We all know that diabetes is a serious disease,
it can have deadly complications,
but what you might not know is that it is striking people in country
far more frequently than anywhere else and we are talking about India.
It's been known for a long time that south Asian populations,
which make up around 2 billion people around the globe,
have had some of the highest rates of diabetes in the world.
But until recently, only food and lifestyle choices had been held responsible.
However, new research has shed light on another culprit,
British colonialism.
So how did colonialism increase rates of diabetes in south Asians?
During the 89 years of official British colonial rule over the Indian subcontinent,
known as the British Raj,
there were approximately 25 major famines.
Which killed at least 60 million Indians.
This compares to just 17 famines in the 2,000 years before British rule.
While drought played a role, British policy increased the intensity of the effects,
harsh land taxes, reductions in spending on the region
and the exportation of food from the country,
greatly worse than the impacts of a series of droughts.
The great famine of 1876 to 1878
struck southern India.
Killing between 5 and 11 million people.
The Bengal famine of 1943, one of the most devastating
in which more than 3 million people died of malnutrition,
was directly linked to British policies.
Winston Churchill's government redirected essential resources
from India to support the war effort,
leading to extreme food shortages.
Rice stocks continued to leave India,
even as London was denying urgent requests from India's viceroy
for more than 1m tonnes of emergency wheat.
While these famines were taking place,
Britain siphoned an estimated $45tn out of the country.
Using exploitative trading practices.
Even though many of south Asia's famines were over a hundred years ago,
they've had a huge impact on how south Asian bodies store fat
and process sugar today.
This is through epigenetics,
the study of how our behaviours and environment
can cause changes that affect the way our genes work.
and how those changes are inherited by following generations.
The environmental impact of famines has made south Asian genes starvation adapted,
which makes them more prone to diabetes and other diseases.
Surviving just one famine nearly doubles the risk of diabetes in the next generation
and doubles the risk of high blood sugar in the survivor's grandchildren.
The starvation adaptation
has meant that many south Asian bodies have become resistant to the hormone insulin,
which helps process our food for energy.
In non-insulin resistant bodies,
the food we eat is broken down into blood sugar which enters our bloodstream,
at which point insulin is released.
That insulin helps the blood sugar to enter our cells so it can be used for energy
and lets the liver know to store any any excess blood sugar for later use.
As we burn energy our blood sugar levels decrease
and our insulin levels decrease too.
Lower insulin levels alert the liver to release stored blood sugar,
so energy is always available, even if we've not eaten for a while.
But that's how the body behaves in a healthy, non-famine situation.
South Asian genes have adapted to hold on to energy for as long as possible,
to survive repeated periods of starvation and famine.
By becoming resistant to insulin,
it's harder for muscle and liver cells to absorb sugar from the blood.
As a result more sugar often gets stored as fat
where it can be used much later when there's a shortage of food.
However, in times of abundant food, like the current climate,
where two-thirds of all packaged foods on supermarket shelves contain added sugar,
the starvation adaptation works against south Asians
and the stored fat leads to an increased risk of diabetes, obesity and heart disease.
There isn't currently a way to reverse the susceptibilities that south Asians have developed,
however certain lifestyle choices can reduce the likelihood
of developing type 2 diabetes.
Researchers recommend a return to their roots in terms of food and exercise,
because south Asians have a long history of advanced and complex health practices,
like Ayurveda, yoga and Yunani medicine.
Which have become less common in favour of western foods and lifestyles,
both of which fail many south Asians.
As insulin costs skyrocket and rates of diabetes are on the rise,
it's more important than ever to decolonise how we research health
and the advice we give to people of different ethnicities.