Young South Asians at increased risk of Type 2 diabetes

    Dr. Parmjit Sohal

 
Dr. Parmjit Sohal

A new study by researchers at the University of British Columbia (UBC) shows Type 2 diabetes has drastically increased in people under 30, even surpassing Type 1 diabetes.

The study, titled “Diabetes in the young: A population-based study of South Asian, Chinese, and white people,” (Ke, C., Sohal, P., Qian, H., Quan, H, Khan, N.) published online on January 28 in the UK  journal Diabetic Medicine, found that the majority of young people under 30 with diabetes have Type 2 diabetes. In white youth with diabetes, 62 per cent have Type 2, among South Asian youth that number increases to 86 per cent, and among Chinese youth it is 87 per cent.

Researchers also uncovered alarming findings about rates of Type 2 diabetes cases, especially for South Asians, who had higher incidences of Type 2 diabetes compared with both Chinese and white people. In those aged 20 to 29, new cases of Type 2 diabetes were 2.2 times higher in South Asians than in white people and 3.1 times higher in South Asians compared with Chinese people.

“South Asians are three to five times more likely to develop Type 2 diabetes than the general

population,” said co-author Dr. Parmjit Sohal, a family physician in Surrey and Clinical Associate Professor in the UBC Department of Family Practice. “This study suggests that this increased risk of Type 2 diabetes may begin at a much younger age likely by age 20.”

Type 2 diabetes, caused mostly by obesity and physical inactivity, has generally been considered a disease of older adults, typically occurring in people 35 years and older. Although the rates for youth remain much lower than in older patients, Type 2 diabetes is a growing health problem, doubling the risk of heart disease, kidney disease, and a significant risk factor for early death.

“Over the last few decades, lifestyles have changed dramatically. Many now live in urbanized environments where people are generally less active, and eat more high-calorie foods. These changes have led to an astounding increase of young people with diabetes,” said Dr. Calvin Ke, first author and a resident in Internal Medicine at St. Paul’s Hospital. “We need to act urgently to prevent diabetes in young people.”

Type 2 diabetes can be controlled and prevented, or at least delayed, with proper nutrition and exercise. The researchers believe these increased rates in youth are a signal that we need to encourage healthy lifestyles beginning in childhood in order to prevent these diseases.

“Current Clinical Practice Guidelines recommend that screening for Type 2 diabetes should start at age 40 in the general population,” said co-author Dr. Nadia Khan, an Associate Professor at UBC Faculty of Medicine. “This study suggests that screening for Type 2 diabetes in high-risk South Asians may need to start at younger ages.”

There are about 382 million people with diabetes in the world and this number is estimated to increase to 592 million by 2035. Canada, with a population of about 35 million, has about 3 million people with diabetes. Diabetes is one of the leading causes of heart attack, stroke, kidney failure, adult blindness, and non-traumatic limb amputations in Canadian adults. The burden of diabetes in the young is relevant given that over half of the global population is aged 29 years and younger. “We should likely start screening South Asians for Type 2 diabetes as early as age 20. Primary prevention of diabetes is of paramount importance to reduce the burden of diabetes and its complications,” said Dr. Sohal.