Hidden diabetes affecting 25m finally gets a name

An unusual and long-overlooked form of diabetes, linked to severe childhood malnutrition and affecting mostly lean patients, has finally been given a name, according to a Bloomberg report.

Researchers estimate that about 25 million people worldwide suffer from "type 5" diabetes, including in countries such as Bangladesh, Rwanda, and Indonesia, where healthcare systems are already strained and communities are vulnerable to climate change.

The findings, published September 18 in The Lancet Global Health, call for urgent development of diagnostic criteria and treatment guidelines. "The diabetes community must formally recognise this neglected entity, which likely affects the quality and length of life of millions of people worldwide," wrote lead authors Pradnyashree Wadivkar of the Albert Einstein College of Medicine in New York and Felix Jebasingh of Christian Medical College, Vellore, India.

Unlike type 2 diabetes, which is commonly linked to obesity and sedentary lifestyles, type 5 diabetes affects patients who are often in their early 30s, thin, and from impoverished communities. Many share a history of severe undernourishment as a fetus or in early childhood.

British researcher David Phillips, emeritus professor at the University of Southampton, first noticed this pattern nearly two decades ago while working in northern Ethiopia.

"There are people who die in a corner of their house because nobody ever thought about them having diabetes," Phillips told Bloomberg, highlighting how atypical patient profiles often delay diagnosis in resource-poor countries.

Phillips began investigating in 2008 alongside Liz Trimble of Queen's University Belfast and Ethiopian diabetologist Shitaye Alemu Balcha, documenting cases that did not fit traditional definitions of type 1 or type 2 diabetes.

The World Health Organization had once recognised "malnutrition-related diabetes" in 1985 but withdrew the classification in 1999 amid scientific debate, leaving patients without clear guidelines for care. Experts now argue that this has contributed to decades of neglect.

The push to formally establish type 5 diabetes as a distinct category gained momentum at a scientific meeting in Vellore earlier this year, drawing support from more than 30 international researchers, including Phillips.