From Bombay to Beijing, a newly affluent
Asian middle class is increasingly adapting Western lifestyles. Many city
dwellers opt for high calorie fast food instead of healthier traditional
meals and are becoming less and less physically active. This comes with a
price: diabetes, mainly caused by excess weight and lack of exercise, has
reached epidemic levels in Asia. The disease is growing at a faster pace
in Asia than anywhere else in the world and is increasingly affecting
younger people. Claudia Blume reports from VOA's Asia News Center in Hong
Diabetes is fast becoming an Asian disease. The
continent is home to four of the world's 10 largest diabetic populations -
India, China, Japan and Pakistan. In India alone, more than 35 million
people are estimated to have diabetes, more than in any other country in
In percentage terms, the worst affected nation is the tiny Pacific
island state of Nauru, where more than 40 percent of the population has
In a healthy body, the
pancreas releases insulin, which transforms blood sugar
into energy. People with diabetes either do not make enough insulin or
their bodies do not use the insulin they make, resulting in the build-up
of sugar in the bloodstream.
Most patients have type 2 diabetes, which is mainly caused by obesity
and lack of exercise. Type one diabetes, often called juvenile diabetes,
usually strikes children and young adults, and occurs when the body's
immune system destroys
insulin-producing cells. Both types can lead to complications such as
heart disease, kidney damage and blindness.
Medical textbooks often describe type 2 diabetes as a disease of the
middle-aged and the elderly. But Jonathan Shaw, deputy director of the
International Diabetes Institute in Australia, says this is changing
rapidly. Increasingly, people under 40 are affected, especially in Asia.
"We are now even in European populations, but especially in Asian
populations, seeing quite commonly type 2 diabetes in adults in their 20s
and 30s and there are now reports of type 2 diabetes in adolescence and
even children," said Shaw. "So it's occurring at younger and younger ages.
At any given sort of level of risk, it always seems that people of Asian
origin will more likely to develop diabetes than people of European
Shaw says there is evidence that some ethnic groups in Asia,
particularly some in South Asia, and Pacific Islanders, have a genetic
predisposition toward diabetes.
But the main culprit is lifestyle. Affluent Asians are rapidly adopting
westernized ways of life, such as high-fat fast food diets and sedentary
lifestyles. Ronald Ma, a diabetes specialist at the Prince of Wales
hospital in Hong Kong, blames unhealthy habits for the fact that about 10
percent of the city's population has diabetes.
"Sometimes if they have to rush they eat a lot of fast food and
unhealthy food - high fat, high salt kind of food," he said. "They rarely
have time to exercise, they spend a lot of time in front of the computer,
sitting around. The general lifestyle is really as unhealthy as it can get
in terms of getting these chronic illnesses like diabetes."
Because of its connection to lifestyle, the disease shows up in Asian
cities far more than in the countryside. In India, for example, urban
residents are four times more likely to develop diabetes than those living
Jonathan Shaw says the epidemic is exploding faster in Asia than in any
"For example the Western Pacific region currently has 67 million people
with diabetes and we project it will increase by 2025 to 99 million,
that's a 48 percent increase," said Shaw. "The Indian sub-continent,
including Bangladesh, Pakistan and Sri Lanka as well, we estimate
currently has 47 million with diabetes. That will grow to 80 million by
the year 2025, almost certainly the growth there is underestimated."
As in the West, most people in Asia with type 2 diabetes are
overweight. But experts say many Asian diabetics are less overweight than
most Western patients. Their body fat tends to be more often stored around
the abdomen, however, which increases the risk of getting the disease.
Diabetes is sometimes called a silent killer because many people do not
know they have the disease. Often, there are no symptoms for years. The
International Diabetes Institute says awareness of the disease is low in
Asia, particularly in less developed countries. Information on how to
manage diabetes once it is diagnosed often is hard to come by.
Some of those affected have taken matters into their own hands.
Lily Zhou's husband was diagnosed with diabetes two years ago. When the
Beijing resident searched for Chinese-language information on the disease
on the Internet, she was disappointed by what she found. Zhou decided to
create her own Web site, called Tangzhu, which means "master of glucose".
"The Web site is for information exchange and self-management of the
diabetes," she said. "We hope it can be a platform for people with
diabetes to share their opinions and work together to have a better life."
Diabetes experts say it is crucial to raise the awareness of
governments in the region about the enormous scale of the problem. They
point out that many diabetics need drugs every day to stay alive, and that
diabetes causes many victims to become disabled or to need extensive
hospital treatment, all of which can cut into government budgets.
They say Asian health officials often do not recognize that
non-communicable diseases such as diabetes are already as big a threat for
developing countries as they are for more developed ones.