{"id":85073,"date":"2022-11-14T16:00:55","date_gmt":"2022-11-14T21:00:55","guid":{"rendered":"https:\/\/newsroom.carleton.ca\/?post_type=cu_story&#038;p=85073"},"modified":"2025-08-19T09:37:08","modified_gmt":"2025-08-19T13:37:08","slug":"south-asians-increased-risk-diabetes","status":"publish","type":"cu_story","link":"https:\/\/carleton.ca\/news\/story\/south-asians-increased-risk-diabetes\/","title":{"rendered":"Why South Asians are at increased risk for diabetes: A complex interplay of genetics, diet and history"},"content":{"rendered":"\n<section class=\"w-screen px-6 cu-section cu-section--white ml-offset-center md:px-8 lg:px-14\">\n    <div class=\"space-y-6 cu-max-w-child-max  md:space-y-10 cu-prose-first-last\">\n\n        \n                    \n                    \n            \n    <div class=\"cu-wideimage relative flex items-center justify-center mx-auto px-8 overflow-hidden md:px-16 rounded-xl not-prose  my-6 md:my-12 first:mt-0 bg-opacity-50 bg-cover bg-cu-black-50 pt-24 pb-32 md:pt-28 md:pb-44 lg:pt-36 lg:pb-60 xl:pt-48 xl:pb-72\" style=\"background-image: url(https:\/\/carleton.ca\/news\/wp-content\/uploads\/sites\/162\/glucometer-1200x900-1.jpg); background-position: 50% 50%;\">\n\n                    <div class=\"absolute top-0 w-full h-screen\" style=\"background-color:rgba(0,0,0,0.600);\"><\/div>\n        \n        <div class=\"relative z-[2] max-w-4xl w-full flex flex-col items-center gap-2 cu-wideimage-image cu-zero-first-last\">\n            <header class=\"mx-auto mb-6 text-center text-white cu-pageheader cu-component-updated cu-pageheader--center md:mb-12\">\n\n                                    <h1 class=\"cu-prose-first-last font-semibold mb-2 text-3xl md:text-4xl lg:text-5xl lg:leading-[3.5rem] cu-pageheader--center text-center mx-auto after:left-px\">\n                        Why South Asians are at increased risk for diabetes: A complex interplay of genetics, diet and history\n                    <\/h1>\n                \n                            <\/header>\n        <\/div>\n\n                    <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"absolute bottom-0 w-full z-[1]\" fill=\"none\" viewbox=\"0 0 1280 312\">\n                <path fill=\"#fff\" d=\"M26.412 315.608c-.602-.268-6.655-2.412-13.524-4.769a1943.84 1943.84 0 0 1-14.682-5.144l-2.276-.858v-5.358c0-4.876.086-5.358.773-5.09 1.674.643 21.38 5.84 34.646 9.109 14.682 3.59 28.935 6.858 45.936 10.449l9.874 2.089H57.322c-16.4 0-30.31-.16-30.91-.428ZM460.019 315.233c42.974-10.074 75.602-19.88 132.443-39.867 76.16-26.791 152.063-57.709 222.385-90.663 16.7-7.823 21.336-10.074 44.262-21.273 85.004-41.688 134.719-64.193 195.291-88.413 66.55-26.577 145.2-53.584 194.27-66.765C1258.5 5.626 1281.34 0 1282.24 0c.17 0 .34 27.596.34 61.3v61.299l-2.23.375c-84.7 13.718-165.93 35.955-310.736 84.931-46.494 15.753-65.427 22.076-96.166 32.15-9.102 3-24.814 8.198-34.989 11.574-107.543 35.954-153.008 50.422-196.626 62.639l-6.74 1.876-89.126-.054c-78.135-.054-88.782-.161-85.948-.857ZM729.628 312.875c33.229-10.985 69.248-23.523 127.506-44.207 118.705-42.223 164.596-57.709 217.446-73.302 2.62-.75 8.29-2.465 12.67-3.751 56.19-16.772 126.94-33.597 184.17-43.671 5.07-.91 9.66-1.768 10.22-1.875l.94-.161v170.236l-281.28-.054H719.968l9.66-3.215ZM246.864 313.411c-65.041-2.251-143.047-12.11-208.432-26.256-18.375-3.965-41.73-9.538-42.202-10.074-.171-.214-.257-21.38-.214-47.046l.129-46.618 6.654 3.697c57.313 32.043 118.491 56.531 197.699 79.143 40.313 11.521 83.459 18.058 138.669 21.059 15.584.857 65.685.857 81.14 0 33.744-1.876 61.306-4.93 88.396-9.806 6.396-1.126 11.634-1.983 11.722-1.929.255.375-20.48 7.769-30.999 11.038-28.592 8.948-59.288 15.646-91.873 20.147-26.36 3.59-50.015 5.627-78.35 6.698-15.584.59-55.209.59-72.339-.053Z\"><\/path>\n                <path fill=\"#fff\" d=\"M-3.066 