Indians Face Higher Post-meal Blood Sugar Spikes Despite Lower BMI, Diabetes Expert Warns

THIRUVANANTHAPURAM:
Asian populations, particularly Indians, experience significantly higher post-meal blood sugar spikes despite developing diabetes at lower body mass index (BMI) levels than Western populations, said Dr Banshi Saboo, Ahmedabad-based internationally acclaimed diabetologist and metabolic physician, while highlighting the need for treatment strategies that go beyond HbA1c levels.

He was delivering a talk on ‘Why Acarbose matters in Indian diabetes management’ at the 14th edition of the three-day Annual Global Diabetes Convention held at Uday Samudra, Kovalam, on Sunday. The conference is led by Dr. Jothydev Kesavadev, who serves as the Organising Secretary of Jothydev’s Professional Education Forum (JPEF) and is also the Chairman and Managing Director of Jothydev’s Diabetes Research Centre.

Dr Banshi Saboo said Indians tend to develop diabetes nearly 1.5 years earlier due to early beta-cell dysfunction, higher visceral fat, greater insulin resistance and impaired first-phase insulin response, even when they are not obese by conventional standards.

Saboo pointed to evidence from a study, which found that India’s carbohydrate-rich diet contributes to elevated postprandial (post-meal) glucose levels across the country. According to the expert, Asians exhibit the highest post-meal glucose response compared with Arab and European populations when consuming similar amounts of carbohydrates.

The diabetologist stressed that glycaemic variability, the fluctuations in blood glucose levels throughout the day, should receive greater attention in diabetes management. Patients with identical HbA1c values may have vastly different glucose patterns, making HbA1c alone an insufficient guide for treatment decisions.

Advocating wider use of continuous glucose monitoring (CGM), the doctor said it can help identify patients, having significant glycaemic variability, who may require personalised treatment rather than a standard escalation of therapy.

The expert also cited research suggesting that higher glycaemic variability is associated with an increased risk of microvascular complications, including diabetic retinopathy, as well as a greater risk of cardiovascular disease and overall mortality.

He noted that therapies targeting postprandial glucose control and glycaemic variability could play a more important role in diabetes management, particularly for Indian and other Asian patients who face unique metabolic challenges.

Before the oration, G. Krishna Kumar, actor and Chairman of the National Film Development Corporation (NFDC), felicitated Dr. Banshi Saboo on stage. Also present were Dr Smita Joshi, Executive Committee Member, Ministry of Health and Family Welfare, Government of India, Dr. Jothydev Kesavadev, and Dr. Harish Kumar.