Health officials have now acknowledged a novel form of diabetes that affects individuals who are young and slender. This discovery sheds new light on the complexities of the disease.

The condition first came to attention in Jamaica back in 1955 when Dr. Philip Hugh-Jones encountered 13 patients exhibiting diabetes symptoms that did not fit the profiles of either type 1 or type 2 diabetes. Intrigued, Dr. Hugh-Jones initially termed it ‘type J,’ but the designation was quickly forgotten.

It wasn’t until three decades later that the World Health Organization recognized the condition as ‘malnutrition-related diabetes mellitus.’ However, this term was abandoned in 1999 due to insufficient evidence supporting its classification.

Fast forward 70 years from its initial discovery, the International Diabetes Federation has now reclassified this enigmatic form as type 5 diabetes, providing it with a formal identity.

Diabetes, a condition where the body struggles to produce or effectively use insulin, is predominantly represented by type 2 diabetes. This variant accounts for roughly 90% of diabetes cases in the United States, often attributed to factors such as obesity, poor diet, and genetics.

Globally, nearly 600 million individuals cope with type 2 diabetes, including 38 million in the U.S. In contrast, type 1 diabetes, an autoimmune disorder, affects about 9 million people worldwide, with 2 million cases in the United States.

However, experts believe 25million people across the world could be living with type 5 diabetes, most of whom don’t know it and are slim teens and young adults living in low- and middle-income countries. This may also include people misdiagnosed as having type 1 diabetes. 

There are no specific estimates for the US, and the American Diabetes Association (ADA) has not yet formally added it to its disease classifications. However, refugees, migrants and people with eating disorders may be at the highest risk due to their potential for malnutrition, experts say. 

Health officials have identified a new form of diabetes, type 5, that typically affects young, slim people (stock image)

Symptoms of type 5 diabetes are largely similar to type 1, including increased thirst, frequent urination, headache, blurred vision, fatigue and slow-healing cuts and sores. These signs also overlap with classic symptoms of malnutrition such as weight loss, fatigue and hunger. 

According to the Mayo Clinic, people with the condition are typically underweight, meaning they have a body mass index (BMI) below 18.5. 

The average American has a BMI of 29, which is considered overweight and bordering on obese.

Experts believe people with type 5 diabetes can produce insulin and are not resistant to it, but their pancreas is underdeveloped and cannot make enough due to malnourishment. 

Because of this, treating type 5 with insulin, like in type 1 or type 2, is often ineffective. 

Doctors are now investigating the effect of a high-protein diet rich in nutrients like zinc, B vitamins and magnesium to help patients gain weight and reduce glucose (blood sugar) spikes. Low doses of insulin may also be used but with caution. 

The above graph shows estimates for global diabetes cases. It is predicted that the number of people with the condition will more than double by the year 2050 compared to 2021

Earlier this year, a study published in The Lancet Diabetes & Endocrinology renewed interest in type 5 diabetes. 

Called the Young-Onset Diabetes in Sub-Saharan African (YODA) study, researchers had sought out to look nearly 900 young adults living in Cameroon, Uganda and South Africa who were diagnosed with type 1 diabetes.

When the team took blood samples from the patients, they found roughly two in three participants lacked specific autoimmune markers seen in type 1 diabetes. 

Further testing also showed they still produced small but measurable amounts of insulin, unlike people with type 1 diabetes. However, those insulin levels were still below those seen in type 2 diabetes. 

The findings suggested the patients had a distinct type of diabetes, much like those Dr Hugh-Jones encountered in the 1950s. 

And writing in the Lancet Global Health a month later, a team of 50 researchers from 11 countries, including the US, concluded: ‘We call upon the international diabetes community to recognize this distinct form of the disease. It likely affects the quality and length of life of millions of people worldwide. 

‘We encourage international organizations such as the International Diabetes Federation and World Health Organization (WHO) to promote more research into the phenotype, pathophysiology, and treatment of type 5 diabetes.’ 

‘Misdiagnosis and underdiagnosis are likely to have negatively impacted the clinical care and lives of millions of individuals [with type 5 diabetes] worldwide.’