Diabetes care in the Hindu patient: cultural and clinical aspects

Patel, Vinod; Morrissey, J; Goenka, Niru; James, Diane; Shaikh, Sakera

doi:10.1177/14746514010010021301

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…260 A reluctance to start insulin therapy is a frequently encountered problem in Asian Indian Hindus, as it is perceived as a failure of self-care and progression from 'mild' to more 'serious' diabetes. 261 These distorted perceptions may have implications in lesser health-seeking behavior and consequent poor prevention and control of the disease in South Asians than in Whites.…”

Section: Problems and Barriers To Diagnosis And Managementmentioning

confidence: 99%

Obesity-related non-communicable diseases: South Asians vs White Caucasians

2010

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South Asians are at higher risk than White Caucasians for the development of obesity and obesity-related non-communicable diseases (OR-NCDs), including insulin resistance, the metabolic syndrome, type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD). Rapid nutrition and lifestyle transitions have contributed to acceleration of OR-NCDs in South Asians. Differences in determinants and associated factors for OR-NCDs between South Asians and White Caucasians include body phenotype (high body fat, high truncal, subcutaneous and intra-abdominal fat, and low muscle mass), biochemical parameters (hyperinsulinemia, hyperglycemia, dyslipidemia, hyperleptinemia, low levels of adiponectin and high levels of C-reactive protein), procoagulant state and endothelial dysfunction. Higher prevalence, earlier onset and increased complications of T2DM and CHD are often seen at lower levels of body mass index (BMI) and waist circumference (WC) in South Asians than White Caucasians. In view of these data, lower cutoffs for obesity and abdominal obesity have been advocated for Asian Indians (BMI; overweight 423 to 24.9 kg m À2 and obesity X25 kg m À2 ; and WC; men X 90 cm and women X80 cm, respectively). Imbalanced nutrition, physical inactivity, perinatal adverse events and genetic differences are also important contributory factors. Other differences between South Asians and White Caucasians include lower disease awareness and health-seeking behavior, delayed diagnosis due to atypical presentation and language barriers, and religious and sociocultural factors. All these factors result in poorer prevention, less aggressive therapy, poorer response to medical and surgical interventions, and higher morbidity and mortality in the former. Finally, differences in response to pharmacological agents may exist between South Asians and White Caucasians, although these have been inadequately studied. In view of these data, prevention and management strategies should be more aggressive for South Asians for more positive health outcomes. Finally, lower cutoffs of obesity and abdominal obesity for South Asians are expected to help physicians in better and more effective prevention of OR-NCDs.

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Section: Problems and Barriers To Diagnosis And Managementmentioning

confidence: 99%

Obesity-related non-communicable diseases: South Asians vs White Caucasians

2010

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“…26 In addition, sociocultural and religious factors might compound this diminished awareness by creating false notions of social stigma and failure to self-care. 27 Diabetes mellitus may be prevented in South Asian communities using programs that promote health-protective lifestyle changes and comprise multi-component interventions that encompass parts of health promotion and behavioral change that are passive (lecture-based), active (activity-based), and individualized (such as targeted counseling). 28 These programs should focus on cultural values related to lifestyle aspects such as food, which reduces carbohydrate intake, and exercise, which raising aerobic exercise at a moderate intensity.…”

Section: Discussionmentioning

confidence: 99%

Diabetes mellitus and obesity among South Asians with ischemic stroke across three countries

Ken-Dror,

Ajami,

Han

et al. 2023

International Journal of Stroke

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Background: Diabetes mellitus and central obesity are more common among South Asian populations than among white British people. This study explores the differences in diabetes and obesity in South Asians with stroke living in the UK, India and Qatar compared with white British stroke patients. Methods: The study included the UK, Indian and Qatari arms of the ongoing large Bio-Repository of DNA in Stroke (BRAINS) international prospective hospital-based study for South Asian stroke. BRAINS includes 4580 South Asian and white British recruits from UK, Indian and Qatar sites with first-ever ischemic stroke. Results: The study population comprises 1751 white British (WB) UK residents, 1165 British South Asians (BSA), 1096 South Asians in India (ISA), and 568 South Asians in Qatar (QSA). ISA, BSA and QSA South Asians suffered from higher prevalence of diabetes compared to WB by 14.5% (ISA 95%CI: 18.6–33.0, P<0.001), 31.7% (BSA 95%CI: 35.1–50.2, P<0.001) and 32.7% (QSA 95%CI: 28.1–37.3, P<0.001), respectively. Although WB had the highest prevalence of BMI above 27 kg/m2 compared to South Asians patients (37% vs. 21%, P<0.001), South Asians patients had a higher waist circumference than WB (94.8cm vs. 90.8cm, P<0.001). Adjusting for traditional stroke risk factors, ISA, BSA and QSA continued to display an increased risk of diabetes compared to WB by 3.28 (95%CI: 2.53–4.25, P<0.001), 3.61 (95%CI: 2.90–4.51, P<0.001), and 5.24 (95%CI: 3.93–7.00, P<0.001), respectively. Conclusion: South Asian ischaemic stroke patients living in Britain and Qatar have a near 3.5-fold risk of diabetes compared to white British stroke patients. Their body composition may partly help explain that increased risk. These findings have important implications for public health policymakers in nations with large South Asian populations.

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“…Many BSA patients are not aware of the common complications associated with diabetes mellitus, the importance of screening clinics and the need to engage with chiropodists [ 42 ]. Furthermore, sociocultural and religious factors can exaggerate this decreased awareness with the distorted perceptions of failure at self‐care and social stigma [ 43 ]. Sex differences can also determine environmental and comorbidity factor prevalence.…”

Section: Discussionmentioning

confidence: 99%