Understanding Type 5 Diabetes: Symptoms, Causes, and Risks in Underweight Individuals

While the public is more familiar with genetic Type 1 diabetes or Type 2 diabetes associated with lifestyle and obesity, health experts are now drawing attention to a medical phenomenon known as Type 5 diabetes, or Malnutrition-Modulated Diabetes Mellitus (MMDM). Unlike other types, Type 5 diabetes has a unique characteristic in that it often affects individuals with a low body mass index (BMI) or those who are underweight. This phenomenon is reported to be more prevalent in developing countries, including regions in Asia and Africa.

Type 5 diabetes is a blood sugar disorder specifically linked to a history of malnutrition early in life, whether during pregnancy or childhood. This condition prevents the pancreas from developing optimally, resulting in permanently impaired insulin secretion. Although sufferers do not have excess body fat, their cells still struggle to process glucose. This significantly distinguishes it from Type 2 diabetes, which is typically triggered by insulin resistance due to fat accumulation.

Based on clinical observations, several distinctive features separate Type 5 diabetes from other forms of the disease. The high prevalence of Type 5 diabetes in developing countries is closely tied to food security and nutritional quality. Poverty, which leads to low protein and micronutrient intake in pregnant women and young children, is a major risk factor. When a child who has experienced chronic malnutrition grows up and begins consuming a high-carbohydrate diet—even if the calorie count is not excessive—the pancreas, already weakened from early life, cannot cope with the workload, causing blood sugar levels to spike.

Currently, management of Type 5 diabetes focuses on appropriate dietary management and insulin therapy as prescribed by a doctor. Since the primary cause is past nutritional factors, the best preventive measure is ensuring adequate nutrition during the first 1,000 days of a child’s life. The public is urged not to neglect blood sugar checks even if they have an ideal or underweight body mass. Early detection remains key to preventing long-term complications such as nerve damage, kidney disorders, and heart disease.

Type 5 diabetes is estimated to affect 20 to 25 million people worldwide, particularly in regions like Asia and Africa. Its recognition marks a significant moment in the understanding of diabetes. Type 5 diabetes is related to malnutrition and predominantly affects lean, malnourished adolescents and young adults, especially in low-income households.