Type 5 Diabetes And Childhood Nutrition: What Doctors Say Parents Need To Know

Type-5 diabetes is categorised as a new form of diabetes that is tied to childhood nutrition. When adults don't receive the quality of nutrition in their childhood, they become more susceptible to developing type 5 diabetes. About 18.7% of children in India as of 2024 suffer from malnutrition, which can exponentially increase their risk to develop type 5 diabetes. The new kind of diabetes is tied to nutrition, and the effects of the same can be seen in the most vulnerable portion of the Indian population. The need to pay attention to the nutritional needs of children is the need of the hour, and practical strategies to make it so are necessary. With the disease burden that is tied to type 5 diabetes set to increase with each passing year, as high-quality nutritious food sources get scarce and lack of access, along with affordability issues, can further worsen the health issue.

What Is Type Five Diabetes?

NDTV spoke to Dr Soma Srinivas, Consultant Endocrinologist, Gleneagles Hospital, part of the Fortis Healthcare Network Hospital who explained, "Malnutrition-related diabetes, distinct from both type 1 and type 2 diabetes, has now been officially recognised and named 'type 5 diabetes'." This category was endorsed on April 8, 2025, during the International Diabetes Federation's (IDF) World Diabetes Congress, held in Bangkok, Thailand.

Type 5 diabetes refers to severe insulin-deficient diabetes (SIDD). Unlike type 2 diabetes, type 5 diabetes is primarily caused by chronic undernutrition, especially during childhood or adolescence. It is estimated to affect 20 to 25 million people, predominantly of Asian and African descent, and disproportionately affects malnourished teens in low- and middle-income countries."

How Poor Child Nutrition Raises Diabetes Risk

Prof. Anoop Misra, Chairman, Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi; Director, National Diabetes, Obesity and Cholesterol Foundation; and Diabetes Foundation (India), explains that the following factors are contributing to type 5 diabetes:

• Early-life nutrition and metabolic programming can affect the risk of type 5 diabetes and increase the disease burden.
• Childhood obesity and future diabetes risk increase exponentially when childhood nutrition is ignored.
• The role of diet quality in Indian children is paramount, as children need nutrient-dense foods on their plate.
• Proper nutrition is needed as it can affect the way children's developing organs build their foundation.
• Inadequate calories and protein affect pancreas development, and their corresponding effect on the way they secrete insulin can be impacted.
• The body struggles to produce enough insulin later in life, which can lead to long-term health complications.
• The long-term impact of repeated childhood undernutrition needs to be considered when midday meals for poor children are created.

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The Root Cause: Malnutrition In Early Life

Dr Soma Srinivas details, "Chronic protein-energy malnutrition during critical growth periods, i.e., from the time they were in utero to adolescent and adult age groups, leads to underdevelopment of the pancreas, resulting in severely reduced b cell mass and insulin secretory capacity. This variant is characterised by severe insulin deficiency. This condition likely involves developmental and epigenetic changes in b cell gene expression triggered by undernutrition."

Why Indian Children May Be More Vulnerable

The population of Indian children is uncontrolled due to poor family planning, centres that are needed to tackle the growing divide in parents' being able to afford nutritious foods for their children. There are other factors that can affect the way Indian children may be becoming more vulnerable to developing type 5 diabetes:

• Persistence of undernutrition in some populations, as uncontrolled children's populations in low- and middle-income households are unable to afford nutritious foods.
• Poor diet quality despite enough calories, as major environmental factors, processed foods dominate diets, and eating out of convenience rather than focusing on nutrition.
• Gaps in protein, micronutrients, and balanced meals are widening the gap between actual nutritious intake and an unhealthy approach to diet.
• The double burden of malnutrition and obesity is causing the disease burden from type 5 diabetes to widen, and the Bangladesh Journal of Endocrinology and Metabolism pinpoints that 20-25 million individuals globally suffer from type-5 diabetes.

Early Warning Signs Parents Should Not Ignore

Parents, guardians, or caretakers of children should be aware of the early warning signs that may present themselves in children. Timely action is needed to course-correct and lead to better long-term health outcomes. Here is what should be alarming to parents if their children have the following:

• Poor weight gain even after eating hearty meals three times a day could be a signal that their internal system is struggling to absorb the nutrients from the food.
• Fatigue, frequent urination, and excessive thirst are all signs of the pancreas struggling with insulin secretion.
• Delayed growth or puberty that doesn't meet the age threshold, as there is a lack of nutrition as per the standards set by the International Council of Medical Research (ICMR) and National Institute of Nutrition (NIN) dietary guidelines.
• Difficulty gaining muscle mass even after rigorous physical exercise is a sign that type 5 diabetes may be brewing underneath the surface.

Note: The symptoms can be subtle, but observation can signal proactive medical intervention.

What Doctors Say Parents Should Focus On

Dr Soma Srinivas explains that parents need to know that type 5 diabetes typically appears in adolescents and young adults and may present symptoms similar to type 1 diabetes. However, people with type 5 diabetes often have a BMI below 19 kg/m and do not show signs of autoimmune b-cell destruction and ketosis, which distinguishes it from type 1 diabetes." Prof. Anoop Misra explains that parents need to focus their efforts on:

• Balancing nutrition from early childhood so that the foundation of their health is strong.
• Adequate protein, healthy fats, and micronutrients need to be given to them at the right time through interesting means of consumption.
• Avoid extreme food restriction that can result in nutrient deficiencies; for instance, making children vegan or vegetarian can be harmful when their nutritional foundation is in question.
• High blood sugar causes the body to burn fat for energy instead of glucose.
• Regular growth monitoring is needed to make sure the child is growing at the benchmarks in terms of their height, weight, and body mass index.

History of chronic undernutrition or food insecurity as evidenced by one or more of the following:

• History of low birthweight
• History of undernutrition in infancy
• History of stunting in childhood

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Can Type Five Diabetes Be Prevented?

Dr Soma Srinivas pinpoints, "For type 5 diabetes, treatment must focus not only on glucose control but also on addressing nutritional deficits. Management may include:

• Nutritional support to correct long-term undernutrition.
• Oral diabetes medications stimulate insulin secretion.
• Low-dose insulin therapy, where appropriate, as determined by a medical professional."

Simple And Practical Steps That Parents

Parents need to follow these simple and practical steps to address the undernutritional levels in their children:

• Prioritise home-cooked balanced meals on a daily basis to build up their foundation well.
• Do not normalise chronic thinness, as toxic body ideals can damage their physical and mental well-being.
• Seek medical advice for growth delays, as timely medical intervention can help make it better for children who suffer from developmental delays.
• Focus on nutrition quality, not just fullness, as a well-balanced meal that has enough macro- and micronutrients needs to be adopted.

Type 5 diabetes shows that diabetes is not always linked to excess weight gain. The primary cause is undernutrition that can silently increase long-term risk. And early awareness empowers parents to protect children's health.

Disclaimer: This content, including advice, provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.