What is Type 5 Diabetes and How is it Coded in ICD-10-CM?

Type 5 diabetes is a newly recognized form of diabetes linked to chronic malnutrition and pancreatic underdevelopment. Because ICD-10-CM does not currently have a specific Type 5 diabetes category, coding requires reporting the underlying malnutrition first, followed by the appropriate code from category E08 Diabetes Mellitus Due to Underlying Condition and any applicable diabetic complications.

Type 5 diabetes is a newly recognized classification of diabetes. This condition was formerly classified as malnutrition related diabetes mellitus (MRDM). The International Diabetes Federation (IDF) formally recognized the type 5 classification in 2025. It joins the classifications of type 1, type 2, type 3c and gestational diabetes.

Unlike type 1 diabetes, which is due to an autoimmune disorder or type 2 due to insulin resistance, type 5 diabetes results from prolonged undernutrition particularly among children and adolescents. Type 5 diabetes is estimated to affect 20-25 million people worldwide in low and middle-income countries, particularly in South-East Asia and sub-Saharan Africa.

Why Does Malnutrition Cause Diabetes?

Chronic mal or undernutrition, both maternal and during critical stages of physiologic development, can lead to poor development of the pancreas. Underdevelopment of pancreatic tissue reduces its ability to produce insulin.

What are the Symptoms of Type 5 Diabetes?

Type 5 diabetes typically presents in adolescents and young adults. Presenting symptoms similar to those of type 1 diabetes include:

• Weight loss
• Excessive thirst
• Frequent urination
• Fatigue
• Elevated blood glucose

Differences in presentation of type 5 diabetics include physiological differences such as stunted growth, delayed development and low BMI (below 19 kg/m²) and no indication of autoimmune β-cell destruction.

How is Type 5 Diabetes Diagnosed?

Underdevelopment is the main diagnostic criteria for distinguishing type 5 from other types of diabetes. Additionally, unlike type 1 diabetics, these patient’s do not typically develop ketosis despite high blood glucose levels. Correct diagnosis is critical to providing treatment meeting the specific needs of patients with this type of diabetes.

How is Type 5 Diabetes Treated?

Treatment of type 5 diabetes involves use of both insulin and oral anti-diabetics for glucose control and introducing nutritional intervention such as a diet high in protein and low in carbohydrates. Management with a tailored treatment plan is crucial to prevention of development of diabetic complications.

For more details about Type 5 Diabetes please visit the International Diabetes Foundation website.

ICD-10-CM Code Assignment

ICD-10-CM classifies diabetes according to cause or type. Currently, ICD-10-CM does not have a code category specifically for type 5 diabetes, but fortunately it does have code options for reporting diabetes type 5 based on cause.

Code category E08 Diabetes mellitus due to underlying condition is used to report type 5 diabetes. This is indicated by the ‘Code first” instructional note associated with this category which includes malnutrition as an example of an underlying condition that causes diabetes.

E08 Diabetes mellitus due to underlying condition

Code first the underlying condition, such as:

congenital rubella (P35.0)
Cushing's syndrome (E24.-)
cystic fibrosis (E84.-)
malignant neoplasm (C00-C96)
malnutrition (E40-E46)
pancreatitis and other diseases of the pancreas (K85-K86.-)

Type 5 diabetes is reported with the appropriate code for malnutrition from categories E40-E46 followed by the code from category E08 specific to whether the diabetes is uncomplicated (E08.9) or complicated. If complicated, assign a code reporting the specific complication, such as E08.22 Diabetes mellitus due to underlying condition with diabetic chronic kidney disease.

Code assignment for type 5 diabetes should also follow the ICD-10-CM guidelines related to use of Z codes to report type of medication management (e.g., insulin, oral hypoglycemics etc.) and BMI if applicable.

Take Aways

• Type 5 diabetes is a classification that was newly recognized in 2025.
• Type 5 diabetes is due pancreatic underdevelopment due to mal or undernutrition.
• Type 5 diabetes primarily affects adolescents and young adults.
• The presentation of type 5 diabetes is similar in symptoms, but different in physiological appearance, to type 1.
• Treatment of type 5 diabetes involves medication management with insulin and/or oral hypoglycemics and nutritional therapy.
• Type 5 diabetes is reported with a code for malnutrition followed by an additional code for secondary diabetes from category E08 Diabetes mellitus due to underlying condition.

References

• https://idf.org/about-diabetes/type-5-diabetes/

FAQ

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The information contained in this coding advice is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.