Low foetal weight puts Indians at risk of diabetes

A new hypothesis has pinned the high prevalence of diabetes among Indians on malnutrition in foetuses.

Writing in the journal Current Science, Sandeep M Eswarappa, an assistant professor at the Indian Institute of Science (IISc), and PhD student Kirtana Vasu said that earlier theories chalking up diabetes to the fact that human genes may be geared towards a hunter-gatherer lifestyle were not ratified by subsequent gene studies.

These studies believed that diabetes is now prevalent because people are not following the hunter-gatherer style of eating and fasting. “Thrifty genes were thought to be maladaptive in the modern obesogenic environment and responsible for the sudden surge in the incidence of insulin resistance and obesity,” the authors wrote.

Instead, what is happening is that the intrauterine environment experienced by the foetus tries to predict the conditions that the foetus will eventually be exposed to as an adult, Eswarappa told this newspaper.

Poor gestational growth permanently programmes the foetus to be insulin-resistant.

As a consequence, low-birth-weight babies are at a higher risk of developing type-2 diabetes in their adult stage, when this is followed by sedentary lifestyles and a high-calorie intake as adults.

“It is important to note that the incidence of low birth weight in India varies from 25% to 30%, which is high compared to other countries. This explains why India has become the diabetes capital,” Eswarappa said.

India houses the bulk of the 425 million patients of diabetes worldwide. Data from the International Diabetes Federation (IDF) shows 77 million Indians afflicted with diabetes as of 2019, showing a 4.1 million increase in two years. By 2045, this number is expected to rise to 134.3 million.

Diabetes in India

* Adult population in India (aged 20-79): 859,956,100

* Adults with diabetes: 77,055,600

* Prevalence of diabetes: 8.9%

* Cost per person with diabetes: $91.6

* Diabetes-related deaths: 1,010,262 (2018-2019)

* People with Type 1 Diabetes (0-19): 171,281

* Proportion of undiagnosed diabetes: 57%

* One in 11 Indians has diabetes; In comparison one in 12 Bangladeshis have diabetes, one in six Pakistanis, have the disease and one in 25 in Nepal.

(Source: International Diabetes Federation)