For decades, diabetes has been broadly categorized into two main types: Type 1—an autoimmune disease often diagnosed in childhood, and Type 2—a metabolic disorder largely linked to obesity and lifestyle factors. But a quiet revolution in medical science has now brought to light a lesser-known, deeply complex third kind—Type 5 diabetes, a form of diabetes that has little to do with sugar or excess but everything to do with scarcity and deprivation.Recently recognized by the International Diabetes Federation (IDF), Type 5 diabetes—also known as malnutrition-related diabetes—marks a pivotal shift in how the world understands and approaches diabetes, especially in vulnerable populations.What Is Type 5 Diabetes?Malnutrition-related diabetes isn’t new. In fact, it was first identified in 1955 in Jamaica and later seen in impoverished communities in India, Pakistan, and parts of sub-Saharan Africa. Known initially as “J-type diabetes,” it primarily affects young, thin, and malnourished teenagers and young adults, often in low- and middle-income countries.The World Health Organization (WHO) even acknowledged it as a distinct form of diabetes in 1985—only to quietly remove the classification in 1999 due to insufficient research. This decision led to decades of diagnostic ambiguity and a lack of targeted care for millions.Fast forward to 2025, and this long-overlooked condition has officially been given a name and a place in global diabetes taxonomy—thanks to the tireless advocacy of Dr. Meredith Hawkins, Professor of Medicine and Founding Director of the Global Diabetes Institute at Albert Einstein College of Medicine in New York.How is Type 5 Diabetes Different From Type 1 And Type 2?While Type 1 diabetes involves an immune attack on insulin-producing cells and Type 2 typically arises from insulin resistance due to obesity, Type 5 diabetes is mechanistically different. It’s not caused by sugar overload or autoimmunity—but by chronic undernourishment.Dr. Hawkins explains, “People with this form of diabetes have a profound defect in their capacity to secrete insulin—a discovery that rewrites the medical script on how we diagnose and treat it.”Earlier assumptions suggested that this form of diabetes was a variant of Type 2 due to perceived insulin resistance. But landmark studies, including a 2022 collaboration between Einstein’s Global Diabetes Institute and Christian Medical College in Vellore, India, confirmed a radically different pathology.It’s estimated that 20 to 25 million people globally live with Type 5 diabetes, primarily across Asia and Africa. Yet, it has remained one of the least diagnosed and most poorly understood forms of the disease.What’s alarming is that many patients do not survive more than a year after diagnosis—not necessarily due to the disease itself, but because the lack of proper classification has prevented the development of effective treatment protocols. Inappropriate use of insulin can cause life-threatening hypoglycemia, as these patients do not respond to insulin the way those with Type 1 do.Dr. Hawkins compares the prevalence of Type 5 diabetes to major global health issues: “It’s more common than tuberculosis and nearly as common as HIV/AIDS in certain regions, yet it has remained invisible in global health policy.”The IDF’s official recognition of Type 5 diabetes is more than symbolic—it is the beginning of a strategic, scientific, and humanitarian effort to right a historic wrong. A dedicated working group has been established to lead the way, with three core objectives:Develop standardized diagnostic and treatment guidelines tailored to malnutrition-related diabetesCreate a global patient registry to enable data collection, longitudinal studies, and targeted interventionsLaunch educational modules and awareness campaigns for healthcare professionals worldwideThese initiatives aim to bridge the gap between scientific knowledge and real-world practice—especially in underserved regions where Type 5 diabetes continues to silently claim lives.Malnutrition-related diabetes, by contrast, has remained unnamed, affecting those with the least access to quality care, diagnostics, and therapies. Dr. Hawkins’ work is a reminder that health systems must be attuned to the full spectrum of human experience—not just the diseases of excess, but also those of scarcity.“It’s not just about having a name,” says Dr. Hawkins. “It’s about making sure that young lives aren’t lost to a treatable condition simply because we weren’t looking.”