Scientists identify new ‘type 5’ diabetes
Scientists have officially recognized a new type of diabetes, called type 5 diabetes, which is believed to affect 20 to 25 million people worldwide.
The disease, most common in Asia and Africa, was first identified more than 70 years ago but has remained largely neglected until now.
Classically, medical textbooks describe three main types of diabetes: In type 1the immune system mistakenly attacks insulin-producing cells in the pancreas, leading to dangerously high blood sugar levels and a risk of ketoacidosis – a potentially fatal condition in which the body breaks down fat for energy. Type 2the most common form, develops when the body does not respond properly to insulin or does not produce enough of it. Gestational diabetes occurs temporarily during pregnancy, marked by insulin resistance This is thought to be due to hormonal changes.
In addition, there is other rare forms diabetes which can result from genetic mutations or specific diseases. But today, scientists say there is another type of diabetes whose cause is very different from the other types.
It was officially classified as “type 5 diabetes” at an international meeting of experts in India earlier this year. (They chose the label “type 5” because other researchers have previously proposed “type 3” and “type 4” for other forms of diabetes.)
“Type 5 diabetes is characterized by insufficient insulin secretion leading to high blood sugar levels, similar to other forms of diabetes.” Dr Rachel Reinertendocrinologist and assistant professor at the University of Michigan, told Live Science in an email. “However, type 5 diabetes is not associated with autoimmunity (as in type 1 diabetes) or insulin resistance (as is common in type 2 diabetes).” It also lacks features of the rarer type 3 and type 4 diabetes, she said.
“People with type 5 diabetes typically have low body weight and a history of undernutrition from an early age,” Reinert said. Doctors believe that chronic undernutrition damages the pancreas early in life, permanently weakening its insulin-producing cells. The pancreas therefore cannot produce enough insulin, but if a patient receives insulin as treatment, their cells are able to respond to it.
Treatment of type 5 diabetes must be managed carefully, as too much insulin, combined with not enough food – a common reality in low-income countries – could lead to dangerous hypoglycemia. “It is important for all diabetic patients to know what specific type of diabetes they have, so they can receive the appropriate treatment,” Reinert said.
The YODA study
Earlier this year, the YODA (Young-Onset Diabetes in sub-Saharian Africa) study, published in The Lancet Diabetes and Endocrinologyrenewed interest in the condition. The team initially set out to study type 1 diabetes in nearly 900 young adults in Cameroon, Uganda and South Africa.
But when researchers analyzed blood samples, they found that about two-thirds of the participants did not have the autoimmune markers seen in type 1 diabetes. Further testing revealed that these individuals still produced small but measurable amounts of insulin, unlike classic type 1 cases. But their insulin levels were lower than those typically seen in type 1 diabetes. type 2 diabetes. These results highlighted a distinct, non-autoimmune, insulin-deficient type of diabetes.
This was not the first time in history that this condition was observed.
In the early 1950s, British physician Philip Hugh-Jones encountered a group of 13 patients at his diabetes clinic near Kingston, Jamaica, whose symptoms did not match Type 1 or Type 2 diabetes. Hugh-Jones called their condition “Type J”, for Jamaica, but the label was forgotten and the condition was neglected for decades.
What’s in a name?
Correctly naming a disease not only helps guide clinicians toward the best treatment options, but can also help researchers track its prevalence and identify factors that affect patient outcomes, Reinert said.
Although type 5 diabetes has probably been around for decades, a lack of research means it is poorly understood. Recognition is essential to ensure this disease is no longer neglected, said Chittaranjan Yajnikdirector of the diabetes unit at KEM Hospital, Pune, India, and co-author of an international consensus statement on type 5 diabetes published in The Lancet Global Health.
“It needs additional research and funding to study its etiology. [causes]the mechanism and treatment,” he told Live Science in an email. “The name is important to attract stakeholder attention and funding opportunities. Otherwise, it will be buried in the background noise of common varieties of diabetes. »
This article is for informational purposes only and is not intended to offer medical advice.
