I'm slim so why am I at risk of diabetes?

[Gert van der Hoek]

Great article

By Anu Anand - BBC World Service, Colombo

12 January 2016

Diabetes is on the rise around the world, and nowhere more rapidly than in developing countries that are adopting the sugary, starchy diet that has plagued the richer world for years. And it turns out that Asians, and especially South Asians, are particularly vulnerable.

The nutritionist runs a white measuring tape around my waist. I defy the urge to suck in my stomach.
I'm 42 years old, a mother of two and a journalist based in India's capital, Delhi, currently one of the world's most polluted cities. I eat organic food, rarely snack, and consider myself pretty slim and active, especially compared to my American friends, whom I can see on Facebook are generally twice my girth.

"It's 87cm (34.25in)," says Chaya Ranasinghe, nutritionist at Sri Lanka's National Diabetes Centre. I'm here to find out why slim-looking Indians and Sri Lankans are increasingly falling victim to type 2 diabetes - a disease we tend to associate with people who anyone could see were obese.

My "lifestyle consultation" reveals that I'm at risk on five of those six factors - all except smoking. This is getting serious.

Wijeyaratne explains that body mass index (BMI) standards, which help classify people as "normal", "overweight" and "obese", need to be adjusted for Asians.

"And it's a misconception that sugar alone causes diabetes," she tells me. "Starch is a big problem too."

Globally, the WHO says at least 350 million people live with type 2 diabetes and the number is set to rise to half a billion in two decades' time. "It's a frightening situation - diabetes is of tsunami proportions, and South Asia is at the epicentre," says Wijeyaratne.

The country's national health system is struggling to cope with the huge rise in patients with chronic illnesses like diabetes. Infectious and other communicable diseases now account for only 10% of the demand on the country's health service. Non-infectious diseases - diabetes, cancer and asthma, for example - swallow up the other 90%.

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