A look at South Asians’ higher risk for diabetes during National Diabetes Month
Bay Area physician Dr. Priya Panneerselvam shares her advice on diabetes prevention.
This post originally appeared on Red, White and Brown’s newsletter on Substack (Issue #61 sent on Nov. 30, 2023).
November is National Diabetes Month, bringing awareness of this condition that affects more than 37 million children and adults in the United States.
South Asians are especially at risk, due to a combination of genetics and environment, according to experts. Lots of visceral fat, the kind that surrounds abdominal muscles and organs like the liver (the “uncle belly,” as I sometimes call it), is particularly correlated with insulin resistance. Some research (see video below) also points to famines in South Asia during the British colonial period that impacted how our ancestors stored body fat and processed sugar.
In the modern context, I spoke with a San Francisco Bay Area doctor — Dr. Priya Panneerselvam — to better understand what we can all do to address our diabetes risks today. Our chat is below.
I’ve also been reading another Bay Area doctor’s work: Dr. Ronesh Sinha and his ”The South Asian Health Solution” book that discusses insulin resistance in detail.
Diabetes Q&A with Dr. Priya
Dr. Priya Panneerselvam is an attending physician at the Santa Clara Valley Medical Center in Northern California. Her expertise is in obstetrics and gynecology (OB-GYN).
Dr. Priya spoke with Red, White and Brown about diabetes risks and prevention, during National Diabetes Month.
The following interview has been edited for length and clarity.
Vignesh: Why is diabetes so prevalent in our South Asian American communities?
Dr. Priya: It has to do with multiple things. Our food habits: Many of us have a lot of rice-based meals. That’s a carbohydrate that becomes sugar. I also think, genetically, there is a predisposition.
There are two types of diabetes. The first is the kind where your body isn’t making insulin at all [Type 1]. The second is your body isn’t producing enough insulin [Type 2], which comes on later in life. A lot of it could be prevented with exercise and diet, but if there’s a strong genetic disposition, it can be very challenging to prevent.
Vignesh: What are diet and exercise habits that can help prevent diabetes?
Dr. Priya: The biggest thing is exercise at least 30 minutes a day, at least 150 minutes per week.
And then a healthy diet. We can still enjoy our Indian food, but we can just make some modifications.
- Instead of having white bread, rice, sweets … you can switch from rice to roti or you can switch to things like quinoa. The amount of carbs may be the same, but because of the way it’s broken down in the body, it takes a little bit longer to break down so you won’t get those sugar spikes.
- Increasing your amount of fiber and increasing your vegetable intake. So with a meal, having things like salad or a lot of veggies — not overly cooked.
- Samosa is like basically all carbs. So maybe instead of doing a full samosa, do half samosa with channa — like a samosa-chaat kind of thing.
- Instead of having dal with rice, have rice with dal, so have a smaller portion of rice and have a lot of dal, or have yogurt as well.
- Another simple swap is sub in cauliflower for potato.
- If we’re a little bit creative, and if we moderate our portion sizes, it will really help.
We don’t want blood sugar to be volatile. We want it to be steady and stable. So the goal is eat food that is filling and nutritious and good for you, so that your blood sugar doesn’t have the ups and downs and your insulin isn’t chasing it around.
Sleeping well, decreasing stress, no smoking, cutting back on alcohol — all of the basics will make a difference.
Vignesh: This isn’t just about aunties and uncles getting diabetes, right? How is it affecting younger folks?
Dr. Priya: It can affect teenagers, it can affect people in their 20s, their 30s. I think a lot of it has to do with an obesity epidemic happening — that’s going to increase our risk for diabetes. Also we’re eating ultra-processed foods and not thinking too much about nutrition. We’re not exercising.
Vignesh: Because of your expertise as an OB-GYN, do you have particular advice for women and pregnancy?
Dr. Priya: The thing about diabetes and pregnancy is it can affect the baby and the baby’s growth. If you’re diabetic and get pregnant — and your blood sugar is not controlled — you’re at higher risk for fetal anomalies. If you’re a person who has gestational diabetes, the issue that usually comes about is the baby grows too big. Once a baby is born, if your blood sugar is high, the baby was living in a sugar soup. So it’s very important to sustain stable blood sugar as much as you can.
Vignesh: What are tests doctors do to detect diabetes?
Dr. Priya: The A1C test looks at your blood sugar over the course of three months. The other thing you can do is a glucose challenge or glucose tolerance test.
Vignesh: What are symptoms people should look out for?
Dr. Priya: Increased thirst and increased urination. If you have a dry mouth. If you feel tired, you’re having vision changes, or if you notice numbness tingling in your hands, feet, fingers, toes. If you have sudden weight loss. If you are having frequent yeast infections. If your wounds don’t heal fast.
Everyone needs to get a physical, at least once a year. If you have any concerns, if you’re feeling really tired, out of it or something isn’t right — go check it out.
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