And What Actually Gets in the Way of Managing It
If you grew up in a South Asian household, you probably know at least one person living with diabetes.
A parent. A relative. A neighbour. Someone at the group or temple you go to.
It is that common in our community. And yet, the advice most people receive is usually not designed with us in mind.
This post is not about blaming our food or our culture. It is about understanding why the risk is higher for South Asians specifically, what makes managing it harder in our context, and what actually helps.
If you have been recently diagnosed — or have been managing diabetes for years and still feel like something is not clicking — this is for you.
For a full overview of what diabetes is, how it is diagnosed, and how it is managed, read my blog: Type 2 Diabetes. Here, I want to focus on the South Asian-specific picture.
The Numbers Are Hard to Ignore
Across Canada, about 30% of the population is living with diabetes or prediabetes.
In other words, that is around one in three people.
Did you know that diabetes is not just about blood sugar? You may be surprised to hear that it contributes to:
- 40% of heart attacks
- 30% of strokes
- 50% of kidney failure requiring dialysis
- 70% of all non-traumatic leg and foot amputations
- It is the leading cause of blindness
People living with depression also face a 40 to 60% increased risk of developing type 2 diabetes — a connection that is still underrecognized in care.
Within the South Asian community, the picture is even more pressing. Diabetes affects an estimated 16% of South Asian adults in Canada — one of the highest rates of any ethnic group. South Asian adults are significantly more likely to develop diabetes than the general Canadian population.
That is a bit worrisome.
Could Your Doctor’s Scale Be Missing Something?
One tool commonly used to assess weight-related health risk is BMI, or Body Mass Index — a number calculated from your height and weight. It is a rough screening tool, not a perfect measure of health, and in some situations like pregnancy, it is not applicable. But it can still be a useful tool, because generally, the higher the BMI, the greater the risk of developing health conditions.
For South Asian populations, it has an important limitation: the standard cut-offs do not apply to us as they underestimate body fat in our community.
The BC Guidelines for obesity management recognize this and recommend lower ranges:
| Classification | Standard BMI | South Asian BMI |
|---|---|---|
| Normal | 18.5 – 24.9 | 18.0 – 22.9 |
| Overweight | 25.0 – 29.9 | 23.0 – 24.9 |
| Obese | 30.0+ | 25.0+ |
This means many South Asians are already at risk at a weight their doctor might consider perfectly normal.
I see this regularly in my practice. Clients are told their weight is fine, their numbers are borderline, nothing to worry about yet — and then a few years later, a diabetes diagnosis arrives that did not feel like it came out of nowhere.
Because it did not.
South Asians are also more likely to carry fat around the abdomen, develop insulin resistance, and have unfavourable cholesterol levels — even at body weights that fall within the standard normal range. The biology is different. The risk threshold is different. And the nutrition advice needs to reflect that.
It Is Not Just About Biology
The research backs this up. Here is what two Canadian studies found:
Exploring the Social Determinants of Health in Nutrition Care for South Asian Communities Balakrishnan, Benea, Banerjee and Mahajan — Dietitians of Canada, 2025
Canadian dietitians reviewed 14 studies looking at what actually gets in the way of diabetes care for South Asians living in Canada.
Why it matters to you: If you have ever felt like the healthcare system was not built for someone like you, this research confirms that — and calls on health providers, including dietitians like me, to do better.
Curious what they found? Language barriers, lack of culturally appropriate nutrition education, work schedules, income insecurity, and discrimination all play a meaningful role in how South Asians are able to manage their health.
These are not personal failings. They are system-level realities.
Comparing Dietary Intake and Cardiovascular Risk Factors in Vancouver’s South Asian Community Jessa, Murphy, Khan and Tang — University of British Columbia, Nutrients, 2025
UBC researchers studied South Asian adults at high risk of diabetes in Metro Vancouver, looking at what they were actually eating and what it meant for their health.
Why it matters to you: The dietary patterns found in this study reflect what many South Asian households look like across Canada — not just in Vancouver.
Curious what they found?
- Both vegetarians and meat-eaters were eating far more sodium than recommended
- Vegetarian diets in this group had a high glycemic load which means the carbohydrates being eaten were raising blood sugar quickly and significantly
- Over 90% of participants were already at risk using South Asian-specific BMI criteria
Many South Asian diets — even vegetarian ones — are high in refined carbohydrates like white rice, maida, and packaged foods. These raise blood sugar fast.
Going vegetarian does not guarantee better blood sugar management. What matters is the quality and balance of what is on your plate — not just the label.
The problem is not our food.
