Type 2 diabetes in migrant south Asians: mechanisms, mitigation, and management

Sattar, N. and Gill, J. M.R. (2015) Type 2 diabetes in migrant south Asians: mechanisms, mitigation, and management. Lancet Diabetes and Endocrinology, 3(12), pp. 1004-1016. (doi: 10.1016/S2213-8587(15)00326-5) (PMID:26489808)

113164.pdf - Accepted Version



South Asians, particularly when living in high-income countries, are at a substantially elevated risk of type 2 diabetes compared with white Europeans, and typically develop the disease 5–10 years earlier and at a lower BMI. Migrant south Asians seem to be more insulin resistant than white Europeans across the life course and potentially experience β-cell exhaustion at a younger age. Differences in adiposity (high percentage of body fat and high proportion of deep subcutaneous and visceral fat) and skeletal muscle (low percentage of lean mass and low cardiorespiratory fitness) are likely to contribute these factors. No clear evidence is available suggesting genetic factors make a major contribution to the increased risk of diabetes in south Asians, but epigenetic factors might have a role. Irrespective of future mechanistic discoveries, south Asians need to be encouraged and helped—by various culturally appropriate methods—to maintain a high physical activity level and low bodyweight across the life course to prevent diabetes. In clinical terms, cardiovascular risks have attenuated over time in migrant south Asians with diabetes but retinopathy and renal complication risks remain high because of the high levels of glycaemia and rapid glycaemic deterioration noted in this population. We review these aspects and suggest areas for future research.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Gill, Professor Jason and Sattar, Professor Naveed
Authors: Sattar, N., and Gill, J. M.R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Lancet Diabetes and Endocrinology
ISSN (Online):2213-8595
Published Online:18 October 2015
Copyright Holders:Copyright © 2015 Elsevier Ltd.
First Published:First published in Lancet Diabetes and Endocrinology 3(12):1004-1016
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
603151EMIFNaveed SattarEuropean Commission (EC)115372RI CARDIOVASCULAR & MEDICAL SCIENCES