Why diabetes hits us younger, harder and thinner

Diabetes, once considered an ailment of the elderly, is increasingly affecting younger generations, particularly South Asians living in South Africa. This trend is alarming, as those diagnosed at a younger age and with lower body weight experience the onset of the disease sooner, and the damage begins earlier. The problem extends beyond increased occurrences; it's the severity of the condition that is concerning.

The Indian community bears the heaviest burden of diabetes in South Africa. Community studies in Durban have documented this trend since the 1980s. The diagnosis rate in South Africans of Indian descent is higher compared to other ethnic groups. The reason behind this is rooted in our biological makeup and lifestyle choices. South Asian bodies tend to carry more fat around vital organs, which impairs insulin production, leading to insulin resistance or type 2 diabetes.

The international measurements of obesity have been adjusted for people of Asian descent, with a higher BMI (Body Mass Index) threshold of 23 compared to 25. Additionally, the waist circumference is considered more indicative of health risks than body weight alone. For men, this is 90cm and for women, 80cm. The focus should be on the tape measure, not the trouser size.

Genetics play a significant role, but they do not change in two generations. The problem lies in our lifestyle choices, such as consuming white rice, roti, and sugary foods. Sedentary lifestyles, with long hours spent sitting, also contribute to the escalating diabetes rates.

Pre-diabetes, a stage before full-blown diabetes, moves to the real thing at a quicker pace in our community. It is crucial to measure the waist regularly. If the measurement exceeds the prescribed limits, it's time to take action. Regular health checks, like an HbA1c or fasting glucose test, can detect diabetes early.

Building muscle through regular exercise can help manage diabetes. Swapping half of the rice intake with vegetables and reducing the number of rotis can make a significant difference. Halving the starch intake can reduce the impact of sugar on the body. The damage done by pre-diabetes can be reversed, and in some cases, early diabetes can even be pushed into remission with weight loss.

The misconception that diabetes only affects older, overweight individuals should be dispelled. The key to preventing or managing diabetes lies in regular health checks, maintaining a healthy body weight, and making lifestyle changes. Diabetes is not an inevitable end but a manageable condition with the right approach.