Experts call for official recognition of this particular form of the disease, still too little known, and warn against unsuitable treatments.
An unknown diabetes that affects millions of young people
Each year, type 1 or 2 diabetes hits millions of people. But another form today attracts the attention of the scientific community: type 5 diabetes in an article published in The Lancet Global Health50 experts from 11 different countries require its official recognition.
Linked to malnutrition, this diabetes mainly affects adolescents and young adults in weight insufficiency. The researchers underline: “Although the growing burden on obesity and aging of the population are key risk factors for the growing prevalence of type 2 diabetes, undernutrition also seems to contribute to this burden, since atypical forms of no -type diabetes have been reported in young people (under 30) and thin (BMI <18.5 kg/m2) in their lives“. They add:”We call on the international community of diabetes to recognize this particular form of the disease“.
According to their estimates, “It is estimated that 25 million people worldwide have this diabetes“, especially in Africa and Asia, in countries like India, Nigeria or Indonesia.
How type 5 is distinguished from other forms
Type 1 diabetes is linked to a total insulin deficit, that of type 2 to insulin resistance often favored by overweight. Types 3 and 4 also exist, associated with certain pathologies or at age.
For Professor Boris Hansel, endocrinologist at Bichat Hospital, “There are a multitude of diabetes types“. According to him,”Its main definition is an accumulation of glucose in the blood. It is a biological anomaly caused by a lack of insulin due to self-immunity or resistance to insulin because of visceral fat for the two main types, 1 and 2. But other factors, such as pregnancy, certain pathologies, certain drugs … can also cause diabetes“.
In the case of type 5 diabetes, the cause would be early malnutrition, sometimes from pregnancy. Insulin is produced, but in too small quantities, because the pancreas is underdeveloped. Unlike type 2, overweight does not play any role.
To better medical management
If this form remains widely ignored, it could also concern certain patients in France. “”This may concern migrant people, but also other patients, in France. Scientists call to be interested in it, in order to better refine its characteristics. The objective being that it is better known and better taken care of, by doctors“, insists Prof. Hansel.
Treatments must also be redesigned. Administering the same therapies as for type 1 or 2 diabetes would be unsuitable, even dangerous. “”Insulin should be used in lower doses and other treatments – such as sulfamids, which are not practically used in type 2 diabetes – could be envisaged“, he specifies.
And to add: “In this diabetes, we are between type 1 and type 2: patients lack insulin but it is not completely absent, as is the case in type 1; But they do not need hygieno-dietetic rules, as could be advised in type 2 diabetes“.
For specialists, only a clear recognition of type 5 diabetes will prevent millions of patients to escape diagnosis and suitable treatment. An approach which, according to Pr Hansel, will facilitate the work of practitioners: “It will be less disconcerting for doctors: facing a thin, diabetic patient, but who does not present self-immunity, they will think about it“.