NYC Gazette

Malnutrition-related diabetes, which primarily affects undernourished adolescents and adults in lower-income nations, has been formally recognized as a separate diabetes type, labeled type 5 diabetes. The International Diabetes Federation's (IDF) decision is influenced by the research and advocacy of Meredith Hawkins, M.D., M.S., who is a professor of medicine at Albert Einstein College of Medicine.

Dr. Hawkins commented on the matter, saying, “Malnutrition-related diabetes has historically been vastly under-diagnosed and poorly understood. The IDF’s recognition of it as type 5 diabetes is an important step toward raising awareness of a health problem that is so devastating to so many people.” Current estimates suggest that 20-to-25 million people globally, mostly in Africa and Asia, suffer from type 5 diabetes. The condition is characterized by a defect in the capacity to secrete insulin, unlike diabetes linked to obesity. Many affected individuals do not live beyond a year after diagnosis.

The disease was initially identified 70 years ago, and the World Health Organization (WHO) temporarily recognized it as distinct in 1985. This recognition was withdrawn in 1999 due to insufficient research and evidence.

Dr. Hawkins discovered malnutrition-related diabetes in 2005. She explained the challenges in its diagnosis, stating, “Doctors from various countries told me they were seeing many patients with an unusual form of diabetes. The patients were young and thin, which suggested that they had type 1 diabetes, which can be managed with insulin injections to regulate blood sugar levels. But insulin didn’t help these patients and in some cases caused dangerously low blood sugar. Nor did these patients seem to have type 2 diabetes, which is typically associated with obesity. It was very confusing.”

In 2010, Dr. Hawkins launched the Global Diabetes Institute to further study this form of diabetes. Her research concluded it differed greatly from both types 1 and 2 diabetes. Her 2022 study in Diabetes Care revealed a major defect in insulin secretion in these patients.

The IDF’s latest move to acknowledge type 5 diabetes as a separate type occurred during the World Diabetes Congress 2025. Dr. Hawkins, co-chair of a working group dedicated to this condition, stated, “Malnutrition-related diabetes is more common than tuberculosis and nearly as common as HIV/AIDS, but the lack of an official name has hindered efforts to diagnose patients or find effective therapies.”

Dr. Hawkins remains optimistic about the future, saying, “I’m hopeful that this formal recognition as type 5 diabetes will lead to progress against this long-neglected disease that severely debilitates people and is often fatal.”

The IDF has also announced the establishment of a type 5 diabetes working group. The objective of this group is to create diagnostic and therapeutic guidelines for type 5 diabetes within the next two years.