Type 5 diabetes: Silent starvation echoes through the modern age

Abstract Malnutrition-related diabetes, now formally recognized as type 5 diabetes by the International Diabetes Federation in 2025, represents a silent but significant global health burden. Unlike the autoimmune origin of type 1 or the insulin resistance hallmark of type 2, type 5 diabetes arises amidst nutritional scarcity, affecting lean young adults predominantly in low- and middle-income countries. Characterized by impaired insulin secretion without ketosis, this condition has often been misclassified and neglected in Western medical literature. This review synthesizes the emerging evidence behind its pathophysiology, clinical presentation, and therapeutic implications, while also highlighting the urgent need for awareness, education, and equitable healthcare strategies. As the global community finally names the nameless, a new chapter in diabetes care begins—one that demands attention to the malnourished millions once left out of the conversation.