295.067 32.06 304.1v9.033H-3.066v-18.066Z\"><\/path>\n            <\/svg>\n            <\/div>\n\n    \n\n    <\/div>\n<\/section>\n\n<p>This article is <a href=\"https:\/\/theconversation.com\/why-south-asians-are-at-increased-risk-for-diabetes-a-complex-interplay-of-genetics-diet-and-history-193613\" rel=\"noopener noreferrer\" target=\"_blank\">republished<\/a> from The Conversation under a Creative Commons licence. All photos provided by <a href=\"https:\/\/theconversation.com\" rel=\"noopener noreferrer\" target=\"_blank\">The Conversation<\/a> from various sources.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n\n\n\n<p><iframe loading=\"lazy\" style=\"width: 100%; height: 100px; border: none; position: relative; z-index: 1;\" allowtransparency=\"\" allow=\"clipboard-read; clipboard-write\" src=\"https:\/\/narrations.ad-auris.com\/widget\/the-conversation-canada\/why-south-asians-are-at-increased-risk-for-diabetes--a-complex-interplay-of-genetics--diet-and-history\" width=\"100%\" height=\"400\"><\/iframe><\/p>\n\n\n\n<p>In 2021, there were <a href=\"https:\/\/www.diabetesatlas.org\">537 million adults living with diabetes<\/a>, of which approximately 90 per cent had Type 2 diabetes. When someone has Type 2 diabetes, specialized cells within the pancreas known as &#8220;beta cells&#8221; produce insufficient amounts of insulin.<\/p>\n\n\n\n<p><a href=\"https:\/\/doi.org\/10.1038%2Fs41591-021-01418-2\">Insulin is a hormone<\/a> that travels through the bloodstream and tells other cells to take excess sugar out of the blood and use this sugar as energy, making sure the body keeps doing everything it needs to. <\/p>\n\n\n\n<p>Individuals with Type 2 diabetes are &#8220;insulin resistant,&#8221; meaning cells do not adequately recognize insulin. These individuals require more insulin than normal to regulate blood sugar levels. When beta cells fail to compensate for the increased insulin demand, blood sugar levels rise, adversely affecting organ function.<\/p>\n\n\n\n<p>Globally, the South Asian community is composed of over two billion individuals. In Canada, <a href=\"https:\/\/www.diabetes.ca\/DiabetesCanadaWebsite\/media\/Advocacy-and-Policy\/Backgrounder\/2022_Backgrounder_Canada_English_1.pdf\">14.4 per cent of South Asians have Type 2 diabetes<\/a>, the highest prevalence of any other ethnic group in the country.<\/p>\n\n\n\n<p>As a member of the South Asian community, it is incredibly common for me (Lahari Basu) to learn that someone I know has been diagnosed with Type 2 diabetes. When I joined <a href=\"http:\/\/www.bruinlab.com\/\">Dr. Jenny Bruin&#8217;s lab<\/a> at Carleton University to study diabetes for my PhD, I was intrigued by this question: Why are South Asians disproportionately impacted by Type 2 diabetes?<\/p>\n\n\n\n<p>That answer lies in a web of genetic, behavioural and cultural factors.<\/p>\n\n\n\n<h2 id=\"genetic-variants\" class=\"wp-block-heading\">Genetic variants<\/h2>\n\n\n\n<p>In 2013, researchers confirmed that South Asians are particularly insulin resistant. Compared to Caucasians, <a href=\"https:\/\/doi.org\/10.1016\/j.metabol.2013.10.008\">South Asians had higher insulin concentrations in their blood after ingesting sugar<\/a>. This means that South Asian individuals require more insulin to regulate their blood sugar levels, a characteristic of Type 2 diabetes.<\/p>\n\n\n\n<p>There are numerous possible explanations for this, but genetic variants could be one culprit. Variation, or mutations, in genes can alter cell function. In the case of beta cells, genetic variants can lead to inappropriate levels of insulin secretion and insulin resistance.<\/p>\n\n\n\n<figure class=\"wp-block-image align-center\"><img decoding=\"async\" src=\"https:\/\/images.theconversation.com\/files\/494899\/original\/file-20221111-2672-d6vtg1.