ReviewFrontiers in public health2016
The Elevated Susceptibility to Diabetes in India: An Evolutionary Perspective.
Review in Frontiers in public health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
87 citing papers in PubMed, 1 synthesis or guideline pooled it, 147 citations in OpenAlex.
- Gestational diabetes mellitus (GDM) and adverse pregnancy outcome in South Asia: A systematic review.Endocrinology, diabetes & metabolism · 2021Pooled it
- Trial
- Body composition, geography and ethnicity: understanding the associations with health.European journal of clinical nutrition · 2026Review
- Organ Size and Metabolic Rate Co-Vary with Dimensions of the Obstetric Pelvis: The Metabolic Coordination of Childbirth Hypothesis.American journal of biological anthropology · 2026Article
- Life-course trajectories of cardiovascular disease risk factors in rural India: Andhra Pradesh Children and Parents Study (APCAPS) 2003-2023.International journal of epidemiology · 2026Article
- Narrative Review: Sugar and Rice and the Diabetes Epidemic in India-A Historical Context.Nutrients · 2026Review
- Article
- Scarcity by design: famine, structural violence, and the biosocial inheritance of political deprivation.Frontiers in public health · 2026Article
- Insulin deficiency is associated with early postpartum T2DM in Indian women with gestational diabetes.Frontiers in clinical diabetes and healthcare · 2026Article
- Ectopic Fat distribution and adverse muscle composition in South Asians: Findings from the UK biobank.American journal of preventive cardiology · 2025Article
- Understanding economic disparities in elderly health outcomes: a decomposition analysis in Bankura district.BMC public health · 2025Article
- Roads diverge: mapping the journey towards diagnostic health equity.BMJ open quality · 2025Article
- Retrospective Analysis of the Efficacy of Integrated Lifestyle Modifications in Managing Prediabetes in the Indian Population.Journal of diabetes research · 2025Article
- Comparison of incidence trends of early-onset and late-onset type 2 diabetes in the Asia-Pacific region, 1990-2021: a join point regression analysis based on the global burden of disease study 2021.Frontiers in endocrinology · 2025Article
- Broadening the vaccine metaphor: The adequate balanced food (ABF) vaccine against tuberculosis (Acid-fast bacilli/AFB) and more.PLOS global public health · 2025Article
- External validation of Prediabetes Risk Test in Indian population for screening prediabetes.Medical journal, Armed Forces India · 2024Article
- Reverse epidemiology of obesity paradox: Fact or fiction?Physiological reports · 2024Review
- Metabolic health tracking using Ultrahuman M1 continuous glucose monitoring platform in non- and pre-diabetic Indians: a multi-armed observational study.Scientific reports · 2024Observational
- Efficacy of Zinc Fortified and Fermented Wheat Flour (EZAFFAW): A randomized controlled trial protocol.PloS one · 2024Article
- Diabetes Care: An Online Web-Based Tool for Improving the Health Outcomes of Type 2 Diabetes Mellitus Patients: A Longitudinal Study.International journal of preventive medicine · 2024Article
27 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
India has rapidly become a "diabetes capital" of the world, despite maintaining high rates of under-nutrition. Indians develop diabetes at younger age and at lower body weights than other populations. Here, we interpret these characteristics in terms of a "capacity-load" model of glucose homeostasis. Specifically, we assume that glycemic control depends on whether the body's "metabolic capacity," referring to traits, such as pancreatic insulin production and muscle glucose clearance, is able to resolve the "metabolic load" generated by high levels of body fat, high dietary glycemic load, and sedentary behavior. We employ data from modern cohorts to support the model and the interpretation that elevated diabetic risk among Indian populations results from the high metabolic load imposed by westernized lifestyles acting on a baseline of low metabolic capacity. We attribute this low metabolic capacity to the low birth weight characteristic of Indian populations, which is associated with short stature and low lean mass in adult life. Using stature as a marker of metabolic capacity, we review archeological and historical evidence to highlight long-term declines in Indian stature associated with adaptation to several ecological stresses. Underlying causes may include increasing population density following the emergence of agriculture, the spread of vegetarian diets, regular famines induced by monsoon failure, and the undermining of agricultural security during the colonial period. The reduced growth and thin physique that characterize Indian populations elevate susceptibility to truncal obesity, and increase the metabolic penalties arising from sedentary behavior and high glycemic diets. Improving metabolic capacity may require multiple generations; in the meantime, efforts to reduce the metabolic load will help ameliorate the situation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.