Type 2 diabetes in SA Indian communities: Why thin does not always mean low risk

South Africans of Indian descent face the highest diabetes burden in the country. According to the national health and nutrition survey, community studies have shown this trend since the 1980s. The issue is not only about a higher prevalence of diabetes, but also the onset of the disease at a younger age, lower body weight, and earlier onset of damage.

A key factor contributing to this alarming trend is the fact that South Asian bodies carry more fat around the organs, such as the liver and pancreas, and less muscle compared to European bodies. This results in insulin resistance, which is the precursor to type 2 diabetes. The international measurements have been adjusted for people of Asian descent, with overweight defined as a body mass index of 23 instead of 25, and waist circumference being a more crucial indicator than overall weight.

The consequences of diabetes are more severe in South African Indian communities due to the duration of the condition. People diagnosed at a younger age face a longer period of high blood sugar levels, which can lead to complications affecting the eyes, kidneys, nerves, and arteries. Early detection and intervention are crucial, as pre-diabetes progresses faster in this community than in others.

To prevent or delay the onset of diabetes, it is essential to monitor waist circumference, which should be under 90cm for men and 80cm for women. Regular testing, such as HbA1c and fasting glucose, can help in early detection. Incorporating muscle-building exercises, such as resistance training, can also help improve insulin sensitivity.

Reducing the intake of carbohydrates, particularly rice and roti, is another crucial step in managing diabetes, as the damage caused by high sugar levels is primarily due to the consumption of starches.