Type 5 diabetes is a condition which was earlier known as malnutrition-related diabetes mellitus (MRDM). In January 2025, the International Diabetes Federation (IDF) classified it as Type 5 diabetes. It is a "distinct form of diabetes linked to chronic undernutrition and health disparities. The condition primarily affects people in low- and middle-income countries (LMICs), especially in South-East Asia and sub-Saharan Africa," says IDF. Recognition is important, as this condition has always been distinct and did not neatly fit into either Type 1 or Type 2 diabetes.
IDF also says that this recognition marks a significant step towards addressing a long-overlooked condition and advancing health equity in diabetes care for the millions affected globally. Here, take a look at the symptoms, causes and complications of Type 5 diabetes.
Symptoms of Type 5 Diabetes
Some of the symptoms of type 5 diabetes include:
- Increased thirst
- Frequent urination
- Headache
- Blurred vision
- Fatigue
- Slow-healing cuts and sores
There are several symptoms of diabetes that overlap with the signs of undernutrition such as weight loss, fatigue and hunger. All of these signs can make it difficult to spot the signs of diabetes. Another sign of the condition is that people suffering from it typically have underweight. They usually have a body mass index (BMI) that's less than 18.5. They may also have features of long-term (chronic) undernutrition, like:
- Impaired skeletal growth
- Enlarged parotid (salivary) gland
- Skin and/or head hair changes
Dr Arora says that one distinguishing feature of type 5 diabetes is that, because pancreatic cells are underdeveloped rather than destroyed, the risk of ketosis is low, unlike in Type 1 diabetes, where the risk is significantly higher.
Causes of Type 5 Diabetes
IDF says that the condition results from prolonged undernutrition, particularly during early childhood and adolescence. "Poor maternal nutrition, frequent infections and chronic food insecurity can impair the development of the pancreas. This reduces its ability to produce insulin."
In this case, the damage to the pancreas is not the result of autoimmune reactions. Dr Arora said, "Type 5 diabetes differs from Type 1 diabetes because it is not autoimmune in nature, and there is no immune-mediated destruction of pancreatic cells. It also differs from Type 2 diabetes because insulin resistance is absent. Instead, patients are typically very lean, undernourished, and have a low body mass index, often below 18. The underlying issue arises from chronic malnutrition during early life, which prevents the pancreas from developing to its full functional capacity. As a result, the pancreas is unable to produce adequate insulin later in life, leading to diabetes."
Dr Arora adds that earlier, many young patients with this condition were misclassified as having Type 1 diabetes and were started on high doses of insulin. Others diagnosed later, often in their late twenties, were incorrectly labelled as having Type 2 diabetes and treated with oral medications. She said, "With the formal recognition of Type 5 diabetes, treatment can now be more appropriately tailored to the specific needs of these patients."
Complications of Type 5 Diabetes
In terms of complications, Type 5 diabetes carries risks similar to those seen in other forms of diabetes, including cardiovascular disease, kidney damage, nerve damage, and eye-related complications. As with all types of diabetes, early detection and appropriate management are critical to preventing these long-term health consequences.
Regular self-monitoring of blood glucose (SMBG) remains a cornerstone of diabetes management, says Dr Arora. Persistently elevated blood sugar levels or a raised HbA1c increases the risk of complications, just as they do in other types of diabetes. Effective glucose control is therefore essential to reduce the likelihood of both short- and long-term complications.
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.
