South Asian Background and the Surprising Risk of Type 2 Diabetes

South Asians at Risk Exploring Type 2 Diabetes with Expert Insights

South Asians and Type 2 Diabetes Expert Q&A

Hey there, folks! Brace yourselves for some shocking news – it turns out people of South Asian descent might have a higher risk of type 2 diabetes than they bargained for, even if they’re not carrying extra weight. Who would’ve thought, right?

Let’s dive into the nitty-gritty. South Asians, including folks from India, Pakistan, Afghanistan, Bangladesh, Bhutan, and Nepal, are up to four times more likely to have type 2 diabetes compared to other ethnic backgrounds. What’s more surprising is that many South Asians with type 2 diabetes maintain a normal weight and BMI. Holy moly!

Afreen Idris Shariff, MD, an endocrinologist and assistant professor at Duke University School of Medicine, knows this risk all too well. She has seen it in her patients, her family, and even experienced it herself. Don’t worry, though – she’s here to share some wisdom on how people of South Asian background can prevent, screen for, and manage, or even reverse, their type 2 diabetes. Hang tight, because things are about to get interesting!

iBioMed: What led you to become an endocrinologist and focus on type 2 diabetes?

Shariff: Well, it all started after medical school when I applied for nephrology. But then, fate had other plans for me! I got hit with gestational diabetes, and that changed the game. Plus, my dad has been tackling type 2 diabetes since I was knee-high to a grasshopper. So, you can say it’s a story that began with my personal experience and ended with me taking care of my own father. Life really knows how to throw a curveball, huh?

iBioMed: Why do thin South Asians have a risk of type 2 diabetes?

Shariff: Prepare yourself, because this is gonna blow your mind! We South Asians have something called “visceral adiposity.” Picture this – our liver and muscles are surrounded by sneaky adipose tissue that makes us resistant to insulin, the hormone that helps regulate blood sugar. It’s like these tissues put up a big ol’ “Do Not Disturb” sign for insulin. So, even if we’re hitting the gym regularly, our muscles struggle to absorb that sugar, leading to insulin resistance and eventually type 2 diabetes. Sneaky, sneaky!

Oh, and by the way, when it comes to BMI and insulin, things can get a bit wonky for South Asians with type 2 diabetes. Most of my patients are super healthy, with normal BMIs and a love for exercising. But guess what? They just can’t figure out why their A1c, an indicator of blood sugar levels, won’t budge. It’s like trying to push a boulder up a mountain!

Even a low-BMI champion like myself had to pack on a whopping 40 units of insulin during my pregnancy – and I’m still considered low BMI! See, when you have type 2 diabetes, you’re dealing with insulin resistance, which means your body needs extra insulin to get the job done. It’s like trying to convince a stubborn donkey to move – you gotta use all your strength and then some!

But wait, there’s more! South Asians have both insulin resistance and insulin deficiency. It’s like playing a game of “double trouble.” Our beta cells, the ones responsible for producing insulin, are a bit sluggish in action. So when we eat, our sugar levels have to reach sky-high heights before our beta cells even think about releasing insulin. It’s like trying to wake up a teenager – you need some serious noise!

iBioMed: So, what risk factors necessitate screening for type 2 diabetes in South Asians?

Shariff: Ah, great question! If you’re of South Asian descent and you’re heading off to see your primary care doctor, keep these risk factors in mind. They’re like the secret password to get screened for type 2 diabetes:

  • A BMI greater than 23 (Yep, below the threshold for being overweight. Tricky, huh?)
  • Any first-degree relative with type 2 diabetes
  • Other family members with type 2 diabetes, plus a history of heart disease, hypertension, and triglycerides higher than 250
  • Females with a history of polycystic ovary syndrome (PCOS)

iBioMed: How can South Asians advocate for themselves to get tested for type 2 diabetes?

Shariff: Ah, the power of self-advocacy! If you’re a South Asian and you want to get tested for type 2 diabetes, speak up and share your concerns with your primary care physician. Let them know that, due to your South Asian background, your risk level is sky-high, even with a lower BMI. Don’t be shy – take the reins and show ’em what you’re made of!

iBioMed: How do you counsel your patients regarding diet and exercise?

Shariff: Now, listen up, because I’m about to drop some knowledge bombs. When it comes to diet, I’m not about restriction – I’m about balance. So, I never tell my patients to stop eating something just because they have diabetes. That would be, well, boring.

Instead, I invite my South Asian buddies to embark on a flavor adventure. Take control of your meals and get creative with modifying those carb portions. Less carbs, more high-fiber and high-protein options – it’s like giving your taste buds a rollercoaster ride they won’t forget!

As for exercise, hey, you do you. Sometimes people feel like hitting the gym, and other times they don’t. But here’s the deal – I put 70% of the emphasis on diet. Why? Because when you eat foods that work with your diabetes diagnosis, your blood sugar levels will thank you. It’s like convincing your body to join a peaceful revolution against insulin resistance!

iBioMed: What message do you want to send South Asians facing a type 2 diabetes diagnosis?

Shariff: Remember, my friends, balance is the key. Don’t let diabetes become your whole identity – seek help, make sustainable changes, and live your best life. You’re not defined by this condition. You’ve got this!

Wow, we’ve covered a lot of ground today, folks! Who would’ve thought having South Asian ancestry could come with a higher risk of type 2 diabetes? But now, armed with this knowledge and Dr. Shariff’s insights, you can take charge and protect your health like a superhero.

So, how about you? Have you ever faced surprising health risks due to your background or ethnicity? Share your thoughts and experiences in the comments below! Let’s have a lively discussion, because knowledge is power, my friends!