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Researchers
look for explanation behind high incidence
of Diabetes among Asian Indians
Newswise — The incidence of type 2 diabetes
is rising, especially in urbanized parts of
the world where sedentary lifestyles and
obesity abound. In addition to weight and
inactivity, race puts some people at
increased risk for developing type 2
diabetes.
The incidence of diabetes is rapidly
increasing globally, and Asian Indians have
the highest prevalence.
An estimated 32 million Asian Indians have
been diagnosed with this condition, and some
experts expect this number to double over
the next 30 years.
In a study published in the March issue of
Diabetes, Mayo researchers examined
whether Asian Indians have observable
differences in the way their cells convert
nutrient fuel to available energy and
whether these differences may increase the
risk for diabetes.
“We know that Asian Indians are highly
susceptible to this condition, and they
often acquire the disease at an earlier age
and at lower body mass index than people of
European origin,” explains Mayo
endocrinologist K. Sreekumaran Nair, M.D.,
Ph.D., the study’s lead researcher.
“The question we asked is whether any
metabolic differences between Asian Indians
and Americans of Northern European origin
can explain the higher incidence of diabetes
in Indians.”
Once known as adult-onset or
non-insulin-dependent diabetes, type 2
diabetes is a chronic condition that affects
the way the body utilizes sugar (glucose).
People with type 2 diabetes don’t produce
enough insulin -- a hormone that regulates
the absorption of sugar into cells -- and
their cells resist the effects of insulin
(insulin-resistant).
While death rates due to heart attack,
stroke and even cancer are decreasing,
deaths related to diabetes are increasing.
Type 2 diabetes is the leading cause of
cardiovascular deaths, kidney failure,
blindness, sexual dysfunction and many other
chronic complications.
Mayo researchers studied 13 diabetic
Indians, 13 nondiabetic Indians, and 13
nondiabetic northeast Americans of European
descent who were matched for gender, age and
body mass to Indian study participants.
Study
participants were fed the same diet and
underwent tests for insulin resistance and
muscle biopsy to see whether differences
occurred at the cellular level among the
different study subject groups.
The study yielded a number of interesting
findings. Researchers observed that the
Indian subjects, irrespective of their
diabetic status, had a greater degree of
insulin resistance than the American
subjects of Northern European origin, even
though the study subjects were not obese, a
condition commonly associated with insulin
resistance.
Earlier research has established that people
with insulin resistance typically have
poorly functioning muscle mitochondria.
Mitochondria are the part of cells
responsible for converting energy from
nutrients to ATP (adenosine triphosphate),
the chemical form of cellular energy that
the body uses for almost all functions.
“Our study showed that the Indian diabetic
and nondiabetic subjects with insulin
resistance actually had mitochondrial
function that was higher than those observed
in the Northern European American subjects,”
says Dr. Nair.
Dr. Nair hypothesizes that key to
understanding this difference may lie in an
examination of how populations adapt as they
become more urbanized.
"Urban
societies typically move away from
lifestyles that involve a higher level of
physical activity and diets dominated by
low-calorie foods.
“The higher capacity to produce ATP that the
Indian subjects displayed may have been an
adaptive advantage for the generations that
preceded them, when energy content of their
diet was lower.
"But today, this trait may be a disadvantage
given the higher energy content of their
current diets,” explains Dr. Nair.
Dr. Nair and his team are hopeful that the
information gained from this study will have
a substantial impact on understanding the
cause of the global epidemic in diabetes.
“Our findings have potential to help
determine the energy requirements of
different populations and what role this
plays in the onset of diabetes” says Dr.
Nair.
Other authors of this article are: Maureen
Bigelow; Yan Asmann, Ph.D.; Lisa Chow; Jill
Coenen-Schimke; Katherine Klaus; ZengKui Guo,
Ph.D.; Raghavakaimal Sreekumar; and Brian
Irving, Ph.D.
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