For several years we have heard that Indians are at a greater risk for diabetes. Indians do have a higher predisposition to syndrome X (clustering of various risk factors, the first step towards diabetes), type 2 diabetes and coronary artery disease, as compared to other ethnic groups.

These phenomena cannot be ascribed to a single factor, it rather appears as multi-factorial in origin.

1. Overall, Indians have more accumulated fat in their bodies, from the time of birth, which is nearly 1.5 times more than the white race. Fat can accumulate in many places, but when it gathers at the abdomen, it interferes with the body’s metabolism and becomes a significant health problem. Thus, marked increased risk for development of diabetes.

2. Our liver, which is a prime site of glucose metabolism, is also full of fat and the metabolism is markedly sluggish. According to a research, fat in the liver is particularly detrimental to metabolism, and is a source of excess blood sugar, triglycerides and also causes ‘low-grade fire’ (subclinical inflammation) in arteries, thus increasing chances of blockages.

3. Certain risk factors are aggravated by the social and economic outcomes of urbanisation, industrialisation and globalisation. In India, rapid urbanisation and changing lifestyles are contributing to the widespread onset of diabetes. More people are leading relatively sedentary and highly stressful lives. These changing patterns of living combined with regular intake of junk food with high quantities of fats and refined carbohydrates are the reason for the increasing numbers of diabetics in India.

4. Migration, whether inter-country or intra-country, appears to be a risk factor for diabetes and other cardiovascular diseases. Adiposity and insulin resistance in migrant Indians tend to be higher than either urban- or rural-based dwellers in India, resulting in the inflation in the percentage of diabetic people around the country.