Diabetes is the most commonly encountered metabolic disease, not only in geriatrics but also in young adults. We are aware of the most common types of diabetes like Type I, Type II diabetes and gestational diabetes. However, is there more to this classification? Can diabetes occur from not eating enough?
Yes. The answer lies in Type 5 diabetes. The International Diabetes Federation has now recognized Type 5 diabetes as a distinct type.
What is Type 5 Diabetes?
Previously known as malnutrition related diabetes mellitus (MRDM), Type 5 diabetes is linked to childhood malnutrition which leads to underdeveloped pancreas.
Causes
Type 5 diabetes results from prolonged undernutrition, particularly during early childhood and adolescence. Poor maternal nutrition, frequent infections and chronic food insecurity impair the development of pancreas thereby reducing insulin secretion. Unlike the autoimmune reaction in Type I and insulin resistance in Type II, insulin secretion in Type 5 is reduced due to underdeveloped pancreas.
Symptoms
Most commonly encountered in adolescents and young adults. Symptoms are similar to Type I, such as
- Weight loss
- Excessive thirst
- Frequent urination
- Fatigue
- Elevated glucose levels
However BMI levels below 19 kg/m² and absence of autoimmune beta cell destruction, differentiates it from type I diabetes.
How to diagnose Type 5 diabetes?
Until now, there is no single test designed specifically for type 5 diabetes. Diagnosis involves combination of blood sugar tests, assessment of patient’s nutritional history, history of recurrent infections and exclusion of other forms of diabetes.
Management
For type 5 diabetes management, treatment is not only restricted to glucose control but also on addressing nutritional deficiencies. High calorie and high protein diet is recommended to correct malnutrition. Oral antidiabetics and low dose insulin therapy may be needed by some patients.
Since Type 5 diabetes has been officially recognized, prevention is the key to reduce its occurrence.
So, how can we prevent Type 5 diabetes or its progression?
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Encourage balanced and nutritious diet
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Improve maternal nutrition
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Strengthening childhood nutrition programs
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Identify and treat infections early
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Increase awareness about health and nutrition through schools and community groups
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Ensuring food security
Final thought
Not all diabetes can be caused by sugar and fat. Some forms like Type 5 can develop due to hunger and silent nutritional deficiencies. India being the diabetes capital and around 100 million people suffering from diabetes, many cases in under resourced regions can be Type 5. To prevent future cases we must address the root cause not just the sugar levels.