Nearly 39 million U.S. adults are living with diabetes today, with 90–95% diagnosed with type 2 diabetes. Type 1 diabetes, though less common, is also widely recognized.
But experts are now drawing attention to a lesser-known variation — type 5 diabetes, also called malnutrition-related diabetes mellitus (MRDM) — a form they say deserves its own classification and unique treatment approach.
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Type 1 vs. Type 2 Diabetes
According to the CDC, type 2 diabetes is strongly linked to age, family history, obesity, and lifestyle choices. It occurs when the body develops insulin resistance, preventing glucose from being properly absorbed.
“Type 2 diabetes develops after years of high-carbohydrate, high-sugar diets, leading the body to resist its own insulin,” explained Dr. Jeffrey Hockings, founder of the Diabetes Reversal Group in Texas. He emphasized that with proper diet and lifestyle changes, type 2 diabetes can often be reversed.
In contrast, type 1 diabetes is an autoimmune or genetic condition where the pancreas produces little to no insulin. “Type 1, often called juvenile diabetes, requires lifelong insulin therapy,” Hockings said. Unlike type 2, this condition is not reversible.
There is also gestational diabetes, which occurs during pregnancy, and type 3c diabetes, linked to chronic pancreatitis or pancreatic cancer.
What Is Type 5 Diabetes?
Type 5 diabetes (MRDM) arises from chronic undernutrition, particularly among individuals with low body mass index (BMI).
The International Diabetes Federation (IDF) describes MRDM as being caused by long-term malnutrition that impairs the pancreas, leading to low insulin production. Unlike type 2 diabetes, patients with MRDM are usually insulin sensitive rather than resistant.
Symptoms include:
- Significant, unexplained weight loss
- Fatigue
- Frequent infections
- Excessive thirst and urination
“People with type 5 don’t share the same insulin resistance seen in type 2 diabetes,” explained dietitian Tanya Freirich, RDN, based in Charlotte, NC. “That distinction makes it clinically unique and deserving of separate recognition.”
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Official Recognition of Type 5 Diabetes
In January 2025, MRDM was formally labeled type 5 diabetes at an international medical meeting in India. Just months later, at the IDF World Diabetes Congress in Bangkok, it was officially acknowledged by the IDF.
Following this recognition, IDF President Peter Schwarz announced the launch of a Type 5 Diabetes Working Group to define diagnostic criteria and develop treatment guidelines.
However, the condition has not yet been formally recognized by the American Diabetes Association (ADA) or the World Health Organization (WHO), and debate continues within the medical community.
Diagnosis and Treatment Approaches
Diagnosis of type 5 diabetes typically includes:
- Reviewing a patient’s history of malnutrition
- Confirming low BMI and early-onset symptoms (usually before age 30)
- Running blood glucose tests to confirm the condition
Treatment centers on nutritional rehabilitation. “Correcting deficiencies and restoring pancreatic health is key,” said Dr. Hockings. While some patients may require insulin, it must be carefully managed to avoid dangerously low blood sugar.
A high-protein diet, oral medications, and personalized nutrition plans are also part of the recommended treatment. Freirich noted that dietary strategies must be tailored, since people with type 5 diabetes are prone to low blood sugar episodes due to insulin sensitivity
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The Bottom Line
While still under debate, many experts argue that type 5 diabetes is biologically and clinically distinct enough to warrant its own category. Recognition may also bring more attention to the role of global malnutrition in chronic disease.
Anyone experiencing symptoms such as fatigue, unexplained weight loss, excessive thirst, or frequent infections should consult a healthcare professional for testing, diagnosis, and treatment.
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