Top Reasons for Rising Diabetes Risk in South Asians

There has been an increased level of diabetes risk in South Asians, particularly in India, where 77 million adults above 18 are diagnosed with type 2 diabetes. Shockingly, nearly 25 million are prediabetic, meaning they are on the brink of developing diabetes. What’s even more concerning?

Over 50% of these individuals don’t know they have diabetes, leading to severe complications like heart attacks, strokes, neuropathy, and even limb amputations. Adults with diabetes are two to three times more likely to experience these life-threatening conditions.

But why are South Asians so prone to diabetes? Is it genetics, lifestyle, or something more serious?  This blog dives into the underlying reasons behind the growing diabetes risk in South Asians, exploring genetic, lifestyle, and environmental factors while preventing diabetes in South Asians.

What is Type 2 Diabetes?

Type 2 diabetes (T2D) is a long-term condition where your blood sugar levels stay dangerously high. Why? Either your pancreas is not producing enough insulin, your body isn’t using insulin properly, or both. 

Insulin is the hormone that helps move sugar from your blood into your cells for energy. Without it working efficiently, sugar builds up in your bloodstream, leading to hyperglycemia.

Unlike Type 1 diabetes, where the pancreas stops insulin production completely due to an autoimmune attack, Type 2 diabetes develops gradually.

Why are South Asians Prone to Diabetes?

Recent studies show that nearly 1 in 4 South Asians have diabetes, with 32% at the prediabetes stage. Men are at higher risk, with 30% diagnosed, compared to 21% of women. Both insulin resistance and β-cell dysfunction are the top reasons for this alarming trend that makes managing diabetes even more challenging.

South Asians have a higher prevalence of a severe hyperglycemia subtype, which is often linked to higher HbA1c levels and cardiovascular risks like atherosclerosis. 

Obesity and Body Composition of South Asians

While South Asians have a lower average body weight, height, and Body Mass Index (BMI) compared to other groups, they face unique health risks that go beyond standard BMI calculations. South Asians can have metabolic abnormalities at a BMI of 19.6, comparable to those seen in other populations, that are up to 25. This means that traditional BMI metrics often underestimate health risks in certain groups, especially South Asians.

Moreover, studies reveal that South Asians have higher levels of abdominal fat, liver fat, and lower lean muscle mass compared to others, even at a healthy weight. These factors are strong predictors of diabetes and cardiovascular issues. The urgency is clear: relying solely on BMI could delay critical health interventions.

Factors Affecting Type 2 Diabetes in South Asians

Individual Factor

Physical activity is a critical factor for the South Asian diabetes epidemic. Many report low exercise levels, which worsens for people with diabetes. Sedentary habits, like excessive TV watching, or working at one place, are linked to higher body fat and an increased risk of diabetes. 

Some other factors influencing an increase in the Type 2 diabetes in South Asians include- 

• Bad Food Choices: Unhealthy eating habits, including processed foods, fried items, and excessive intake of spicy curries, can start chronic inflammation in the body. Inflammation damages cells and reduces insulin sensitivity, making it harder for your body to manage blood sugar levels.

• Increased Sugar Intake: South Asians have a cultural inclination toward sweet treats, which increases the risk of Type 2 diabetes. High sugar consumption spikes blood glucose levels, leading to insulin overproduction and eventual resistance.

• Carb-Based Diets: Staple diets are rich in refined carbohydrates like white rice, naan, and parathas, leading to rapid glucose spikes. Over time, this constant sugar surge wears out insulin function, increasing the risk of diabetes.

• High Seed Oil Intake: Seed oils like vegetable seed oils are high in omega-6 fatty acids, which increase inflammation in the body. Chronic inflammation can damage insulin-receptor cells, reducing your ability to process glucose effectively.

• Poor Stress Management: Chronic stress releases hormones like cortisol, increasing blood sugar levels and promoting insulin resistance. In today’s fast-paced world, unaddressed stress is a significant factor in the rising diabetes risk in South Asians.

• Insulin Resistance: Insulin resistance is an essential factor for Type 2 diabetes in South Asians. This condition occurs when your body’s cells stop responding effectively to insulin, a hormone essential for regulating blood sugar levels. As a result, glucose builds up in the bloodstream, leading to elevated sugar levels and eventually Type 2 Diabetes. South Asians face a unique genetic predisposition, combined with lifestyle factors like high-carbohydrate diets, sedentary habits, and chronic stress. Even those with a healthy weight may have hidden abdominal fat, a major contributor to insulin resistance.

Intrapersonal Factor

South Asians have strong, family-focused networks that influence their lifestyle choices, from diet to exercise habits. For example, men who work out with a friend tend to exercise more, while women see the biggest health boost when exercising with their spouse. Your close relationships, including those with adult children, can encourage healthier behaviors, like eating better and staying active.

But there’s more to consider. As immigrants adapt to life in a new country, their connection to traditional or new cultural values, called acculturation, shapes health outcomes. For instance, people who stay rooted in traditional South Asian culture may exercise less but consume fewer harmful substances like alcohol. On the other hand, those who fully adapt to Western lifestyles might exercise more but face increased risks from higher tobacco and alcohol use.

Structural Factors

Neighborhood environments, including social connections, air quality, and walkability, also shape health. For instance, South Asian women living in areas with high social cohesion had almost 50% lower odds of hypertension compared to those in low-cohesion neighborhoods.

The issue doesn’t stop there. Persistent organic pollutants like DDT (Dichlorodiphenyltrichloroethane) have been found at alarmingly higher levels in South Asian countries. These toxic chemicals have been linked to higher body fat, insulin resistance, fatty liver, and increased odds of diabetes.

Preventing Diabetes in South Asians

1. Culturally Tailored Education and Community-Based Programs

• Increase Awareness: Many South Asians are unaware of the risks associated with increasing weight, leading to diabetes. Culturally relevant education is key.
• Community Engagement: Several community programs have focus groups to understand the needs of South Asians. These programs include healthcare professional training and peer education to spread awareness.
• iThrive’s Solution: At iThrive, we understand the urgent need for holistic diabetes prevention. We help people reverse Type 2 diabetes using a holistic, data-backed approach, driven by care. Our expert Functional Nutritionists work with you on Root Cause, offering personalized, integrative care to transform your health and help you achieve your goals. Book a free consultation today.

2. Education for Healthcare Professionals

• Understand Increased Risks: Healthcare professionals must recognize the higher diabetes risk in South Asians and coronary heart disease, especially those with a family history of these diseases.
• Preventive Measures: Studies show that lifestyle changes and medications can prevent or delay diabetes in high-risk groups, reducing the risk by up to 58%.

3. Focus on Cardiovascular Health

• Target High-Risk Patients: Type 2 diabetes in South Asians face higher risks for complications. Lower thresholds for intervention in blood pressure, cholesterol, and glucose levels are necessary for better outcomes.

Conclusion

South Asians, including lean and youths under 40, are 2 - 4 times more likely to develop early-onset type 2 diabetes than others. This "Asian Indian Phenotype" highlights a unique genetic inclination, accelerating the advancement from pre-diabetes to full-blown diabetes, often despite having a normal BMI. By 2045, over 151 million South Asians will face diabetes, making it a growing health crisis. ⁸

This calls for immediate action - early detection, personalized care plans, and innovative treatments are the need of the hour. Your health is in your hands; act now to protect your future.