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Asian Indians Developing Diabetes After Adopting Poor Lifestyle

Aug 4, 2018

Asian Indians developing diabetes in U.S: sedentary lifestyle, unhealthy eating increasing risk of developing cardiometabolic diseases.

With comments by Dr. V. Mohan, M.D., FRCP, FNASc, FASc, FNA, FACE, FACP, FTWAS, MACP,


In an observational study, 1000 Asian Indians were observed to be at an increased risk of developing type 2 diabetes after living in the United States for more than 20 years. After adopting the American lifestyle and unhealthy diet habits, HbA1c levels were elevated and HDL-c levels were low. At the ADA 2018 Scientific Sessions, Nitha Matthew Johnson presented these findings during an oral presentation.

Clinicians need to be made aware of the risk that Asian Indians have of developing type 2 diabetes. These patients need to be screened for prediabetes, insulin resistance, and diabetes and need to be advised of healthier lifestyle habits, including dietary choices. This can be done by implementing dietary and physical activity education. Because this group of patients usually has a carbohydrate-rich diet, management and education regarding healthy eating can be very beneficial in preventing diabetes. Compared to other ethnic groups, Asian Indians have the highest incidence of diabetes, metabolic syndrome, and cardiovascular disease following people of Chinese descent.

In a study of 1,038 Asian Indians, Matthew Joseph and colleagues sought out to investigate the relationship of diet, physical activity, and acculturation with the risk of diabetes and CVD. Participants had an average age of 48.5 years old and had been living in America for an average of 18.5 years. Acculturation was measured using an English proficiency scale and questionnaires were completed to assess diet and physical activity. HbA1c, fasting blood glucose, blood pressure, total cholesterol, body mass index, LDL-c, and HDL-c were measured for all participants. Of these variables, HbA1c and acculturation were highly influenced by dietary behavior (p = 0.047). The relationship between HDL-c and acculturation was mediated by physical activity (p = 0.011).

With these results, it is safe to say that this high-risk ethnic group will benefit from education on healthy eating and the implementation of physical activity. These two lifestyle interventions can not only help prevent diabetes but can reduce other cardiometabolic risks.

Practice Pearls:

  • Asian Indians are a high-risk group for developing cardiometabolic diseases.
  • Adoption of a sedentary lifestyle and unhealthy eating leads to increased risk of prediabetes and diabetes.
  • Education on healthy eating and physical activity can benefit this group as it has benefits on HbA1c and cholesterol levels.

ADA 78th Scientific Sessions 2018

Amanda Cortes, 2019 LECOM School of Pharmacy PharmD Candidate

Dr. V. MohanComment from Dr. V. Mohan:

This is an interesting study by Nitha Mathew Joseph of 1,000 adult Asian Indians living in the US.  Ms. Nitha Joseph shows that in Asian Indian Americans who are already at high risk of developing diabetes, if they change over to a western diet and adopt poor lifestyle, their control of diabetes worsens and also it seems to increase their risk of developing diabetes. Our group in our publication in Diabetes Care as well as Naveed Sattar’s group from the UK, in their publication in Lancet Diabetes and Endocrinology showed that Indians have a very high risk of developing prediabetes and diabetes.  These conversion rates are among the highest in the world. In such a background, which may be due to increased ethnic/genetic susceptibility, lifestyle modification is extremely important.  If one adopts an unhealthy lif

Dr. V. Mohan is on the advisory board for Diabetes In Control and is the Chairman and Chief of Diabetology at Dr. Mohan’s Diabetes Specialities Centre at Chennai in South India which is a WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and IDF Centre of Excellence in Diabetes Care. He is also President and Director of the Madras Diabetes Research Foundation, which is an ICMR Centre for Advanced Research on Diabetes.
estyle by taking more carbohydrates and not exercising, the risk of developing diabetes and the risk of worsening of diabetes in those who already have diabetes is much more. Conversely, our group also showed in the D-CLIP prevention study published in
Diabetes Care that by cutting down on carbohydrate, increasing physical activity and adopting [a healthy] lifestyle, diabetes could be prevented in up to 32% of people with prediabetes. Hence with the increased ethnic/genetic susceptibility, Asian Indians have to be particularly careful about their lifestyle if their diabetes is to be either prevented or kept under control.