Why Indians are more likely to develop diabetes

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Sydney-based researcher  Anandwardhan Hardikar on why Indians are at higher risk of diabetes and other chronic diseases

Compared to those in the developed world, middle classes in India and other developing countries are more susceptible to Type-2 diabetes, obesity and cardiovascular diseases, thanks to their undernourished ancestors, says a study.

The results, published in the journal Cell Metabolism, could explain projections that more than 70 percent of the global burden of Type-2 diabetes will fall on individuals from developing countries by 2030.

According to the World Health Organisation (WHO), India will have 80 million people with diabetes by 2030.

Based on their results that eating a ‘normal’ diet can make animals overweight, if their ancestors had been undernourished for several generations, the researcher from University of Sydney in Australia, the National Centre for Cell Science and the DYP Medical College in Pune, India said that diabetes is linked to the nutrition endured by ancestors.

“People in developing countries have faced multi-generational undernutrition and are currently undergoing major lifestyle changes, contributing to an epidemic of metabolic diseases, though the underlying mechanisms remain unclear,” the study said.

Increasing prosperity in developing countries has been accompanied by a sudden increase in caloric intake.

However their populations’ epigenetic makeup, whereby changing environmental factors alter how people’s genes are expressed, has not compensated for these dietary changes.
This means their bodies are still designed to cope with undernourishment; so they store fat in a manner that makes them more prone to obesity and its resulting diseases than populations accustomed to several generations of a ‘normal’ diet.

This scenario was recreated in a 12-year study of two groups of rats by associated professor Anandwardhan Hardikar’s team at the University of Sydney and colleagues overseas.

The first group was undernourished for 50 generations and then put on a normal diet for two generations.

The second (control) group maintained a normal diet for 52 generations. At the end of the study it was found that when the descendants of the first group were exposed to a normal diet, these rats were eight times more likely to develop diabetes and multiple metabolic defects when compared to the control group.

“Their adverse metabolic state was not reversed by two generations of nutrient recuperation through a normal diet,” Hardikar said.

“Instead this newly prosperous population favoured storage of the excess nutrients as fat leading to increased obesity, cardiovascular disease and metabolic risk for diabetes when compared to their ‘developed world’ counterparts.”

Lower Vitamin B12 levels in the undernourished rats could also be an indicator of this trend, the study said.

“Human studies from Ranjan Yajnik’s group at KEM Hospital in Pune, India have demonstrated that low circulating B12 and high folate levels are associated with insulin resistance and Type-2 diabetes,” Hardikar said.

National Diabetes Week

National Diabetes Week in Australia this year runs from 12-18 July. With this silent killer on the rise, it’s time to arm yourself with the knowledge necessary to stave off its rapid advances.

Diabetes is a disease caused by elevated glucose levels in the blood. A normal blood sugar level is between 80-120. A fasting blood sugar over 125 is considered diabetic.

Diabetes can go undetected for years and, if untreated, can lead to serious complications like heart disease, stroke, gangrene of the extremities, nerve disease that can lead to amputation of lower limbs, blindness, hypertension, skin infections and kidney failure.

Referred to as “Asia’s new epidemic”, diabetes claims more than 3.2 million lives every year with six deaths every minute, and is fast becoming the number one killer in the world. Indians have been identified as particularly prone to the disease, leading the world with 50.8 million sufferers. (China follows at 43.2 million). In Australia alone it is estimated that over 1 000,000 people are diabetic and 280 Australians now develop diabetes every day.

“People from the Indian subcontinent and its diaspora may be the fulcrum of the diabetes tsunami,” warns Dr Soji Swaraj, consultant physician and specialist endocrinologist (diabetes and hormone specialist) at Concord Hospital and the University of Sydney. Of the projected 333 million people with diabetes in 2025, he stresses, a large proportion will be of Indian subcontinent ancestry.

The diabetes specialist notes that people of South Asian origin are 4 times more likely to develop Type-2 diabetes than Caucasians.  They also develop diabetes at a younger age, and at lower adiposity (obesity) levels.

“All subcontinental people are at much higher risk than the general Australian population (as high as 30% compared with 7%).”

Preventing diabetes

Rather than undergoing treatment, the best course of action is to take the necessary measures to prevent becoming a diabetic.  Primary prevention measures include a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use.

These can prevent or delay the onset of diabetes. Secondary prevention would include early detection and good treatment.

Research shows that most people do not think diabetes is a serious condition and underestimate their risk. Don’t be the type to leave it too late. Could you or one of your family members or friends be at risk of developing Type 2 diabetes? If you are over 40, are overweight and have a family history of Type 2 diabetes, get yourself checked today and get on top of the game.

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