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South Asians – people who find themselves from or hint their ancestry to the Indian subcontinent, which incorporates India, Pakistan, Afghanistan, Bangladesh, Bhutan, and Nepal – are as much as 4 occasions more likely to have Type 2 diabetes than individuals of different ethnic backgrounds. And lots of South Asians identified with kind 2 diabetes have a standard weight and physique mass index (BMI).
Afreen Idris Shariff, MD, an endocrinologist and assistant professor at Duke College College of Drugs, has seen this threat in her sufferers, her household, and even herself. Right here, she shares her ideas on what individuals of South Asian background must know to assist forestall, get screened for, and handle and even reverse their kind 2 diabetes. This interview was edited for size and readability.
WebMD: What led you to change into an endocrinologist and direct your focus towards Type 2 diabetes?
WebMD: Why do South Asians who’re skinny have a threat of Type 2 diabetes?
Shariff: That is as a result of we’ve adipose tissue round our liver and our muscle that makes us insulin resistant. Name it visceral adiposity. It mainly blocks the impact of insulin on these crucial buildings. Now, the mind and the muscle are two areas in your physique that basically do not want any insulin to uptake glucose. So … though persons are exercising, they [can] develop insulin resistance and sort 2 diabetes [if] their muscle mass will not be ready to take in that blood sugar.
Shariff: Most of my sufferers who are available in with Type 2 diabetes are sometimes very wholesome. They’ve a standard BMI, they train, and so they nonetheless can’t perceive why they can not budge that A1c.[Editor’s note: The hemoglobin A1c test checks your average blood sugar level for the past 2-3 months. A normal A1c level is below 5.7%. An A1c level of 5.7% to 6.4% is in the prediabetes range. And 6.5% or higher is in the diabetes range. You’d get that checked twice before diagnosing diabetes.]
instance is myself; I’ve a low BMI but I took 40 models of insulin after I was pregnant [and had gestational diabetes].
Usually when you may have Type 2 diabetes, you may have insulin resistance. You have got lots of insulin, however it does not work as properly. So that you require an entire lot extra insulin to do the job of what it ought to have completed with out the resistance.
WebMD: If somebody of South Asian descent goes to their main care physician, what threat components necessitate screening for Type 2 diabetes?
Shariff:
- A BMI higher than 23. [Editor’s note: This is below the BMI threshold for being overweight.]
- Any first-degree relative [parent, child, or sibling] that has Type 2 diabetes
- Some other member of the family who has Type 2 diabetes plus a historical past of coronary heart illness, hypertension, and triglycerides higher than 250
- Females who’ve a historical past of polycystic ovary syndrome (PCOS)
WebMD: How can somebody of South Asian descent advocate for themselves to get examined for Type 2 diabetes at their main care physician’s workplace?
WebMD: How do you counsel your sufferers concerning weight-reduction plan and train?
Shariff: I by no means say you could cease consuming one thing [if you have] diabetes, which is a breath of contemporary air for many sufferers. I say, ‘I would like you to grasp what you’ll be able to eat much less of and what you ought to be consuming extra of and steadiness your weight-reduction plan.’
Many South Asians are vegetarian and it’s a heavy carb weight-reduction plan. No matter kind of carb you’re going to eat, it’s going to lift your blood sugar. Attempt to keep true to your flavors and be artistic with how one can modify the carb parts of your meals into much less carbohydrates, or excessive fiber, excessive protein choices.
WebMD: What message do you wish to ship South Asians concerning a Type 2 diabetes analysis?
Shariff: It’s important to steadiness sustainability and perceive you could search assist. You don’t need diabetes to outline you.
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