We recently learned how to eat healthy Indian food without insulting your

We recently learned how to eat healthy Indian food without insulting your mom, but for many the effects of an unhealthy diet are already being felt as the rate of diabetes in South Asians continues to climb. The South Asian diet can be full of fatty, unhealthy foods, so it’s no surprise that diabetes is a growing problem within the community. According to the World Health Organization, diabetes affects more than 220 million people worldwide and can lead to serious damage to the body’s heart, blood vessels, eyes, kidneys, and nerves. Furthermore, the 2011 National Diabetes Factsheet estimates that the prevalence of diabetes in the United States is 8.3 percent for the general population and 8.4 percent for all Asian Americans.

A recent study looking specifically at foreign-born South Asians from the Indian subcontinent found that the prevalence in this group was nearly twice that of other foreign-born Asians (13.6 percent vs. 7.4 percent). Despite the extraordinary epidemic of diabetes in South Asians, there is limited evidence-based knowledge on primary and secondary prevention specific to the same group.

The Center for the Study of Asian American Health (CSAAH) and the NYU Health Promotion and Prevention Research Center (PRC) have been conducting research on diabetes in the Asian American community since 2003. We asked staff members from the Centers some pertinent questions about how to prevent and manage diabetes.

What makes South Asians especially susceptible to diabetes?
South Asians may be especially susceptible to diabetes for several reasons. For one, South Asians have been found to have a high prevalence of insulin resistance, meaning that the body produces insulin but does not use it properly, which may be related to increased abdominal fat. South Asians may also have a thrifty genotype which favors storage of fat. While in the past this had survival benefits, it is now a disadvantage since foods are no longer scarce.

Lifestyle, social, and cultural risk factors may also contribute to higher rates of diabetes in South Asians. Many South Asian immigrants have lived a traditional farm-based lifestyle until recently and have begun to adopt an urban lifestyle. According to a study from 2003, some South Asians may also consider health problems to be a part of their destiny making them less proactive about taking steps to improve their health.

What are the best methods to prevent diabetes, particularly for South Asians?
Physical activity should be a target. Research has shown that even a modest increase in physical activity (walking 30 minutes a day) without any weight loss reduces the risk of Type 2 diabetes for susceptible, pre-diabetic Indians by approximately 30 percent. Early screening and prevention can also play a big role in reducing disease burden. High fasting glucose and insulin resistance is seen even in children, so prevention should begin before adulthood. Prevention methods should include physical activity and maintaining a healthy diet.

What is CSAAH/PRC doing to prevent and help manage diabetes in the South Asian community?
CSAAH and the PRC are implementing two interventions targeting the South Asian community. In the RICE program, South Asian individuals at risk for diabetes are recruited through screening events, and the program is designed to teach about diabetes prevention. In the DREAM program, Bangladeshi individuals with diabetes are similarly recruited but the program is designed to teach about diabetes management. Both programs include regularly scheduled workshops and contact with community health workers to help monitor diabetes prevention/control goals. Both programs are also designed to address diabetes prevention/control in ways that are culturally tailored for their target communities.

CSAAH and the PRC also promote awareness campaigns and events in the community. Diabetes Alert Day, one event organized by the PRC and United Sikhs, included healthy cooking demonstrations for community members at the Sikh Cultural Society Gurdwara in Queens. This included a cooking demonstration for Sikh community members that focused on healthier ways to make their favorite traditional foods.

What should people who have already been diagnosed with diabetes do to stay healthy?
Individuals who have already been diagnosed with diabetes should be careful to maintain their blood glucose levels within a healthy range, as directed by their doctor. This includes maintaining a healthy diet and controlling their intake of foods high in sugar, such as refined carbohydrates and sweets (namely mithai). Additionally, diabetic individuals should take part in regular physical activity, even a modest amount. In the event that blood glucose levels cannot be controlled through diet and exercise alone, insulin injections or other diabetes medications may be prescribed.

Diabetic individuals should also take note of any complications, such as change in vision, gum disease, and sores on their feet, as well as monitor their blood pressure and cholesterol levels in order to prevent other diseases associated with diabetes, such as hypertension and heart disease. They should visit a doctor for care and treatment of their diabetes on a regular basis.

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