Simple steps of eating more healthily can limit the damage the disease inflicts. Think in terms of preventing complications rather than treating the disease itself. With diabetics, think about heart disease, eye damage, blood pressure, weight loss, so dietary advice would be the same as for someone with coronary heart disease or high cholesterol.


Although weight loss is advisable, a low-carb diet to achieve it is no good here. Regular meals based on starchy foods such as bread, pasta, potatoes, rice and cereals will help control blood glucose levels. Go for carbs with a low-glycaemic index (GI) – sweet potatoes, wholewheat bread, long grain rice – which give slow-release energy and help keep blood sugars low.


Those with a family history of diabetes should also go for annual check-ups. If both your parents have type-2, the chances of you developing it are 75 percent; if either your mother or your father has it, the chances are 20 percent. It’s here that perhaps the most pernicious aspect of the current diabetes problem reveals itself. Although anyone can get diabetes, those of Afro-Caribbean or South-east Asian origin are three to five times more likely to do so than Caucasians. More than 20 percent of Indian men over the age of 50 have diabetes, and some ethnic groups are even more prone. Clearly, then, there is more to the illness than being fat, lazy, greedy and indifferent. Could genes also play a part in the global type-2 epidemic?


Nurture not Nature


There’s a complex interplay of genetics and lifestyle factors that have created this near-pandemic. Some people are born with a predisposition to type-2 diabetes, expressed more readily in certain ethnic groups. Urban black men develop diabetes at a higher rate than white men. Researchers say there is clearly a genetic reason for it – but if you look at previous generations of the family, they didn’t have it. So their environment is clearly playing on the genes in some way.


It’s likely that the world’s steady conversion to a Western diet of processed foods high in fat, sugar and salt is responsible. There’s a theory as to why certain populations have a higher incidence of diabetes – the thrifty gene hypothesis.


Populations that are genetically adapted to survive in a feast-or-famine environment, where the pattern of the seasons dictates what, and how much, food is available carry this gene. In times of bounty, people with this kind of genetic make-up store energy as fat; in leaner times, they draw on that reserve for survival. In developed Western societies – and those that ape them – sugary, high-fat food is available all year and the thrifty gene is redundant. A population of hunter-gatherers finds itself doing nothing more energetic than driving to the local takeaway joint.


This clash of environmental and genetic factors may explain the surge in diabetes in some ethnic groups. By exporting its lifestyle, the developed world is effectively exporting diabetes.


In Togo, West Africa, a place relatively immune to Western influence, the incidence of type-2 diabetes is zero. It is only when those genetically predisposed to diabetes migrate to a relatively affluent setting – or have the lifestyle of the developed world thrust upon them – that their high susceptibility is revealed. In India, prevalence of type-2 diabetes increased fivefold between 1972 and 2000.


Some experts believe white Caucasian populations, too, are feeling the effects of abandoning their hunter-gatherer ancestry. The obesity crisis in Western countries (linked to the dramatic rise in diabetes) is due to a collision between our ancient genome and the new condition of life in affluent communities. While our genetic make-up has changed only 0.02 percent compared to that of our ancestors, 70 percent of the foods we eat today would be completely unrecognizable to them. This change, has spawned a new generation of food-related illnesses such as metabolic syndrome and diabetes.


Does this mean we are prisoners of our genetic make-up and the diabetes trend is irreversible? The consensus is that half of all cases might be eliminated if weight gain in adults could be prevented – in other words, if we ate healthily and took more exercise. Your genes load the gun, but it is your environment that pulls the trigger.


Studies clearly show that through lifestyle modifications and medication, diabetes can indeed be controlled. The invisible epidemic need not claim you. Take note and take action.

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