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Age-Related Diabetes? Here's What We Know So Far About Type 4 DM

Expertly reviewed by Dexter Macalintal, MD · Internal or General Medicine

Written by Lorraine Bunag, R.N. · Updated Apr 05, 2022

    Age-Related Diabetes? Here's What We Know So Far About Type 4 DM

    Types 1 and 2 diabetes mellitus are, in no doubt, the most known types of diabetes. It’s followed by gestational diabetes – the type that develops during pregnancy, and might also predispose a woman to have type 2 diabetes later in life. But, did you know that experts are also looking into types 3 and 4 DM? In this article, we’ll briefly define the third type, but will focus on type 4 diabetes. 

    First, What’s Type 3 DM?

    Before we talk about type 4 diabetes in detail, let’s briefly discuss type 3 diabetes. 

    Type 3 diabetes, according to reports, is when the brain cells become unable to respond to insulin. This “unresponsiveness” may affect tasks, such as learning and memory. For this reason, some experts link type 3 diabetes to Alzheimer Disease, which is a form of dementia. 

    Note that while some people use the term type 3 DM instead of AD, many healthcare professionals do not accept type 3 as an actual diagnosis. 

    Type 4 Diabetes: Is It An Actual Diagnosis?

    If type 3 DM is not yet an official diagnosis, what about type 4 diabetes?

    Like type 3, type 4 DM is also not yet officially recognized. But many experts believe that a lot of people already have this type of DM. 

    Generally, scientists use type 4 diabetes to describe the insulin resistance occurring in lean, elderly people. Them being lean is crucial because most older adults with type 2 diabetes are obese or overweight. 

    The fact that many seniors have insulin resistance in the absence of excessive weight might indicate age-related DM. 

    What We Know So Far About Type 4 Diabetes

    Given that it’s not an official medical diagnosis, we can only depend on the studies centering on insulin resistance in the lean elderly. Here’s what we know so far about type 4 diabetes:

    1. Animal studies show different causes between types 1 and 4 DM

    First, let’s talk about the cause. In animal studies with mice, researchers noted that:

    • Mice with type 2 DM have abnormally low levels of a type of immune cell called T regulatory cells. 
    • On the other hand, mice with type 4 DM have abnormally high levels of T cells. 

    2. Type 4 diabetes may be responsible for millions of newly diagnosed diabetics aged 65 and up

    Despite not being a recognized medical diagnosis, experts believe millions of people have type 4 DM. 

    One report even mentioned that age-related DM may affect 20% of newly diagnosed diabetic people aged 65 and up. This accounts for 2 million people in America alone. 

    3. Once accepted, type 4 diabetes will bring several changes in diagnosis and treatment 

    As of now, scientists are still looking into the possibility of age-related diabetes. But if it gets recognized, it might bring several changes in diabetes diagnosis and management. 

    For instance, doctors may recommend diabetes screening even if the older adult has a healthy weight. Some of the recommendations for people with type 2 diabetes may also not work for those with type 4. For instance, weight management may not be effective since patients are already lean. 

    Finally, if there are differences in causes or pathophysiology, experts might need to look into other drug therapies. 

    Key Takeaways

    Besides types 1 and 2 DM, experts are also looking into type 4 DM. Here’s what we know about it so far:

    • It occurs in elderly people who are lean. Hence, experts theorize that it might be age-related. 
    • It appears to have a different pathophysiology or cause from type 2 DM. 
    • Type 4 DM might change the way we diagnose, manage, or treat diabetes. 
    • It might affect millions of people. 

    Still, we need further studies as type 4 is not yet a recognized medical diagnosis. For now, be mindful of the signs and symptoms of diabetes, so that you can readily report to your doctor if you experience them. 

    Learn more about Diabetes here


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Expertly reviewed by

    Dexter Macalintal, MD

    Internal or General Medicine

    Written by Lorraine Bunag, R.N. · Updated Apr 05, 2022

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