Or could it be that people of colour are just more genetically prone to getting D?
Your article title reminded me of a report I read about 'the Indian paradox' with regards to heart disease. Basically, that people from South Asian stock have such a genetic propensity for heart disease that it affects them at lower BMIs and younger ages, and affects them more severely. And of course, I'm sure you know that South Asia has a huge incidence of type 2 as well. This, despite the predominantly vegetarian diet in much of the region (so I don't know how valid the change in the Korean diet is as a factor...)
I also think there must be a link with the way people of South and East Asian origin store fat in their bodies. Even quite slim people can have lots of abdominal fat and double chins. Plus the incidence of acanthosis nigricans, a sign of severe insulin resistance. I have yet to see a white person exhibiting this, and I see lots and lots of fat white people everyday. But everytime I see an overweight (not even obese) person of colour, I automatically look for acanthosis nigricans and probably 30-40% of the time it's there.
So given that so much of this seems genetically determined, maybe it is not such a paradox after all.
BTW did your Korean friends say anything about the treatment of D in Korea? I'm in my 30s, person of colour, recently diagnosed. My endo tells me my 'severe' condition is not the same as the D that 'white middle-aged people' get and 'cannot be treated with diet and exercise or simply by popping some pills'.
Dear Tabea,
My Korean friend, Charlie Jean, organized a huge diabetes support group. All the people in his group take insulin even though few of them have type 1 diabetes. Insulin is one of the only ways that you can treat your diabetes aside from what your endo says won't work for you (diet, exercise, pills). The only other thing that will help you -- if your endo is right, and I do wonder if he or she is -- would be stress reduction, like with meditation.
Best regards,
David
Dear David,
Thanks for your reply. I was put on insulin and metformin. I wasn't given much useful advice on diet but went online and read everything I could, then made up my own mind - in the process coming to quite different conclusions from the 'official' advice. It seems to have worked as my HBA1C went from 20+ at dx in DKA, to 5.9 3 months later. My diabetes team is now trying to tell me that's too tight control, and that I don't eat enough carb - 120g a day was mentioned as an ideal figure!!!
I saw pre-industrial Korea in 1970, courtesy Uncle Sam.
Those folks were hard-working then too, but life was
far more physical - A Korean truck was a guy with an
A-frame pack on his back, GI's joked, but it was largely
true.
I suspect the level of exercise is significant in the in-
crease of diabetes, but I also wonder how much of the
"epidemic" is simply an epidemic of diagnosis. I was
diagnosed in 1993, but now realize I'd been symptomatic
since my mid-twenties, in the 1970s... One suspects that
Korean medical care was also rudimentary, pre-"miracle".
I'm less sure what our excuse is...
However that may be, a sad reward for so much effort...
Jack
quite interesting...
do studies (if they exist) indicate a higher incidence among individuals in high stress careers (air traffic controller, police, fire, corrections, etc)?
and if so, do stress reduction interventions (yoga, meditation, 'getting away from it all") have a protective effect
thanks! david - your blog is always interesting and informative
best!
I had just returned from living for some years in Hong Kong and Singapore, when I was found to be diabetic. At the time I was told that there is a lot of diabetes in China. Subsequently I found out that the situation in India was similar. Assuming, that the diet in Korea is also rice based, could this be connected to the situation there.
Putting forward an idea which seems too obvious not to have been tested, could the daily consumption of rice be the cause? It is eaten at any and all meals, it is very refined and is ubiquitous.
(I now eat very few carbs and those that I do eat are as high-fibre as I can find.)
I think it is a combination of genetics (unfortunate consequence of being the descendants of those who could survive famine by being good at storing fat) and high carb. The food is so carby across all of Asia and the idea of low-carb is just culturally foreign.
At a Vietnamese restaurant, I once asked for my grilled lemongrass pork to be served without the rice noodles. I only wanted the pork+salad it came with and didn't want to waste the noodles I wasn't going to eat anyway. My request was turned down! I was told the noodles came with the dish and that I would be charged extra for leaving out the noodles. Fine - so the dish came and I just left all the noodles behind.
In comparison, I've never had a problem getting salad as a substitute for potatoes/fries.
BTW, most people in Asia still think you get diabetes from eating too much sugar!!!
Featuring Content From:
By using this service, you accept our Terms of Use. Please read them. The consumer health information on is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen. Copyright © 2012 Remedy Health Media, LLC. All Rights Reserved.
I've found the reference to lifestyle-related-stress as a cause to be interesting!
how the statistics compare to Japan? a few quick web search indicates more _die_ from diabetes in Korea than in Japan (reason for this maybe debated).
(I'm a japanese in US: pre-diabetic)