Diabetes mellitus is a condition characterized by elevated blood sugar levels. Today, type 2 diabetes is the most common variant, strongly associated with lifestyles in developed countries. However, it is less well-known that malnutrition can also cause this disease. Recently, a new variant linked to poor diet has been recognized: type 5 diabetes.
You may know someone with type 2 diabetes. This variant is associated with a sedentary lifestyle, a diet rich in carbohydrates and fats, and obesity. All these conditions contribute to pancreatic exhaustion, leading to a loss of its ability to produce insulin – the hormone necessary to maintain adequate blood glucose levels.
Due to its association with obesity, type 2 diabetes has become a major concern for Western healthcare systems. According to projections, 140 million people with type 2 diabetes are expected in Europe and the United States by the year 2050. The socioeconomic cost of these patients is estimated at 8.6 billion euros annually in Spain alone. What we have is a difficult burden for even the most robust national health system to sustain.
Type 5 Diabetes
Paradoxically, experts have officially recognized a new variant of diabetes in recent months. This is type 5 diabetes – types 3 and 4 are used more in an academic context, so we will not explain them in this article.
Type 5 diabetes is defined as a form of diabetes due to a deficiency in insulin production in the pancreas, but associated with prolonged malnutrition in children and adolescents. This is not a new discovery; experts have simply named a disease that has been treated in developing countries for years, as best as possible. The number of people affected, although estimated to be high, is not officially known.
It is ironic that two opposing situations – a hypercaloric diet versus a poor diet and malnutrition – can lead, through different pathways, to a common phenomenon. In both wealthy countries – type 2 – and developing countries – type 5 – the underlying problem is a loss of insulin production in patients.
What Can We Do?
Treatments have been numerous and varied since antiquity. As early as Roman times, the physician and encyclopedist Aulus Cornelius Celsus prescribed diet and exercise. Later, from the second half of the 20th century, oral antidiabetic drugs and exogenous insulin were used.
Today, there is a common point leading to the increase in both types of diabetes, both type 2 and type 5. This refers to low incomes in the population.
In poor countries, these limit access to any type of food and condemn children and adolescents to chronic malnutrition, which favors cases of type 5 diabetes. In developed countries, an increasing stratum of the population has difficulty accessing fresh and quality food. They base their diet on ultra-processed products rich in sugars, which are much cheaper. This, combined with a sedentary lifestyle, promotes an increase in the prevalence of obesity, accompanied by one of its major complications: type 2 diabetes.
To address this, a first step must be the treatment of patients with both forms of diabetes. This often involves nutritional support and the use of oral antidiabetic drugs.
But what seems simple in the West is a difficulty in developing countries. On the one hand, due to the economic impossibility of acquiring the drugs and their availability in sufficient quantities. Due to the limited capacity for distribution and maintenance, as some require cold storage.
However, programs are being implemented by international organizations such as the WHO’s Global Diabetes Compact and the campaigns of the World Diabetes Foundation – WDF to facilitate this access.
Facilitating Access to Healthy Food
Beyond this, a common strategy is also needed to curb the spread of the two variants of diabetes. This involves facilitating access to healthy and quality food in both cases. In Western countries, this could be concretized with measures aimed at reducing the price of fresh and healthy products, for example, through tax reductions or purchase bonuses for the lowest incomes. All this, together with awareness and dietary and nutritional education policies for the public.
It is more complicated in the poorest countries. These are some measures that can help alleviate the scourge of type 5 diabetes:
- Support for small local producers.
- Implementation of agricultural and livestock innovation projects.
- Direct aid and social protection measures for vulnerable groups such as children and adolescents.
This could facilitate access to an ideal diet for the population. Cases of malnutrition and type 5 diabetes would be reduced. Of course, all this will involve hard work for years to come.
Diabetes reminds us that two realities as distant as those of the first and third worlds sometimes suffer problems that, although they may present a different face, share common roots.
