Context:
At the World Diabetes Congress 2025 held by the International Diabetes Federation (IDF) in Bangkok, a historic decision was made to officially recognize and address Type 5 Diabetes a malnutrition-related form of diabetes affecting millions worldwide. The IDF announced the formation of the Type 5 Diabetes Working Group, marking the first coordinated global effort to study and manage this underdiagnosed condition.
What is Type 5 Diabetes?
- Origin: First reported in Jamaica in 1955 as “J-type diabetes”
- WHO Classification: Recognized in 1985 as malnutrition-related diabetes, removed in 1999 due to lack of causal evidence
- Nature: Associated with early-life undernutrition, low BMI, and lean diabetes phenotype
- Current Estimate: Affects 25 million people globally, particularly in countries like India, Sri Lanka, Bangladesh, Uganda, Ethiopia, Rwanda, and Korea
Scientific Basis and Research
- Research Leadership: Led by Dr. Nihal Thomas (CMC Vellore) and Prof. Meredith Hawkins (Albert Einstein College of Medicine).
- Key Study (2022): Demonstrated that Type 5 is a distinct metabolic entity in lean individuals with intrauterine malnutrition.
- Thrifty Gene Hypothesis: Suggests prenatal programming causes disproportionate fat accumulation explaining the “thin-fat” phenotype.
- Pathophysiological Insight: Malnutrition disrupts metabolic function without the typical obesity-linked insulin resistance of Type 2 diabetes
Global Collaboration: The Vellore Declaration
- Initial Consensus Meeting: Held in January 2025 at Christian Medical College (CMC), Vellore
- Outcome: 42 global experts signed the Vellore Declaration
- Objective: Advocate for global recognition, funding, and education for Type 5 diabetes
- Naming: “Type 5 Diabetes” coined by IDF President Prof. Peter Schwarz during this meeting
Mandate of the IDF Type 5 Diabetes Working Group
- Define diagnostic criteria and management guidelines
- Develop global registry for collaborative research
- Create training modules for clinicians and healthcare providers
- Promote awareness and education worldwide
- Support research on the pathophysiology of malnutrition-induced diabetes
Global and Clinical Significance
- Fills a critical gap in diabetes care among undernourished populations
- Sheds light on non-obesity-related diabetes mechanisms
- Encourages inclusive global health policies, especially in LMICs (Low and Middle-Income Countries)
