South Asians develop Type-2 diabetes up to ten years earlier and at lower BMI than Europeans

Sixty Indian diabetologists and endocrinologists, with 15-35 years of clinical experience, argue that South Asians develop Type-2 diabetes nearly ten years earlier than Europeans and at a lower BMI because of a unique metabolic profile. This "South Asian phenotype" features elevated insulin, pronounced insulin resistance, higher abdominal and visceral fat, and a greater proportion of body fat at any BMI. Dietary patterns exacerbate the risk: a national survey found 62.3% of calories come from refined carbs, while protein and fibre consumption are insufficient for most patients.

The specialists call for individualized, culturally sensitive dietary guidance that prioritizes whole grains, millets, vegetables, fruits, nuts and protein, and discourages fried and processed foods. They also suggest using South Asian-specific cut-offs for weight, waist circumference and lipid measures, and consider meal replacements or high-protein, high-fibre supplements for those with poor nutrition, obesity or uncontrolled glucose. Access to dietitians and affordable products remains limited, especially in rural areas, hindering adherence to these recommendations.