Risk of metabolic and vascular disease in South Asians: potential mechanisms for increased insulin resistance

The impending global pandemic of obesity, Type 2 diabetes and vascular disease suggests an urgent need for prevention strategies. Of all the common ethnic groups, South Asians, who make up a fifth of the world's population, experience the highest prevalence of both Type 2 diabetes and vascular disease. The high rates of diabetes, in particular, occur with lower average adiposity levels, suggesting that South Asians are more susceptible to the adverse effects of obesity. This review explores in detail the potential mechanisms underlying this phenomenon. A better understanding of these mechanisms may ultimately lead to better interventions to prevent diabetes and heart disease in this at-risk group.