Understanding Diabetes Types and New Classifications
Recent data reveals that over 588 million adults in the U.S. are living with diabetes, with a staggering 90-95% of these cases being type 2 diabetes. Conversely, type 1 diabetes comprises only about 5-10% of cases, though it’s more widely recognized. Researchers are now advocating for the acknowledgment of less commonly known variations, such as type 5 diabetes or malnutrition-related diabetes (MRDM), suggesting that they require distinct classifications and treatments.
Type 1 vs. Type 2
Type 2 diabetes is generally more prevalent among adults but can occur in children as well. According to the CDC, its development is often tied to factors such as family history, age, obesity, and lifestyle choices. Dr. Jeffrey Hockings, the founder of the Texas Diabetes Adversity Group, suggests that type 2 diabetes arises when prolonged sugar-rich diets lead to insulin resistance. In such cases, the body begins to view its own insulin as foreign, resulting in elevated blood sugar levels that necessitate medications or insulin injections for management. Fortunately, with appropriate lifestyle adjustments, type 2 diabetes can be reversed.
In contrast, type 1 diabetes stems from genetic factors or autoimmune issues, leading to insufficient insulin production by the pancreas. Consequently, those with type 1 must administer insulin shots daily. This condition isn’t reversible in the same way as type 2.
Interestingly, a more recent classification, type 5 diabetes, or MRDM, is believed to arise from chronic nutritional deficiencies, affecting individuals with low BMIs. Symptoms typically include significant weight loss, fatigue, increased susceptibility to infections, frequent urination, and extreme thirst. Healthcare professionals note that type 5 diabetes shares some traits with types 1 and 2 but also has distinct characteristics that justify a different diagnosis.
Recognition of Type 5 Diabetes
Type 5 diabetes was formally classified at the International Conference of Experts in India in January 2025. It was later recognized at the IDF World Diabetes Conference in Bangkok in April 2025. In response to its classification, the IDF has initiated a Type 5 Diabetes Working Group to establish guidelines for diagnosis and treatment. However, some members of the medical community are still debating whether this type warrants its own category.
Dr. Bronwynhomes emphasizes that the unique clinical presentation and underlying biological mechanisms of type 5 diabetes justify a separate classification. Yet, it’s important to note that neither the American Diabetes Association nor the World Health Organization officially recognizes type 5 diabetes at this time.
Diagnosis and Treatment Strategies
Diagnosing type 5 diabetes typically involves assessing malnutrition, a low BMI, and a patient’s age at diagnosis—generally under 30. Blood glucose tests help confirm the diagnosis. Treatment approaches focus on nutritional rehabilitation, restoring defects, and improving pancreatic function, with some individuals requiring carefully monitored insulin. Additionally, oral medications and high-protein diets may be recommended.
It’s crucial for anyone experiencing symptoms of type 5 or any variation of diabetes to seek consultative care from qualified healthcare professionals for testing, diagnosis, and tailored treatment plans. The metabolic differences inherent in type 5 diabetes demand careful attention. Maintaining an optimal diet not only addresses malnutrition but also helps in stabilizing blood sugar levels.