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\" alt=\"Cropped image of a young man in a plaid shirt holding an insulin pen for Type 2 diabetes\"\/><figcaption class=\"wp-element-caption\">\n              <span class=\"caption\">Individuals with Type 2 diabetes are insulin resistant, meaning cells do not adequately recognize insulin. Some people with Type 2 diabetes inject insulin with an insulin pen.<\/span><br>\n              <span class=\"attribution\"><span class=\"source\">(Shutterstock)<\/span><\/span><br>\n            <\/figcaption><\/figure>\n\n\n\n<p>It turns out that South Asians have <a href=\"https:\/\/doi.org\/10.1038\/s42003-022-03248-5\">acquired mutations in various genes required for proper beta cell function<\/a>. They also have a higher prevalence of mutations in a <a href=\"https:\/\/doi.org\/10.1038%2Fng.921\">gene called GRB14<\/a>, resulting in increased insulin resistance.<\/p>\n\n\n\n<p>Although not all South Asians have these mutations, a significant proportion do. There are also likely other gene variants that have yet to be uncovered in this population. These gene variants begin to paint an interesting picture of how genetic predisposition increases their risk of developing diabetes.<\/p>\n\n\n\n<h2 id=\"physiological-adaptations\" class=\"wp-block-heading\">Physiological adaptations<\/h2>\n\n\n\n<p>Genetic variants only explain a small part of the increased insulin resistance in South Asian individuals. This observed insulin resistance may also have historical context.<\/p>\n\n\n\n<p>South Asians have faced multiple famines throughout history. The recurrence of depleted food sources and malnutrition led to the development of a <a href=\"https:\/\/doi.org\/10.2337%2Fdc11-0442\">starvation adaptation<\/a>. This adaptation allowed them to efficiently process food and store fat during times of abundance, providing an advantage during famine.<\/p>\n\n\n\n<p>Now, with urbanization and migration, this trait can be detrimental to South Asians. The adaptation does not bode well in a world with increased access to high-fat foods. Combined with modern-day diets, this adaptation can result in <a href=\"https:\/\/doi.org\/10.1007\/s00125-022-05803-5\">increased fat storage and abdominal obesity in South Asian individuals<\/a>, leading to greater risk of insulin resistance and diabetes.<\/p>\n\n\n\n<h2 id=\"cultural-differences\" class=\"wp-block-heading\">Cultural differences<\/h2>\n\n\n\n<p>Food plays an important social role in South Asian culture. For as long as I can remember, big family dinners were integral to my lifestyle and cultural identity. For us, food is a way to communicate, to honour ancestors and to celebrate.<\/p>\n\n\n\n<p>The staples of South Asian cuisine include white rice, flatbreads and potatoes, with most cooking being done in clarified butter. This diet is influenced from a time before refrigerators and food abundance, focusing on shelf-stable, self-preserving foods. Diets high in carbohydrates and fat have been <a href=\"https:\/\/doi.org\/10.1017\/s0007114508073649\">linked to increased insulin resistance and decreased metabolism<\/a> (the process of converting food into energy).<\/p>\n\n\n\n<h2 id=\"south-asian-ethnicity-and-diabetes-risk-culture-centred-treatment\" class=\"wp-block-heading\">South Asian ethnicity and diabetes risk: Culture-centred treatment<\/h2>\n\n\n\n<figure class=\"wp-block-image align-right\"><img decoding=\"async\" src=\"https:\/\/images.theconversation.com\/files\/494900\/original\/file-20221111-11-bzc8rr.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip\" alt=\"A woman in a green shirt listening to a man in a white coat with his back to the camera\"\/><figcaption class=\"wp-element-caption\">\n              <span class=\"caption\">Implementing treatment programs that focus on the culture of the patients can help approach diabetes management in a new light.