What makes India the diabetes capital of the world?

7th of April is commemorated as the World Health Day. The theme this year is “Beat Diabetes”. Currently, every fifth diabetic in the world is an Indian! By 2030, over 100 million Indians are expected to have diabetes. 

Did you know Indians are four times more susceptible to diabetes than their European counterparts? Let’s find out what makes Indians so prone to the sugar disease.

We Indians may be more susceptible because of our genetic makeup, diet and lifestyle factors.diabetes

Our genes

There is limited knowledge about the genetics of diabetes. However, our genetic makeup is such that we Indians have a low threshold for diabetes. While Americans develop diabetes when their body mass index (BMI) is 30-35 kg/m2, Indians tend to develop diabetes when they have a BMI of only 25 kg/m2.

Indians tend to have less muscle and more abdominal fat. This increases their insulin resistance. This prevents insulin from helping the cells of the body to take up glucose from the blood and change it to energy.

Even with what is considered as a healthy BMI, Indians tend to have more fat around their organs and in the belly area than westerners with the same BMI. You can be at a high risk for diabetes even if you are not overweight. An “apple-shaped body” with more fat around your waist can put you at higher risk for diabetes even if you have a normal BMI.

Our diet

Like most Asians, we Indians include a lot of white rice and other refined grains in their diet. These are linked to an increased risk of diabetes. Trans fats and saturated fats such as palm oil are often used to cook Indian dishes. A high fat diet increases the risk of diabetes.

If a pregnant mother gets poor nutrition (and this is not very uncommon in India), the child is likely to develop diabetes when he or she grows up, especially if there is rapid transition to a diet rich in refined carbohydrates, sugar and fats.

Our lifestyle

Modernization has led to a more sedentary lifestyle. We walk less, cycle less, and exercise less. Many Indians smoke or chew tobacco regularly. Nearly, 40% of Indian men smoke. Use of tobacco is associated with higher abdominal fat and about 45% increased risk for developing diabetes.

Air pollution, an ever increasing problem in the country, also puts Indians at higher risk of insulin resistance and diabetes.

Our geographical area

A recent study published in 2015 says even among the Asian Indian community, the prevalence of prediabetes and diabetes varies depending on where they live. Asian Indian living in the United States have a 20% higher prevalence of prediabetes while those living in India have 50% higher prevalence of diabetes. Though diabetes is less prevalent among Indians living in US than those living in India, the prevalence rate is considerably higher than in the general American population.

Taking this into account, the American Diabetes Association recommends that Asian Americans should be screened for type 2 diabetes if they have a BMI of 23 kg/m2 or more instead of the usual 25 kg/m2 that is the starting point for diabetes screening.

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