SP2-5 Diabetes in Asia: a hypothesis

Introduction With rapid economic development, diabetes is reaching epidemic proportions in Asia, even in relatively non-obese populations. Changing lifestyles, obesity and genetics undoubtedly play a key role, however it is increasingly recognised that causes of disease may extend over generations. Methods The developmental origins of health paradigm has focused on the health consequences of constrained pre-natal or infant growth. Here we consider the complimentary question of constrained pubertal growth. Specifically, we examined the physiological and biological consequences for long-term health of constrained pubertal growth. Results Generations of constrained environments, common in Asian countries such as China, Indonesia or India, may increase vulnerability to diabetes, via low pubertal sex-steroids and hence low muscle mass. Furthermore, this hypothesis is consistent with the observed negative associations of diabetes with some hormonally related cancers and the sex-specific associations of diabetes with cardiovascular diseases. Conclusion We offer a hypothesis for conceptualising diabetes in developing populations and the aetiology of diabetes in all populations with corresponding practical and testable implications for diabetes prevention.