Malnutrition-related diabetes receives own classification

 

Malnutrition-related diabetes, distinct from both type 1 and type 2, has now been officially recognised and named type 5 diabetes.

 

The vote to endorse the category took place on April 8, during the International Diabetes Federation’s (IDF’s) World Diabetes Congress, held in Bangkok, Thailand. 

 

The American Diabetes Association's classification defines type 1 and type 2, followed by specific types due to other causes such as single genes, exocrine pancreatic diseases such as cystic fibrosis or drug/chemical-induced diabetes. Gestational diabetes is listed separately.

 

Malnutrition-related diabetes was first described in Jamaica in 1955. It is seen most commonly in young men in low- and middle-income countries (LMICs) who have a body mass index < 19. They are often misdiagnosed as having type 1 diabetes, but they don’t develop ketonuria or ketosis despite high blood glucose levels and high insulin requirements.

 

In 1985, the World Health Organization officially classified “malnutrition-related diabetes mellitus” as a distinct diabetes type, but then in 1999 dropped the category, citing a lack of evidence that malnutrition or protein deficiency causes diabetes.