Are Indians just born with a higher diabetes risk at birth?

India is the world capital of both early-life undernutrition and type 2 diabetes. A 2019 UNICEF survey found that nearly 1 in 10 children (aged 5 to 9) were pre-diabetic and 1 per cent are already diabetic in the country.

Why is diabetes so common among the Indian population?

In an effort to understand this, scientists embarked on the Pune Maternal Nutrition Study in 1993 which tracked 700 families for over three decades. The study, now published in Diabetes Care, a journal of the American Diabetes Association, tracked women before, during, and after pregnancy as well as their children who are now adults.

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They found that 37 per cent of men and 18 per cent of women were prediabetic at the age of 18, even when half of them were underweight. In fact, signs of elevated glucose levels were visible even at ages 6 and 12.

Looking backwards, the team concluded that sub-optimal growth in the womb leads to higher levels of risk factors for diabetes from early childhood. The findings suggest a cycle of poor growth of the pancreas in the foetus leading to poorly functioning adult pancreas, making it harder for the person to cope with demands of increasing age.

They said that smaller birth size, maternal pregnancy hyperglycaemia, and higher glycemia from childhood could all signal future glucose intolerance.

In the end, the team recommends lowering the screening age for diabetes from 30 to 25 years and suggests focussing on maternal nutrition as a preventative measure.

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