<\/span><br>\n              <span class=\"attribution\"><span class=\"source\">(Shutterstock)<\/span><\/span><br>\n            <\/figcaption><\/figure>\n\n\n\n<p>There is clearly a complex relationship between South Asian ethnicity and diabetes risk. The interplay of culture and genetics presents a unique challenge for this community. For many, <a href=\"https:\/\/doi.org\/10.1002\/pdi.619\">unfamiliarity with diabetes<\/a> may prevent them from getting the care they need.<\/p>\n\n\n\n<p>Implementing <a href=\"https:\/\/doi.org\/10.1186\/s12992-019-0451-4\">treatment programs that focus on the culture of the patients<\/a> can help approach diabetes management in a new light. Healthier versions of traditional foods, familiar languages and being cognizant of cultural barriers can help South Asians with diabetes understand the seriousness of the condition, their predisposition to it, and how to manage their symptoms.<\/p>\n\n\n\n<h2 id=\"a-call-for-south-asian-centric-research\" class=\"wp-block-heading\">A call for South Asian-centric research<\/h2>\n\n\n\n<p>As a South Asian woman studying diabetes, learning about this phenomenon opened my eyes to how little we know about ethnicity-specific diabetes risk. <a href=\"https:\/\/doi.org\/10.1136%2Fbmjopen-2016-014889\">South Asians are severely underrepresented in clinical research<\/a>. To truly understand the complex relationship between Type 2 diabetes and South Asians, it is vital to conduct clinical studies that specifically target this ethnic group.<\/p>\n\n\n\n<p>A better scientific understanding of the link between South Asians and increased Type 2 diabetes and implementing culture-centred management programs can help alleviate the mystery and stigma behind this phenomenon.<\/p>\n\n\n\n<p>&#8212;<br>\n<a href=\"https:\/\/newsroom.carleton.ca\">Carleton Newsroom<\/a><\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/counter.theconversation.com\/content\/193613\/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\"\/><\/figure>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In 2021, there were 537 million adults living with diabetes, of which approximately 90 per cent had Type 2 diabetes. When someone has Type 2 diabetes, specialized cells within the pancreas known as \u201cbeta cells\u201d produce insufficient amounts of insulin.<\/p>\n","protected":false},"author":410,"featured_media":85076,"template":"","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"cu_story_type":[1623],"cu_story_tag":[],"class_list":["post-85073","cu_story","type-cu_story","status-publish","has-post-thumbnail","hentry","cu_story_type-expert-perspectives"],"acf":{"cu_post_thumbnail":false},"_links":{"self":[{"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story\/85073","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story"}],"about":[{"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/types\/cu_story"}],"author":[{"embeddable":true,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/users\/410"}],"version-history":[{"count":3,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story\/85073\/revisions"}],"predecessor-version":[{"id":85078,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story\/85073\/revisions\/85078"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/media\/85076"}],"wp:attachment":[{"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/media?parent=85073"}],"wp:term":[{"taxonomy":"cu_story_type","embeddable":true,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story_type?post=85073"},{"taxonomy":"cu_story_tag","embeddable":true,"href":"https:\/\/carleton.ca\/news\/wp-json\/wp\/v2\/cu_story_tag?post=85073"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}