Indian J Med Res
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The metabolic syndrome is a crucial factor in causation of type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) in South Asians. Approximately 20-25 per cent of urban South Asians have evidence of the metabolic syndrome. Furthermore, insulin resistance was reported to be present in nearly 30 per cent of children and adolescents in India, more so in girls. ⋯ It is particularly important to effectively implement and strengthen population-based primary prevention strategies for the prevention of 'epidemic' of obesity and the metabolic syndrome. The lifestyle factor modification to prevent the metabolic syndrome and T2DM in South Asians should start in early childhood. Finally, there is an urgent need to conduct research studies regarding the correct definitions of the metabolic syndrome and genetic and perinatal factors related to insulin resistance in South Asians.
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The rapid increase of diabetes prevalence in the US population and across all westernized world has been associated with environmental changes that promote obesity. However, studies conducted in various ethnic groups within the US population have pointed out differences in susceptibility to diabetes within the same environmental pressure. ⋯ The elucidation of the mechanisms responsible for the heterogeneous relationship between obesity and type 2 diabetes in various ethnic groups, and particularly in Asian Indians, may give important contributions to better understand the complex mechanisms involved in the development of type 2 diabetes. This review examines epidemiological and pathophysiological aspects of the interaction between environment and ethnic predisposition to type 2 diabetes in Asian Indians migrated to the US.
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Genes play an important role in the development of diabetes mellitus. Type 2 diabetes is a polygenic disorder with multiple genes located on different chromosomes contributing to its susceptibility. Analysis of the genetic factors is further complicated by the fact that numerous environmental factors interact with genes to produce the disorder. ⋯ As Asian Indians have an increased susceptibility to diabetes and have increased insulin resistance, they are a unique population for carrying out genetic studies. There appears to be certain genes which predispose Indians to diabetes while other genes (for example Pro 12 Ala polymorphism of PPAR gamma gene) which afford protection against diabetes and insulin resistance to Caucasians, do not appear to protect Indians. Further studies are needed to unravel the genetics of diabetes in South Asians .