Friends, we all are aware that generally diabetes are of two types. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition. In this condition the pancreas makes little or no insulin. Insulin is a hormone the body uses to allow sugar (glucose) to enter cells to produce energy. In type 2 diabetes, cells do not respond normally insulin. This is called insulin resistance. Your pancreas has to produce more insulin to try to get cells to respond. Overtime your pancreas can not keep up, and your blood sugar rises, setting the stage for pre diabetes and type 2 diabetes.
Now scientists have discovered more types of diabetes, and prominent among them is MODY 5 diabetes, and one more is recently discovered and is called Type 5 diabetes.
MODY 5 Diabetes
MODY 5, is also known as HNF1B-MODY, is a form of Maturity-Onset Diabetes of the Young (MODY) caused by a mutation in the HNF1B gene, which leads to a range of issues, including diabetes and other health problems. It is an autosomal dominant condition, meaning a child a 50% chance of inheriting it from apparent.
Key Features of MODY 5:
1 Inheritance– Autosomal dominant, meaning a single copy of the mutated gene is enough to cause the condition.
2 Onset– Typically diagnosed in adolescence or early adulthood, but can vary.
3 Diabetes– May present with signs and symptoms of diabetes, such as increased thirst, frequent urination, and weight loss.
4 Renal and genital Abnormalities– A significant feature is the presence of renal cysts, and other kidney abnormalities like renal agenesis or dyspalasia, and genitourinary tract malformations.
( Agenesis refers to the failure of an organ to develop completely during embryonic development, and Dyspalasia refers to abnormal development of cells within tissues or organs)
5 Pancreatic Dysfunction– Can also involve impaired pancreatic exocrine function, leading to digestive issues like abdominal pain, loose stools, and weight loss.
Other Features- May include hypomagnesemia (low magnesium levels), hyperuricemia (high uric acid levels), and even neurological problems.
Diagnosis– Misdiagnosis with Type 1 of Type 2 diabetes is common, so a genetic test is often needed.
Management
Blood Sugar Control- Focus on managing blood sugar levels through diet, exercise, and potentially medication, as with other forms ofdiabetes.
Genetic Counseling– Important for individuals and their families to understand the inheritance pattern and risk of passing on the condition.
Monitoring– Regular monitoring of kidney function, glucose levels, and other relevant parameters is crucial.
Treatment of Complications– Addressing complications like renal cysts, hypomagnesemia, and other issues associated with MODY 5.
Type 5 Diabetes
A less-understood form of diabetes, first described more than three-quarters of a century ago, is now getting a second look. Its new name is Type 5 diabetes, was officially announced recently by the President of International Diabetes Federation, at World Congress of Diabetes 2025 at Bangkok.
People living with Type 5 diabetes are typically underweight, have no family history of diabetes and show symptoms that do not quite match with Type or Type 2 diabetes.
Those with Type 5 are insulin deficient, but not insulin resistant. This is a key difference from Type 2 diabetes, where the body resists insulin’s action despite producing it.
Earlier studies have established that low birth weight babies who are even slightly overfed after birth, become more prone to Type 2 diabetes. But those with low birth weight and poor nutrition after delivery may develop Type 5 diabetes. The researchers also found that patients do not have antibodies related to Type 1 diabetes. Also about 50% of them could be managed with tablets, not insulin. This is important as Type 5 is mostly seen in areas of low resources. In India, for example, Type 5 is more prevalent in the lower GDP regions.
Lastly Type 5 should not be confused with Mody 5 (Maturity Onset Diabetes of the Young or HN1beta mutations.
As the research progresses we will know more about Type 5 and MODY 5 diabetes.
Waiting for your views on this blog.
Anil Malik
Mumbai, India
14th April 2025.