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Since the 1950s, researchers have noted an unusual form of diabetes linked to malnutrition. The condition has remained obscure for years, but now researchers are hoping to attract more attention to it by giving it a name. NPR's Jonathan Lambert has more.
JONATHAN LAMBERT, BYLINE: In the early 1950s, British physician Philip Hugh-Jones got tired of the U.K.'s dreary weather. So when he saw an advertisement for an opening at the University of the West Indies in sunny Jamaica, he applied. Michael Boyne, an endocrinologist currently at the institution, says that when Hugh-Jones got there, he discovered there was a real need for medical expertise.
MICHAEL BOYNE: There were a lot of issues with chronic diseases, undernutrition, infections.
LAMBERT: And diabetes. Hugh-Jones ended up running the diabetes clinic there, where he saw hundreds of patients. There were still a lot of unknowns about diabetes then, so he decided to write up his observations in a research paper.
BOYNE: It might have been one of the first descriptions of diabetes in the Caribbean.
LAMBERT: At the time, researchers knew diabetics fell into two broad categories. Today, we call these Type 1 and 2, actually thanks to Hugh-Jones, who coined the terms in this paper. The vast majority of his patients fell into these buckets.
BOYNE: But then he said, I found 13 people who don't fit any of these. And so he said, huh, these guys are different.
LAMBERT: They were generally young.
BOYNE: They were thin and kind of undernourished-looking.
LAMBERT: Normally, that points to Type 1, where people are unable to produce their own insulin and need injections to survive. But these 13 patients could survive without insulin injections, but they weren't overweight, like most Type 2 diabetics. He even did some liver biopsies.
BOYNE: When he looked at the liver, they didn't fit 1 or 2, and he called it Type J.
LAMBERT: Type J for Jamaica. The paper was published in 1955.
BOYNE: After that, around the world, people start to say, hey, we notice this type of diabetes doesn't fit 1 or 2.
LAMBERT: They also noticed it most in places affected by malnutrition. In 1985, the WHO dubbed it malnutrition-related diabetes. But years later, they got rid of the name, citing lack of evidence.
MEREDITH HAWKINS: Once the entity had lost its name, it became quite neglected and forgotten. But the problem was it didn't go away.
LAMBERT: That's Meredith Hawkins, a diabetes researcher at Albert Einstein College of Medicine. She says that in the intervening years, cases kept popping up. She herself saw them in Uganda.
HAWKINS: A lot of very impoverished patients that were coming in from rural areas, very thin and malnourished, very high blood sugars.
LAMBERT: Most clinicians would assume these patients have Type 1 diabetes and prescribe them lots of insulin. That can be a problem. In fact, when there's not much food available, she says too much insulin can drive their blood sugars to dangerously low levels.
HAWKINS: Basically, in many cases, committing them to a death sentence from low blood sugar. That was really what motivated our research.
LAMBERT: Since then, there's been lots of research showing that early malnutrition, even in the womb, may be harming the pancreas' ability to pump out insulin.
HAWKINS: They're malnourished as toddlers, as children, as adolescents and as adults. So these are the ones that don't catch up. And that makes them different from other forms of diabetes.
LAMBERT: So different that Hawkins thinks it deserves its own name. Not everyone agrees with critics still citing lack of data. But earlier this year, the International Diabetes Federation gave it a name - Type 5 diabetes. Now she and her colleagues are hoping other organizations will follow suit.
HAWKINS: The time is ripe.
LAMBERT: She and other researchers estimate that some 25 million people could have Type 5 diabetes, and with ongoing food crises in the world, more cases could be coming.
Jonathan Lambert, NPR News. Transcript provided by NPR, Copyright NPR.
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