Department of Endocrinology Grant Medical College and Sir J J Group of Hospitals, Lilavati Hospital, Bhatia Hospital, Joshi Clinic, Bandra Reclamation, Bandra West, Mumbai, India.
Curr Diab Rep. 2012 Apr;12(2):204-12. doi: 10.1007/s11892-012-0260-0.
India and other countries in Asia are experiencing rapidly escalating epidemics of type 2 diabetes (T2D) and cardiovascular disease. The dramatic rise in the prevalence of these illnesses has been attributed to rapid changes in demographic, socioeconomic, and nutritional factors. The rapid transition in dietary patterns in India-coupled with a sedentary lifestyle and specific socioeconomic pressures-has led to an increase in obesity and other diet-related noncommunicable diseases. Studies have shown that nutritional interventions significantly enhance metabolic control and weight loss. Current clinical practice guidelines (CPGs) are not portable to diverse cultures, constraining the applicability of this type of practical educational instrument. Therefore, a transcultural Diabetes Nutrition Algorithm (tDNA) was developed and then customized per regional variations in India. The resultant India-specific tDNA reflects differences in epidemiologic, physiologic, and nutritional aspects of disease, anthropometric cutoff points, and lifestyle interventions unique to this region of the world. Specific features of this transculturalization process for India include characteristics of a transitional economy with a persistently high poverty rate in a majority of people; higher percentage of body fat and lower muscle mass for a given body mass index; higher rate of sedentary lifestyle; elements of the thrifty phenotype; impact of festivals and holidays on adherence with clinic appointments; and the role of a systems or holistic approach to the problem that must involve politics, policy, and government. This Asian Indian tDNA promises to help guide physicians in the management of prediabetes and T2D in India in a more structured, systematic, and effective way compared with previous methods and currently available CPGs.
印度和亚洲其他国家正经历着 2 型糖尿病（T2D）和心血管疾病发病率的迅速上升。这些疾病的患病率急剧上升归因于人口、社会经济和营养因素的快速变化。印度饮食模式的迅速转变，加上久坐不动的生活方式和特定的社会经济压力，导致肥胖和其他与饮食有关的非传染性疾病增加。研究表明，营养干预措施可显著改善代谢控制和体重减轻。目前的临床实践指南（CPGs）不适用于不同的文化，限制了这种实用教育工具的适用性。因此，开发了跨文化糖尿病营养算法（tDNA），然后根据印度的区域差异进行了定制。由此产生的印度特定 tDNA 反映了疾病在流行病学、生理学和营养方面的差异、人体测量学切点以及该地区特有的生活方式干预措施。这个跨文化化过程的印度的具体特点包括：具有高贫困率的过渡经济的特点；在给定的体重指数下，体脂百分比更高，肌肉质量更低；更高的久坐生活方式率；节俭表型的元素；节日和假期对遵守诊所预约的影响；以及必须涉及政治、政策和政府的系统或整体方法来解决问题的角色。与以前的方法和当前可用的 CPG 相比，这种印度亚洲 tDNA 有望帮助指导印度的医生更结构化、系统和有效地管理糖尿病前期和 T2D。
