A newly identified form of diabetes is believed to arise from childhood undernourishment.(Image credit: Dragos Condrea via Getty Images)ShareShare by:
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Researchers have officially recognized a novel kind of diabetes, termed diabetes type 5, which is projected to impact 20 to 25 million individuals globally.
Predominantly seen in Asia and Africa, this ailment was initially spotted more than 70 years prior; however, it was mostly disregarded until recently.
Typically, medical texts outline three primary diabetes categories: In type 1, the immune defense system mistakenly targets insulin-generating cells within the pancreas, resulting in precariously elevated blood glucose and the possibility of ketoacidosis — a potentially hazardous condition where the body metabolizes fat to produce energy. Type 2, the most prevalent variety, occurs when the body does not adequately respond to insulin, or when there is insufficient production. Gestational diabetes arises temporarily during pregnancy, indicated by insulin insensitivity that is thought to be triggered by hormonal shifts.
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Furthermore, other uncommon diabetes presentations may stem from specific genetic variations or illnesses. Scientists now propose the existence of another diabetes type, distinct in origin from all others.
It gained formal recognition as “type 5 diabetes” during a global expert assembly held earlier this year in India. (The designation “type 5” was adopted due to prior suggestions by other researchers to label additional diabetes forms as “type 3” and “type 4.”)
“Type 5 diabetes is distinguished by inadequate insulin production, leading to increased levels of glucose in the bloodstream, akin to different forms of diabetes,” according to Dr. Rachel Reinert, an endocrinologist who serves as an assistant professor at the University of Michigan, who stated to Live Science in an email. “However, type 5 diabetes does not involve autoimmunity (like type 1 diabetes) or insulin unresponsiveness (as generally occurs in type 2 diabetes).” Moreover, she added, it lacks the distinguishing aspects observed in rarer type 3 and type 4 diabetes.
“Individuals affected by type 5 diabetes typically exhibit low body mass and past instances of malnourishment commencing in their early stages,” Reinert explained. It is thought by medical professionals that persistent malnourishment induces impairment of the pancreas from early life stages onward, which leads to enduring diminishment of the insulin-producing cells. As a result, the pancreas is not capable of generating sufficient insulin, yet if insulin is given as a treatment, the patient’s cells demonstrate the capacity to respond.
Management of type 5 diabetes treatment demands considerable caution, as administering an excess of insulin alongside insufficient nutritional intake — a consistent issue in low-income communities — bears the risk of critically diminishing blood glucose levels. “It is imperative that all diabetes patients ascertain the specific form of diabetes that affects them, enabling appropriate and tailored treatment,” Reinert stated.
The YODA study
Earlier in the year, the Young-Onset Diabetes in sub-Saharan Africa (YODA) research, which appeared in The Lancet Diabetes & Endocrinology, stimulated fresh attention to the illness. Initially, the team intended to probe type 1 diabetes across almost 900 young individuals hailing from Cameroon, Uganda, and South Africa.
Nevertheless, through assessing blood specimen analysis, the research personnel found that approximately two-thirds of the participants showed no indication of the autoimmune flags associated with type 1 diabetes. More probing investigations indicated that these participants retained the capability of generating limited yet appreciable amounts of insulin, in contrast with cases of typical type 1. However, their insulin readings fell below the standards commonly noted in type 2 diabetes. These results hinted at a distinctive, non-autoimmune, insulin-deficient classification of diabetes.
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This occurrence was not unprecedented.
During the early years of the 1950s, Philip Hugh-Jones, a British doctor, noticed 13 diabetes clinic participants close to Kingston, Jamaica, presenting symptoms inconsistent with type 1 or type 2 diabetes. Hugh-Jones named their ailment “type J,” standing for Jamaica, but the label was eventually dismissed and the ailment went largely unnoticed for many decades.
What’s in a name?
The correct diagnosis for a disease not only assists clinicians towards appropriate treatment options, but also facilitates researchers in observing its distribution and determining which determinants impact patient results, Reinert noted.
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Despite type 5 diabetes being possibly present for several decades, constrained research has resulted in its insufficient comprehension. Chittaranjan Yajnik, the director of the Diabetes Unit at KEM Hospital based in Pune, India, and co-author of a global joint statement focusing on type 5 diabetes in The Lancet Global Health, emphasized that recognition remains fundamental to ensure the ailment ceases to be neglected.
“Further studies and financial assistance are essential to examine its aetiology [reasons], mechanisms, and treatments,” he mentioned to Live Science in an email. “A name holds importance when it comes to drawing consideration from relevant parties and funding possibilities. Otherwise, it may disappear amidst the background details of more generic diabetes types.”
Disclaimer
This writing is purely educational and should not be considered medical guidance.
Clarissa BrincatLive Science Contributor
Clarissa Brincat operates as a contract author focusing primarily on health and medical studies. Upon finishing an MSc in the field of chemistry, she determined she’d prefer writing about science than engage in it practically. She acquired abilities in refining scientific papers while temporarily employed as a chemistry copyeditor before taking on a role as a medical writer within a healthcare establishment. Producing material for physicians and specialists has benefits, but Clarissa desired to connect with a wider audience, consequently leading her to health and science freelancing. Her contributions have featured in Medscape, HealthCentral, and Medical News Today, among other places.
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Eliminating ‘senescent cells’ in blood vessels may be essential for diabetes treatment, initial research indicates