South Asians at Higher Risk of Early, Aggressive Type 2 Diabetes, BMJ Review Reports

South Asians face an earlier, more aggressive type 2 diabetes driven by abdominal fat and sedentary behaviour; the BMJ review urges early prevention and better access to care.

Highlights:

Earlier diabetes at lower BMI in South Asians
Abdominal obesity, along with sedentary behaviour, drives risk
Early prevention and affordable care are critical

A review published in The BMJ reports that South Asians, including Indians, face type 2 diabetes earlier and more aggressively than many other populations. The disease often begins at a younger age and lower body weight, then progresses rapidly, leading to more complications such as kidney disease and heart attacks. Lead author Dr. Anoop Misra, Director of the Diabetes Foundation (India), told IANS that the team’s analysis underscores both the speed and severity of the condition in this group ().

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TOP INSIGHT

Did You Know?
South Asians get diabetes earlier, and it progresses faster-abdominal fat and sedentary time are key. Start prevention early. #diabetes #southasia #prevention #endocrinology #medindia

Why Risk Is Higher

The review points to a cluster of biological and lifestyle factors. South Asians tend to have greater abdominal obesity, ectopic fat accumulation, especially hepatic (liver) fat, and lower skeletal muscle mass than white populations of similar age and BMI. These features, together with rapid beta-cell dysfunction, contribute to earlier onset and accelerated glycemic progression, which in turn raises rates of retinopathy, cardiovascular disease, and chronic kidney disease.

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Faster from Prediabetes to Diabetes

The study notes higher post-meal (postprandial) glucose levels and quicker progression from prediabetes to diabetes among South Asians. Environmental factors, more sedentary behaviour, and dietary shifts towards processed, refined carbohydrates further amplify risk and speed of progression.

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Access Gaps Worsen Outcomes

Beyond biology and behaviour, limited access to affordable care delays diagnosis and treatment in many communities. The authors warn that this fuels more frequent and severe complications, calling for affordable, innovative solutions, stronger health systems, and population-wide prevention measures across the region.

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What Clinicians and Policymakers Can Do

According to the review, prevention should begin early with a healthy diet, regular physical activity, and weight control, tailored for South Asian populations. Given an earlier onset at lower BMI, screening should not rely on weight alone; paying attention to waist circumference and abdominal adiposity is essential. Health systems should prioritize awareness, screening, and accessible treatment to blunt rapid progression and reduce complications.

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