoverished and having little support may have been an additional factor in less attention being given to its potential existence. Moreover, calling it malnutrition-related diabetes was probably not something which would encourage acknowledging it. It was unlikely that a policy maker would be too keen on saying that malnutrition was an issue in any country. A patient would also not like to have a title such as "malnutrition modulated..." for a disease. Giving it a novel nomenclature would help in addressing these issues in part, thereby fostering greater research and policy making capacity in this regard. Cumulative research from cohorts, animal studies and epidemiology from low-income populations in Asia and Africa, has shown that having antenatal undernutrition (low birth weight) along with postnatal undernutrition (childhood undernutrition) may be responsible for this condition, a lot of work being done, particularly by Prof Chittaranjan Yajnik from Pune and Prof Allan Vaag from Copenhagen. Why did it take so long to identify this as a distinct type of diabetes For this to be acknowledged as a distinct type of diabetes, we have to rule out all other causes for diabetes like Type 1 and 2. We had to rule out a condition called fibro calculous pancreatic diabetes occurring in tropical regions and characterized by stones in the pancreas, and which, like Type 5, showed inadequate production of insulin rather than insulin resistance. We also had to rule out genetic disorders such as maturity-onset diabetes of the young (MODY) which is caused by inherited genetic mutations that affect the body's ability to produce insulin. We had to identify lean people with diabetes and rule out all these other conditions. The basic science study involving high end research, done by CMC Vellore in collaboration with the Albert Einstein College of Medicine in New York, took eight years, with committed and trained support staff implementing a tedious protocol and informed consent from patients willing to cooperate with repeated tests and close monitoring. It took time to establish beyond doubt that this was a distinct form of diabetes. Though it is still not back into the WHO classification, it has been endorsed at the World Congress of Diabetes in April 2025 by Dr Peter Schwarz , the president of the International Diabetes Federation, and is still on the International Classification of diseases (ICD).
Khaleej Times
23-04-2025
- Health
- Khaleej Times
UAE doctors warn of 'silent' diabetes emerging from chronic childhood malnutrition
Doctors in the UAE are warning of a newly recognised, silent form of diabetes — this disease doesn't stem from obesity or higher sugar levels. Different from both Type 1 and Type 2 diabetes, Type 5 diabetes stems from chronic malnutrition. It has recently been classified as a separate category, and was endorsed at the International Diabetes Federation's (IDF) World Diabetes Congress in Bangkok on April 8 this year. Dr Jobran Habeeb Al Salman, specialist in Internal Medicine at Burjeel Day Surgery Center, Shahama, said that Type 5 diabetes primarily affects those who have experienced chronic malnutrition during childhood. 'Unlike Type 1, which is an autoimmune disease, and Type 2, which is linked to insulin resistance and lifestyle, Type 5 originates from poor pancreatic development,' said Dr Al Salman. This underdevelopment often begins during critical growth phases, including the prenatal stage, due to a lack of essential nutrients. As a result, individuals with Type 5 diabetes face lifelong challenges in insulin production. Dr Rajashaker Reddy K, specialist in Internal Medicine at Lifecare Hospital, Musaffah, said: 'This form of diabetes is believed to result from chronic nutritional deficiencies that impair pancreatic function and reduce insulin output.' Symptoms like frequent urination, fatigue and weight loss, are common with the other forms of diabetes. However, Type 5 has its own distinguishing features. 'A history of stunted growth, low body weight, minimal insulin levels, and the absence of autoimmune markers are key indicators,' said Dr Al Salman. Patients are typically young, underweight, and without any family history of diabetes, making diagnosis a challenge. 'Patients with Type 5 diabetes tend to have slightly more serum insulin than those with Type 1, but less than Type 2,' said Dr Reddy. 'Physicians need to consider this possibility when diagnosing atypical diabetes cases, especially in undernourished individuals.' According to doctors, the condition is often misdiagnosed because many are still unfamiliar with it. 'It's frequently mistaken for either Type 1 or Type 2,' said Dr Al Salman. 'Primary care doctors should be vigilant when assessing slim, young patients without known risk factors. Taking a detailed nutritional history and conducting antibody tests can help confirm a Type 5 diagnosis.' Doctors said that management of the disease also requires a tailored approach. While insulin therapy is usually necessary due to the pancreas's limited function, doctors stress that nutritional rehabilitation is just as crucial. 'These patients need a comprehensive treatment plan that addresses both glycemic control and their long-term nutritional needs,' said Dr Reddy. Can it be prevented? 'If mothers and children receive proper nutrition during pregnancy and early childhood, many cases of Type 5 could be avoided,' said Dr Al Salman. 'This condition serves as a powerful reminder of how early-life nutrition shapes long-term health.' Doctors in the UAE have a clear message for residents — awareness makes a difference. 'Communities with high rates of childhood undernutrition must understand that diabetes can affect even the slim and seemingly healthy,' said Dr Al Salman. 'Doctors and patients need to consider nutritional history when diagnosing unexplained diabetes cases in lean individuals.'
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.'
