Why do Indo-Asian folk get more diabetes? A good question.
It is clear from data, that Indo-Asian folk get T2DM when less obese and younger than Europid folk.
See
http://onlinelibrary.wiley.com/doi/10.1111/dom.12915/full
It has been suggested that the increased prevalence is due to lifestyle, sugary diet, lack of exercise, and obesity. But the above shows that they get diabetes more easily and the westernisation of lifestyle just makes it worse.
I have always been struck by the sugar content of Indian sweets, pure sugar! But I doubt that poorer folk could afford these; some studies eg in Nederlands have shown that a high sugar diet increases risk of diabetes, even with same BMI.
One study looked at middle aged folk in rural India, and on testing (cos 30 – 50% T2DM undiagnosed) 3% had diabetes despite being skinny and working on the fields – this is a high rate of diabetes.
Cannot find the paper, but the following summarises:-
http://journals.sagepub.com/doi/abs/10.1177/14746514070070010301
Some proposed the “Thrifty Genotype” theory which is in populations at risk of starvation, skinny folk do not survive, and the fatter ones survive episodes of starvation to breed and maintain their genes; this tendency to be energy efficient and fat is believed to make one more susceptible to diabetes (I have always felt this is a bit of an unsupported leap). Also, in Europe, we also had starvation; after the Black Death, there were not the folk to work the fields so there was no food, and people were not unduly upset to get press ganged into the Navy, cos they got “a square meal per day” (hence the origin of the English phrase).
https://en.wikipedia.org/wiki/Thrifty_gene_hypothesis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723682/
Others (Barker and Hales) were also not convinced and developed the thrifty phenotype hypothesis which is that if one is starved in utero as a foetus before being born, then one adapts to this, and this programming makes one more prone to diabetes, and cardiovascular disease.
Folk seem to favour this idea, and the data is clear; if one is born underweight and then gets overweight, one has a greatly increased risk of heart attack, stroke etc. But again, with modern life, maternal under nutrition will hopefully be less common; we have had Indo-Asian families in UK for decades, but their “children” – adults and parents themselves now, still have a very high prevalence of diabetes. So I am not totally convinced this is the answer – I think the phenomenon exists cos of good data, but am not sure it explains fully why so much diabetes in Indo-Asian people.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390698/
https://en.wikipedia.org/wiki/Thrifty_phenotype
We know that relatives of Indo-Asian diabetic folk who do not have diabetes themselves, have insulin resistance (the start of T2DM), at a much greater rate than white Europeans. So something is happening to cause this, whether it be genetic or environmental.
At the end of the day, I suspect that it is a lot of bad luck giving the Indo-Asian population genes that confer high risk of T2DM, plus the thrifty phenotype and then they just cannot cope with a western lifestyle. The “Bad Luck Theory” has never been proposed before. The Finns have a lot of T1DM, cos of the bad luck to be a small population with an above average number of genes for T1DM (known as “The Founder Effect”).
Perhaps, you could ask your diabetes doctors and see what they think? Would be interested to know.
Best wishes