Diabetes is Not the Same Everywhere: How Genetics and Lifestyle Matter
Share
Diabetes is a growing problem around the world, affecting over 500 million people. Most of us know about Type 1 and Type 2 diabetes. But did you know that diabetes looks very different depending on where you live and who your ancestors are?
A new study published in Endocrine Reviews (Oxford University Press) explains how genetics and lifestyle factors create major differences in diabetes across populations.
Here’s what you should know.
Diabetes is Not One-Size-Fits-All
In Europe and North America, Type 2 diabetes often appears in older, overweight adults. But this pattern changes in other parts of the world.
In many African, Asian, and Latin American populations, diabetes can happen at younger ages and even in people who are slim.
This shows the typical picture of diabetes doesn't fit everywhere.
How Genetics Change the Story
Our genes strongly influence how diabetes develops.
- In Africa, diabetes tends to happen with less fat stored in harmful areas like the liver. Unique genetic variants impact insulin production and fat storage.
- In East Asia, even slim individuals can store more fat around their organs, which increases diabetes risk.
- In Native American and Pacific Islander groups, special gene variants affect how the body handles sugar and fat, influencing diabetes risk.
Each group’s genetics create a different pathway toward diabetes, showing why a “one-size-fits-all” model doesn't work.
India and South Asia: A Special Case
South Asians, including Indians, Pakistanis, Bangladeshis, and Sri Lankans, have a higher risk of developing diabetes even at lower body weights compared to Europeans.
Here's why:
- Early Insulin Deficiency: Many South Asians have weaker insulin production even before diabetes fully develops.
- Younger Age of Onset: Diabetes often appears earlier in life.
- Inflammation and Fat Storage: Even small amounts of extra fat, especially around the organs, can cause big metabolic problems.
Studies show that even South Asians with “normal” BMI can have high diabetes risk because of fat stored in the liver and pancreas rather than just under the skin.
Also, dietary factors like high white rice intake and lower muscle mass make the situation worse.
In simple terms: South Asians may "look healthy" on the outside but still be at high risk inside.
Lifestyle Still Plays a Huge Role
Even though genes matter, lifestyle is a powerful driver.
- Moving to urban areas leads to more diabetes because of processed food, less exercise, and more stress.
- Migrants from countries like India who move to Western countries often see their diabetes risk rise sharply.
Thus, it’s not just about genes — the environment we live in matters too.
Special Forms of Diabetes
Besides the typical Type 1 and Type 2 diabetes, some special types are more common in certain populations:
- In Africa and India, forms linked to early malnutrition have been observed.
- East Asians sometimes develop a rare, very rapid form called "fulminant diabetes."
- Among South Asians, many people suffer from a mix of insulin resistance and poor insulin production at the same time.
These differences mean treatments must be adapted for different groups.
Why This Matters
Most diabetes research has been done on people of European descent. This can lead to wrong assumptions and poor outcomes for people from Africa, Asia, Latin America, and the Pacific.
Recognizing genetic and lifestyle diversity can help:
- Design better screening tools.
- Personalize treatments based on ancestry.
- Reduce health gaps between different communities.
For example, certain medicines might work better in people from one ancestry than another. Screening methods might need adjusting too — like checking blood sugar levels differently in South Asians.
Final Thoughts
Diabetes is a complex disease with many faces. It doesn't look the same in every country or every person.
Genes, environment, migration, and even early life nutrition all play important roles.
The future of diabetes care will be about precision medicine — giving the right advice, the right test, and the right treatment based on each person’s unique background.
By understanding these differences, we can move closer to fairer, better health for everyone.