July 23, 2025, 5:01 pm | Read time: 5 minutes
When diabetes is mentioned, it almost always refers to Type 1 and Type 2 diabetes. However, there is increasing evidence that there are additional forms. The latest findings could lead to new therapies and help diabetes patients who have been misdiagnosed. FITBOOK has compiled all the information on the new diabetes subtypes.
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In a recent study, international researchers investigated why some African children and young adults do not show typical symptoms despite being diagnosed with Type 1 diabetes.1 They discovered that the subjects have a novel subtype of diabetes that differs from both the autoimmune disease Type 1 and Type 2 diabetes. While the researchers have not yet named this type of diabetes, the International Diabetes Federation introduced Type 5 diabetes in April 2025.2 This describes diabetes resulting from malnutrition and undernutrition. Thus, there are at least two new forms that differ from the well-known types.
Why Can Some Affected Individuals Survive Without Insulin Injections?
In their study, published in the journal “The Lancet,” the researchers explain that Type 1 diabetes in Africa is insufficiently researched due to the lack of solid observational studies. However, existing studies suggest that the disease may have a different phenotype in sub-Saharan Africa than in other countries. The researchers questioned why many young people in Africa diagnosed with Type 1 diabetes manage to survive for some time without insulin. Typically, those with Type 1 diabetes urgently need insulin injections.
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What Did the Researchers Discover?
To get to the bottom of the phenomenon, the scientists evaluated health data from 894 Black patients in Cameroon, Uganda, and South Africa. The study participants were under 30 when they were diagnosed with Type 1 diabetes. Since then, they have been treated with insulin injections. The data of the sick participants were compared with those of a healthy control group from the same countries.
It turned out that only 35 percent of the diabetes patients had the Type 1 variant. The remaining 65 percent lacked the typical characteristics of the autoimmune disease. For example, there were no indications that the pancreas was attacked by the immune system with corresponding antibodies. The genetic predisposition was also relatively low, as only 20 percent of the patients had a parent with this disease.
What Characterizes the New Form of Diabetes?
Although all patients suffered from a blood sugar regulation disorder, 65 percent of the subjects exhibited a unique symptom: They had low insulin levels, even though a biomarker in the blood indicated excessive insulin production by the pancreas. Since none of the known forms have this symptom and the patients were not malnourished, the researchers conclude that it must be a new form.
To find out if this new form also occurs outside Africa, the researchers took it a step further. They analyzed the health data of over 3,000 American children. They found similar results, but only 15 percent of the Black participants exhibited the unique symptom of the new diabetes condition. Interestingly, white children were not affected.
Symptoms Indicating Type 1 Diabetes
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Many Patients Are Likely Misdiagnosed
According to the researchers, the new finding suggests that many Type 1 diabetes patients, especially in Africa, are likely misdiagnosed, as they actually have a different form of diabetes. It is even possible that the current therapy is not effective. Since research on this new type is still in its early stages, many questions remain. For example, what are the triggers? Is it the environment or ancestry? Much points to these factors.
The next step is to examine the possible causes more closely. Only then can new cases be prevented and effective treatment methods developed.
What Is Type 5 Diabetes?
In addition to the variant presented, international scientists introduced Type 5 diabetes in April 2025 through the International Diabetes Federation (IDF). Unlike Type 2 diabetes, which usually results from obesity and lack of exercise, Type 5 diabetes arises from malnutrition and undernutrition—especially in children.
In a 2022 study, researchers from the Indian Christian Medical College in Vellore showed that diabetes associated with malnutrition fundamentally differs from Type 1 and Type 2 diabetes.3 It is usually triggered in childhood by reduced beta-cell function combined with increased glucose absorption. These mechanisms likely represent adaptations to chronic energy deficiency due to malnutrition.
People with Type 5 diabetes suffer from insulin deficiency but are not insulin resistant. Many of them could potentially be treated with oral medications instead of insulin injections, according to experts from the International Diabetes Federation. Since Type 5 diabetes primarily occurs in resource-poor countries, this cost-effective approach could prove important in the affected regions.
“The recognition of Type 5 diabetes marks a historic shift in the global approach to diabetes. For too long, this condition has been ignored, affecting millions of people and denying them access to adequate care. With the establishment of the Type 5 Diabetes Task Force, we are now taking important steps to correct this. It is about justice, science, and saving lives,” says IDF Chairman Professor Peter Schwarz. Type 5 diabetes is estimated to affect between 20 and 25 million people worldwide, especially in regions like Asia and Africa.