Diabetes in the South Asian Community, Ishrat Rehmani RPh, CDE
Certified Diabetes Educator
The prevalence of Diabetes type 2 in South Asians, both in their home countries and abroad, is extremely high and is continuing to rise rapidly. South Asians, those who live in or have their roots in Pakistan, India, Sri Lanka, Bangladesh, Nepal, Bhutan, or the Maldives seem to be at especially high risk for developing type 2 diabetes.
The large scope of this problem calls for investigations into the cause of increased susceptibility and preventative efforts at both the individual and population level that are early start, aggressive, and culturally sensitive.
In the recent years, awareness and literacy has now increased in the South Asian communities in their countries and aboard. The patients feel more empowered and are keener to get involved in their own management. They are no longer satisfied with being dictated on to a management plan. The patients now demand the focus of the management to shift from the disease to their lives as a whole. With all the decisions being taken together, the ‘patient centred approach’.
South Asian patients are fully able to make healthy and appropriate choices provided they are diabetes literate and numerate. In the context of diabetes, this necessity is related to the blood glucose levels, time intervals and insulin doses of the patient. If patients are diabetes literate, they should be trusted with making choices about their own health and there is no reason to consider them less capable of making their own decisions in comparison to other patients.
That being said, it is important to note that there are several sociocultural and religious issues affecting south asian patients that are of concern to a physician practicing patient centred care. These issues are mentioned in various studies of National Center of Biotechnology Information as well. All of these issues need to be addressed while employing Patient centred care for diabetes in a South Asian community.
Gender-based challenges in South Asian society include a lack of outdoor activities for women, the reluctance of female patients in visiting male doctors, the reluctance of skin exposure by female patients in order to teach insulin administration sites, a lack of enthusiasm shown by family members towards the treatment of female patients, and non-acceptance of their diagnosis by female patients due to marriage issues.
Some diet-related challenges are the use of oily foods and bitter vegetables to restore health, the prolonged fasting periods during Ramadan in uncontrolled diabetes, the excessive use of honey and dates, and eating a lot of fruits upon diagnosis with diabetes.
Physical exercise-related challenges in South Asian society include a lack of outdoor activities for patients, especially females, and the sedentary lifestyle adopted by many during Ramadan.
Some challenges in South Asian society related to their acceptance of diagnosis and therapy are their alternative usage of traditional cultural medicine, a lack of faith in modern medicine, considering insulin a forbidden substance, and not using insulin injections because of a belief that they may worsen the disease.
It is essential for the South Asian community to recognize the importance of treatment and discuss any questions or concerns with a healthcare practitioner. It is also essential for those employing care to understand these concerns and do their best to alleviate them or encourage change. Through these principles, an entire community will be able to receive appropriate treatment, and the community’s overall health and wellness will improve.