Why Should Type 5 Diabetes Be Formally Recognised?

New Delhi, Sep 18 (NationPress) The formal acknowledgment of Type-5 diabetes, a relatively obscure malnutrition-related diabetes variant, is crucial for establishing diagnostic standards and facilitating effective treatment strategies for this condition. An estimated six million individuals in India and 25 million globally are affected, as highlighted in a recent article published in The Lancet Global Health journal.

Type-5 diabetes primarily impacts lean, malnourished adolescents and young adults, particularly in low- and middle-income nations. It is estimated that around 20 to 25 million people worldwide are affected, predominantly in Asia and Africa.

Meredith Hawkins, a Professor of Medicine at the Global Diabetes Institute at Albert Einstein College of Medicine, New York, explained to IANS that this condition is more prevalent in resource-limited environments and areas with high undernutrition rates. Those with a history of intrauterine undernutrition followed by ongoing adult undernutrition are considered at a heightened risk for Type-5 diabetes.

In India, it is estimated that around 6 million people have Type-5 diabetes, given that there are approximately 101 million people with diabetes in the country, with about 6 percent classified as underweight.

The condition has been reported in numerous low- and middle-income countries, such as India, Bangladesh, Sri Lanka, Ethiopia, Rwanda, Uganda, Nigeria, and Indonesia, over the past 70 years. Although the World Health Organization initially classified it as malnutrition-related diabetes mellitus in 1985, this designation was removed in 1999.

This lack of formal recognition has led to limited research and funding, resulting in confusion and inconsistencies in diagnostic practices.

“Establishing formal recognition with standardized diagnostic criteria would help clarify and unify how the disease is defined across various healthcare settings. It would also enhance awareness among healthcare providers, leading to better screening and diagnosis, particularly for individuals currently misdiagnosed as having Type 1 or Type 2 diabetes,” Hawkins stated.

Symptoms of Type 5 diabetes include excessive urination (polyuria), increased hunger (polyphagia), and excessive thirst (polydipsia). However, patients may also display severe signs of undernutrition and dehydration, such as sunken eyes, stunting, wasting, pallor, and fatigue.

Unlike Type 1 diabetes, patients do not typically exhibit a history of diabetic ketoacidosis. Biochemically, individuals with Type-5 diabetes are insulin-sensitive, contrasting with the insulin-resistant nature of Type 2 diabetes.

Notably, Type-5 diabetes is often poorly controlled, leading to significant hyperglycemia and potential complications like peripheral neuropathy. Misdiagnosis can have severe consequences; patients mistreated for Type 1 diabetes may face hypoglycemia due to excessive insulin, while those misdiagnosed as Type 2 may suffer from detrimental weight loss.

Formal recognition of this condition will promote the development of tailored diagnostic criteria and management recommendations applicable across diverse healthcare environments.

(Rachel V Thomas can be contacted at Rachel.t@ians.in)