Classifying a distinct form of diabetes in lean individuals with a history of undernutrition : an international consensus statement
(2025) In The Lancet. Global health 13(10). p.1771-1776- Abstract
Since 1955, a form of diabetes in lean, young (BMI <18·5 kg/m2, age <30 years) individuals with a history suggestive of undernutrition from before birth and throughout childhood has been described in the literature. In 1985, WHO formally classified it as malnutrition-related diabetes, but subsequently removed the classification in 1999 over a disagreement as to whether undernutrition was a sufficient risk factor to cause this type of diabetes. Emerging evidence now strongly supports the distinct classification of this unique diabetes phenotype, which is characterised by substantial impairment of pancreatic insulin secretion, with normal hepatic and peripheral insulin sensitivity, an absence of ketoacidosis, and no islet cell... (More)
Since 1955, a form of diabetes in lean, young (BMI <18·5 kg/m2, age <30 years) individuals with a history suggestive of undernutrition from before birth and throughout childhood has been described in the literature. In 1985, WHO formally classified it as malnutrition-related diabetes, but subsequently removed the classification in 1999 over a disagreement as to whether undernutrition was a sufficient risk factor to cause this type of diabetes. Emerging evidence now strongly supports the distinct classification of this unique diabetes phenotype, which is characterised by substantial impairment of pancreatic insulin secretion, with normal hepatic and peripheral insulin sensitivity, an absence of ketoacidosis, and no islet cell autoantibodies. In this consensus statement, we synthesise this evidence to produce a set of common features of the disease, proposed pathogenetic mechanisms, and suggested management and prevention strategies. During a consensus meeting in Vellore, India, in January, 2025, type 5 diabetes was proposed as the nomenclature for this distinct form of diabetes, subsequently formalised at the International Diabetes Federation (IDF) World Diabetes Congress in April, 2025. We call upon the international diabetes community to recognise this distinct form of the disease, and to support the IDF's Type 5 Diabetes Working Group and its goals to promote more research into its phenotype, pathophysiology, and treatment, which will benefit millions of patients worldwide, particularly in low-income and middle-income countries.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2025-10
- type
- Contribution to journal
- publication status
- published
- subject
- in
- The Lancet. Global health
- volume
- 13
- issue
- 10
- pages
- 1771 - 1776
- publisher
- Lancet Publishing Group
- external identifiers
-
- pmid:40975084
- scopus:105016549916
- ISSN
- 2214-109X
- DOI
- 10.1016/S2214-109X(25)00263-3
- language
- English
- LU publication?
- yes
- id
- 540a5b54-cbbb-4010-918f-f4809e6c23ab
- date added to LUP
- 2025-11-26 12:13:54
- date last changed
- 2025-12-08 11:59:37
@article{540a5b54-cbbb-4010-918f-f4809e6c23ab,
abstract = {{<p>Since 1955, a form of diabetes in lean, young (BMI <18·5 kg/m2, age <30 years) individuals with a history suggestive of undernutrition from before birth and throughout childhood has been described in the literature. In 1985, WHO formally classified it as malnutrition-related diabetes, but subsequently removed the classification in 1999 over a disagreement as to whether undernutrition was a sufficient risk factor to cause this type of diabetes. Emerging evidence now strongly supports the distinct classification of this unique diabetes phenotype, which is characterised by substantial impairment of pancreatic insulin secretion, with normal hepatic and peripheral insulin sensitivity, an absence of ketoacidosis, and no islet cell autoantibodies. In this consensus statement, we synthesise this evidence to produce a set of common features of the disease, proposed pathogenetic mechanisms, and suggested management and prevention strategies. During a consensus meeting in Vellore, India, in January, 2025, type 5 diabetes was proposed as the nomenclature for this distinct form of diabetes, subsequently formalised at the International Diabetes Federation (IDF) World Diabetes Congress in April, 2025. We call upon the international diabetes community to recognise this distinct form of the disease, and to support the IDF's Type 5 Diabetes Working Group and its goals to promote more research into its phenotype, pathophysiology, and treatment, which will benefit millions of patients worldwide, particularly in low-income and middle-income countries.</p>}},
author = {{Wadivkar, Pradnyashree and Jebasingh, Felix and Thomas, Nihal and Yajnik, Chittaranjan S. and Vaag, Allan Arthur and Kibirige, Davis and Bahendeka, Silver and Bajaj, Mandeep and Boyne, Michael S. and Bavuma, Charlotte and Abodo, Jacko and Wild, Sarah and Kolthur-Seetharam, Ullas and Mukhopadhyay, Satinath and Somasundaram, Noel P. and Schwarz, Peter and Christensen, Dirk L. and Pathan, Faruque and Jones, Angus G. and Mathur, Sandeep and Kehlenbrink, Sylvia and Hawkins, Meredith}},
issn = {{2214-109X}},
language = {{eng}},
number = {{10}},
pages = {{1771--1776}},
publisher = {{Lancet Publishing Group}},
series = {{The Lancet. Global health}},
title = {{Classifying a distinct form of diabetes in lean individuals with a history of undernutrition : an international consensus statement}},
url = {{http://dx.doi.org/10.1016/S2214-109X(25)00263-3}},
doi = {{10.1016/S2214-109X(25)00263-3}},
volume = {{13}},
year = {{2025}},
}