Presented at congress: Researchers discover new type of diabetes - who is affected

The International Diabetes Federation (IDF) introduced a new type of diabetes at the World Diabetes Congress in Bangkok. It's called type 5 diabetes. What is it all about?

Unlike type 1 diabetes, this type of diabetes is not an autoimmune disease. Unlike type 2 diabetes, neither hereditary predisposition nor an unhealthy lifestyle are causative factors.

Rather, another factor triggers this type of diabetes: chronic malnutrition in childhood and adolescence with a persistently low body mass index (below 19). Apparently, malnutrition causes the pancreas to develop improperly and therefore produce too little insulin.

This type of diabetes is characterized by increased insulin deficiency and poor metabolic control. Insulin requirements are high, as is the risk of complications. However, those affected are not insulin resistant.

This disease often develops before the age of 30. Men suffer from it significantly more often than women; they account for approximately 85 percent of the 20 to 25 million affected people worldwide. Most of them come from poorer countries in Asia and Africa.

Meredith Hawkins, endocrinologist and founding director of the Global Diabetes Institute at the Albert Einstein College of Medicine in New York, who is working with other IDF researchers in a working group to develop diagnostic criteria and therapeutic guidelines for type 5 diabetes, reports on her first encounters with those affected as follows:

"The patients were young and thin, which suggested they had type 1 diabetes, which is treated with insulin injections to regulate blood sugar levels. But insulin didn't help these patients and, in some cases, caused dangerously low blood sugar." Furthermore, the patients didn't have type 2 diabetes. "It was very confusing."

Although type 5 diabetes has been recognized for over 70 years, it has not played a role in the global public health debate, say IDF researchers. Initially, it was mistakenly classified as type 1 or type 2 diabetes .

At the time, scientists assumed that this type developed due to insulin resistance. However, more recent research shows that type 5 patients have a clearly defined metabolic profile.

This form of diabetes is treated with medications taken by mouth. These medications allow for better metabolic control than insulin injections. These medications are also more cost-effective.

To better manage the disease, Hawkins recommends that those affected consume higher amounts of protein and fewer carbohydrates. At the same time, they should pay attention to micronutrients. "But this still needs to be carefully studied."

IDF President Peter Schwarz, meanwhile, spoke of a "historic shift" in the global approach to diabetes in light of the categorization of type 5 diabetes. "This disease has been misunderstood for far too long, affecting millions of people and denying them access to adequate care," he said.

By establishing the working group, the IDF is taking important steps to change that. "This is about justice, science, and saving lives."