Abstract
Dear Editor,
The global diabetes landscape is evolving, necessitating a reassessment of traditional classifications. Malnutrition-related diabetes (Type 5 diabetes), sometimes referred to as severe insulin-deficient diabetes (SIDD), was officially recognized by the International Diabetes Federation (IDF) in April 2025,1,2 marking a significant advancement in the acceptance of a long-ignored illness. Unlike type 1 and type 2, this kind of diabetes mostly affects undernourished and lean teens and young adults in low- and middle-income countries (LMICs), with an estimated 20 to 25 million cases globally. 1
The etiological route of SIDD, marked by persistent undernutrition throughout crucial developmental phases, results in compromised pancreas function and ensuing insulin insufficiency. 3 This stands in stark contrast to the autoimmune obliteration of beta cells in type 1 diabetes and the prevalent insulin resistance associated with type 2 diabetes. The clinical manifestation, characterized by significant weight loss or failure to thrive in conjunction with typical diabetic symptoms, further emphasizes its distinct etiology. 4
Significantly higher rates of SIDD are observed in LMICs, creating unique obstacles. 5 Diagnostic delays or errors are common outcomes of inadequate healthcare infrastructure and diagnostic instruments. Although nutritional assistance is crucial for SIDD treatment, it can be difficult to administer in areas where food insecurity and poverty are prevalent. Insulin and other life-sustaining drugs may be hard to come by at reasonable prices. Healthcare providers’ lack of knowledge of this kind of diabetes makes it harder to collect accurate data, which in turn makes it harder to gage the severity of the disease and provide resources accordingly.
Technological advancements, including accessible and affordable diagnostic instruments suitable for resource-limited contexts, can significantly improve early detection. The prevention of SIDD may be significantly enhanced through the incorporation of nutritional interventions within comprehensive public health programs aimed at mitigating malnutrition. To enhance the visibility of SIDD on the global health agenda and to mobilize resources for research, capacity development, and improved access to care in LMICs, international collaborations and advocacy efforts are crucial. A coordinated global initiative is necessary to address the challenges posed by this emerging type of diabetes.
In conclusion, the IDF’s official recognition of diabetes linked to malnutrition is a significant development. To successfully treat and perhaps prevent this substantial but hitherto underrecognized type of diabetes on a global scale, it is imperative to address the particular issues in LMICs and take advantage of future opportunities through research, technological innovation, and cooperative action.
Footnotes
Ethical Considerations
No ethical approval has been taken because the study type did not involve any samples from humans or animals for any kind of experiments.
Data Availability Statement
Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.