ReviewIndian journal of endocrinology and metabolism
Malnutrition Modulated Diabetes: A Variant of Type-1 Diabetes or Hybrid Diabetes and Not Type-5 Diabetes'.
Review in Indian journal of endocrinology and metabolism. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Type 5 Diabetes Mellitus: Pathophysiology, Clinical Phenotype, and Nutritional Management.Diabetes/metabolism research and reviews · 2026Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Malnutrition-modulated diabetes (MMDM) has been extensively studied by the various investigators over the last 70 years. It initially emerged as a distinct clinical entity as youth-onset diabetes in the twenties, having severe hyperglycaemia, ketosis resistance, and requiring a high insulin dose. In 1985, World Health Organisation (WHO) placed it under a major type of diabetes along with type 1 and type 2. Subsequently, it was removed from classification when research revealed that patients with MMDM, though had severe hyperglycaemia, were not immune to ketosis, had no insulin resistance on systematic investigation. With the availability of anti-GAD and IA-2 antibody assays, several investigators assessed a large cohort of MMDM. Demonstration of islet cell antibodies, especially anti-GAD65 led to the realisation that MMDM is possibly a variant of type-1 diabetes. However, the spread of autoimmunity was limited to fewer autoantigens and organs due to the prevailing malnutrition. Limited pancreatic beta cell autoimmunity led to better C-peptide reserves than those of type 1 diabetes. This further brings MMDM near Type-1 in pathogenesis. Alternative MMDM can be called a hybrid of Type-1 and severe Type-2. It will be in the fitness to categorise it as a type of 'hybrid diabetes in the WHO, 2019 classification. Recently, the 'International Diabetes Federation' renamed MMDM as type-5 diabetes. Giving a new name to MMDM is like putting old wine in a new bottle. The current review provides details of MMDM, its possible place in the current classification, and independent views on the term 'Type-5 diabetes'.
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