By – Saesha Sharda
Throughout my childhood, I have witnessed members of my family battling diabetes. I have vivid memories of my grandmother injecting insulin before every meal, my aunt anxiously checking her blood sugar levels at the end of the day, and my mother nervously awaiting the results of her blood tests. Despite living a relatively healthy and active lifestyle, I was recently told by my doctor that I have insulin resistance and am on the path to becoming prediabetic. When I asked why, her answer was simple yet unsatisfying: “You’re fighting a genetics battle.”
This response left me with more questions than answers. What’s really behind these “unfortunate genes”? Why does diabetes seem to affect nearly every other Indian family I encounter? Why is it that I, along with so many other Indian teens, must grow up with the looming concern of this disease?
As I searched for answers, I stumbled across an unexpected explanation: colonialism. While many sources attribute the prevalence of diabetes in South Asians to historical famines, I discovered a deeper connection. Under British rule, India endured widespread famine and chronic malnutrition. To survive, individuals developed genetic adaptations to store fat and nutrients more efficiently. According to an NIH study, “famine might conceivably have selected in favor not only of smaller size but also of metabolic adaptations and an increase in the ratio of fat mass to lean mass”—a phenomenon contributing to the so-called “skinny-fat” body type common among Indians. Remarkably, surviving even one famine can double the risk of diabetes and obesity in the next generation. Now, imagine the impact of enduring over 200 years of such hardship.
This history reframed my understanding of diabetes in South Asians. Our bodies, adapted to survive in conditions of scarcity, are now struggling in food-abundant environments. Colonialism, initially designed to exploit and subjugate, continues to exert its influence 75 years after India’s independence, shaping both the mental and physical health of generations.
Learning this left me stunned. It’s mindblowing to think that the ripple effects of colonialism are one of the reasons I am at a higher risk for diabetes today.
While I now have a clearer understanding of my initial question, I’ll admit I’m still frustrated. At just 18, I’m being told I need to monitor what I eat more carefully—all because of historical events beyond my control. As someone who loves food, this was a tough pill to swallow. But over time, I’ve come to accept it. Understanding the “why” behind my risk has not only empowered me to take charge of my health but also deepened my awareness of how history can shape the present in unexpected ways.