Viswanathan Mohan Part 3, Do People of Color Have Higher Rates of Diabetes?

In part 3 of this Exclusive Interview, Viswanathan Mohan talks with Diabetes in Control Publisher Steve Freed about the reasoning behind higher rates of diabetes in communities of color, especially in India.

Viswanathan Mohan, PhD, MD, DSc is the chairman of Dr. Mohan’s Diabetes Specialties Centre and president and director of the Madras Diabetes Research Foundation in Chennai, India.

Transcript of this video segment:

Freed:  Anyways, let’s get back to India. I have a philosophy or at least the knowledge I believe that people that have darker skins whether you’re Italian, Indian, American-Indian, African-American, Japanese, whatever, people with darker skins have more diabetes in their history.

Mohan:  Yes.

Freed:  What do you say to that?

Mohan: I think that is true in some way, because even if you look at the US population, if you look at the prevalence of diabetes in the white population in the US and compare them with virtually any other population, whether it’s the Pima Indians or the Asians, or the Black population, or the Non-Hispanic whites, you compare them with any other population, they have the lowest, the white population. Lowest, and every other ethnic group has higher. In India, there are other causes and one of them is consanguinity. People tend to marry into their own families. This traditionally has been to keep the wealth within the family. So, it’s not unusual for a girl to marry her uncle for example. The mother’s brother would be the first choice for marriage and then would be the cousins, the first cousins, and then the second cousins, and very rarely outside that. So, for centuries this has been going on particularly in some communities. And so, what happens is when you have a diabetes gene, it gets multiplied over and over and over again, and therefore everybody in the family then has the gene, and that’s why you get diabetes.

But if you go back to the time when my father started his work and when I joined him in the year 1971, the prevalence of diabetes – and at that time we didn’t have a national study, that’s being done by my daughter now, the whole country is being studied — but in my father’s days, we used to just study a city. So, in my city, Chennai, which the fourth largest city in India, the prevalence of diabetes is 2% of the adult population [then]. Today, it is 24% of the population. So, one in four of all adults about 20 years in Chennai have diabetes. And if you go to age, let’s say 50 or 55 in Chennai or Delhi, or Mumbai, both 40% have diabetes and 35% have pre-diabetes, so 75% of the population has either diabetes or pre-diabetes at that age and only 25% are normal. Now, these are highly — very, very worrying statistics. And it means that if you take a country with 1.3 billion people and then you talk about such high prevalence rates of diabetes, you’re talking about almost a hundred million people with diabetes in India. Currently it’s about 73 million, but the projection is that it’ll soon reach a 100 million, maybe in the next five years or so.

Freed:  So, I can quote — because I’m here in the US, I can say there’s 30 million people here with diabetes, 25% don’t know they have it, 10% of those people have type 1 diabetes. And we have a 100 million approximately. It keeps going up. We started at 70 but now we’re up to a 100 million people most likely with pre-diabetes and 90% of those people–

Mohan:  Don’t know.

Freed:   –don’t know they have it yet. So, what are the numbers in India?

Mohan:  The percentages? So, in India it would be much worse. The undiagnosed will be much worse because we don’t have systematic screening as you have here. So, I would say half of the people don’t know that they have diabetes. Among the pre-diabetics, I would say about nobody knows because it’s totally asymptomatic and nobody screens at that age and there are no symptoms. So, the number of people with pre-diabetes in India is about 80 million now. So, we have 73 million people with diabetes and 80 million people with pre-diabetes. And of course it depends on the definition that you use. If you use the American definition which is 100 milligrams and above, 100-125, then it’ll probably be more than 100 million in India. We use  110, the WHO criteria which is slightly stricter, and even with that we have 80 milion people. So, you’re right about that and so half the people really don’t know that they have the disease.

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