Type 5 diabetes: a 70-year perspective and its implications for the Americas

Type 5 Diabetes (T5DM) was first identified by Hugh-Jones in Jamaica in 1955 as J-type diabetes. Since then, multiple reports from various countries have supported the idea that T5DM differs from other known forms of diabetes. Common features that distinguish T5DM include a body mass index of <18.5 kg/m², low hepatic fat mass, low C-peptide concentrations, normal insulin sensitivity, and absence of ketoacidosis. Despite this unique phenotype, T5DM is often missed or misdiagnosed, potentially resulting in underreporting, though the magnitude is unknown. While the majority of Latin America and the Caribbean are experiencing a nutritional transition, chronic undernutrition still exists in some regions facing food insecurity and geopolitical conflicts, thus raising the risk for incident T5DM. This paper aims to highlight the 70-year history of T5DM, which began in the Americas, and proposes refocusing our attention on this underexplored but critical condition, which will probably continue to affect many individuals in the Americas.