Type 5 diabetes (T5D) is a malnutrition-related form of diabetes associated with chronic pancreatic injury and typically affects lean individuals, unlike type 2 diabetes mellitus (T2DM), which is driven by obesity and insulin resistance. These differences make accurate distinction essential, as misclassification can lead to inappropriate therapy. Understanding the glycemic and metabolic profiles of both conditions is therefore important for proper diagnosis and management. This study aims to systematically evaluate and compare these profiles between T5D and T2DM

A comprehensive literature search was performed using predefined MeSH terms and relevant keywords across major databases. Eligible studies were screened systematically, and data extraction followed standardized procedures. Meta-analysis was conducted to compare BMI, fasting blood glucose (FBS), postprandial blood glucose (PPBS), glycated hemoglobin (HbA1c), triglycerides (TG), and total cholesterol (TC) between individuals with T5D and T2DM

Patients with T5D showed significantly higher FBS (p < 0.0001), PPBS (p < 0.05), and HbA1c (p < 0.00001), with mean differences of 28.16, 38.88, and 0.91 respectively. In contrast, individuals with T2DM had notably greater BMI (p < 0.0005), TG (p < 0.005), and TC (p < 0.0001). These findings demonstrate clear glycemic and metabolic distinctions between both groups. T5D is characterized by more severe hyperglycemia and poorer glycemic control, likely reflecting diminished insulin production due to pancreatic damage. T2DM, meanwhile is marked by metabolic dysregulation and elevated lipid levels. These contrasting patterns emphasize the need for personalized therapeutic strategies tailored to each condition's underlying physiology

The distinct glycemic and metabolic profiles of T5D and T2DM highlight the importance of individualized management approaches