00:00India is called as the diabetes capital of the world but if you actually look at the numbers
00:07China is little ahead of us as far as the number of people with diabetes is concerned
00:12and the reason for that is that although the population of India and China are equal in fact
00:17we are now ahead of China as far as population is concerned they are a much older population
00:23half of our people are below 20 years of age China has only one child's policy for long time
00:31so their population is much older so they have people who are 80 years old 85 years you have
00:38lot of diabetes at that age for that reason the actual number of people with diabetes is higher
00:44in China but the question was what has changed in the last say 30 years as far as diabetes
00:53is concerned number one it was considered as a rich man's disease so they said only rich
00:58people get disease then it came to middle class today even poorest of the poor people slum
01:05people are having diabetes that's one big change so the rich to the poor second is that they
01:12said it's a disease of old age when you give when you become 60 70 80 you will get little
01:17diabetes then it started coming I mean if 50 40 50 years old then it started coming when
01:23you're 20 30 years old today type 2 diabetes I'm not talking about type 1 diabetes comes
01:29in children that's a children's age group disease type 1 I'm talking about usual type 2 diabetes
01:36comes in adults has now started coming at 12 years of age 13 years of age I have got one
01:42or two
01:43children who are 7 years old already they are so obese and they've got type 2 diabetes that's one
01:49another big shift coming from old age to even children it has started coming the third is that
01:58it was believed to be an urban disease so it's in rural areas villages nobody will get diabetes only in
02:04the big cities it used to be like that then it started going to the smaller cities tire 2 tire
02:103 cities
02:11today even in the villages diabetes is increasing so these are three big changes which have occurred no
02:20longer a rich man's disease no longer an urban disease and no longer restricted to old age it
02:27started occurring in young people also these are the major changes which have occurred
02:31your research highlighted that indians develop diabetes at a young age and lower bmi compared
02:38to western population could you explain the concept of the asian indian phenotype for readers for many
02:46years when i started my research on this about 30 years ago we found that there are a lot of
02:53differences between diabetes in indians type 2 diabetes in indians compared to the white european
03:00population one of the things is that it occurs at a younger age whereas in white europeans it occurs
03:08when you are 50 60 years old in indians it starts coming when you are 20 30 years old itself
03:15is
03:15started coming in fact when you look at our statistics 50 percent of all are type 2 diabetic patients get
03:21it
03:21before 45 years of age which is very very uncommon in in a white person so that is the first
03:27difference
03:27second is in u.s and in most other developed countries diabetes associated with obesity so you
03:34have to be very big obese you have to have a lot of obesity lot of body weight and excess
03:40fat to get
03:41diabetes we get it even if we are thin people in fact indians are called as thin fat indians so
03:48what
03:48does that mean we look very thin on the outside but inside we have lot of fat so we call
03:53it as t o f i
03:55thin outside fat inside so that is the typical characteristic of the indian and all this is
04:02what we call as the indian phenotype or the asian indian phenotype or south asian phenotype this makes
04:09treatment also a little different because in the west mostly it's about weight reduction if you reduce
04:15weight it will go away in india that is there the obese patients are also there but we also have
04:20a lot of
04:20thin people in whom there is no weight to lose at all in fact they should put on some weight
04:25so the
04:25treatment pattern the medicines that we take all differ because of this asian indian phenotype
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