One of the most common things I hear from clients:
“Indian food is just carbs. There is no protein or nutrients in it.”
Actually, that is not accurate. While many South Asian meals can be higher in carbohydrates, our traditional foods also offer plenty of protein-rich and nutrient-dense options that, when included consistently and paired thoughtfully, can support stable blood sugars and overall health.
Dal, dahi, paneer, chana, and rajma are all solid sources of protein. In fact, our everyday vegetables and spices like bhindi (okra), methi, karela, and turmeric have also been studied for their health-supportive properties.
The issue is not South Asian food itself. It is how our eating patterns, portions, and cooking habits have gradually changed over time. There are more refined grains, less fibre, fewer vegetables, and larger portions than many traditional meals once included.
What Actually Gets in the Way at Home
Beyond the research, there are everyday realities in South Asian households that I hear about regularly in my practice.
Cooking for the whole family.
In many South Asian homes, the woman of the house is the one in the kitchen. And often, she is also the one managing diabetes.
But she is not cooking just for herself.
She is trying to cater to a variety of needs within the household — whether it is cooking to please her husband or kids, or making something her mother-in-law will actually eat. Her own blood sugar comes last.
Does this sound familiar?
Family pressure to eat more.
Food is love in our culture.
Refusing a second roti at someone’s home, or not finishing what is on your plate, can feel like a rejection of the person who made it.
“Bas ek aur le lo” is not just a phrase. It is a whole dynamic.
Navigating this while managing blood sugar takes real skill — and most diabetes education does not touch it.
Relying on traditional remedies alone.
Bitter melon juice, methi seeds, jamun — these are often the first response to a diabetes diagnosis in many South Asian families.
Some of these may have mild effects that research is still exploring. But they are not a replacement for medical management.
And here is the part nobody says out loud:
Karela juice in the morning does not cancel out everything else happening throughout the day. Neither does relying on occasional “healthy” remedies while the overall eating pattern remains imbalanced.
As a result, blood sugars can stay poorly controlled for months without anyone realizing it — because the family genuinely feels they are trying to manage it.
Getting advice that actually fits your life.
Have you ever left a dietitian appointment with a meal plan full of chicken breast and steamed broccoli?
Research confirms what many South Asian clients already know: they often end up translating generic Western advice into their own cultural context themselves. Or explaining their own food to the person who is supposed to be helping them.
I hear this regularly:
“She was great. But she didn’t get my questions. Which atta should I use? Can I eat dal — half a cup or one cup?”
Those are not small questions. After all, those are the questions that actually change what happens at dinner.
Care that includes your real food — dal, roti, rice, sabji, dahi — leads to better outcomes. Generic plate models do not cut it.
A Few Simple Shifts That Actually Fit Your Kitchen
This does not mean carbohydrates are off limits.
It means the choices you make at each meal — the type, the amount, and what you eat alongside them — genuinely matter.
According to Diabetes Canada’s Glycemic Index Food Guide, brown rice is a low GI grain option and sits in the “choose most often” category. Basmati and parboiled rice are medium GI — still better than sticky or jasmine rice, but not the top choice.
Similarly, roti and chapati (white or whole wheat) are also medium GI — not high. Overall, context matters more than cutting things out completely.
A few shifts that fit real South Asian kitchens:
- Pair rice with dal and a sabji — it changes how your body handles the meal
- Add dahi to your plate — it adds protein and slows digestion
- Choose brown rice when you can as a step in the right direction
- Use whole wheat or multigrain atta, or mix in some oat bran or chickpea flour
- Watch the sodium in packaged chutneys, pickles, and sauces — it adds up fast
These are not dramatic overhauls. They are practical shifts.
What Helps Most
Ultimately, getting the right support matters.
For South Asians, that means working with someone who understands your food, your family, and the real barriers you face — not just handing you a generic meal plan.
If you are in BC and looking for nutrition support that actually speaks to your experience, I would love to connect. I work with South Asian adults managing diabetes and related conditions, and I bring both the clinical training and the cultural context to the conversation.
Book a free 15-minute call here: calendly.com/mamtabhasin-nourishtothriverd/15min
References
- Diabetes Canada. Diabetes in Canada: Backgrounder. Diabetes Canada; 2024. Available from: https://www.diabetes.ca/getmedia/9c717b08-e53e-47c4-a522-c0937ce0861b/2024-Backgrounder-Canada-EN_FINAL_1.pdf
- Public Health Agency of Canada. Inequalities in diabetes in Canada: infographic. Government of Canada; 2024.
- BC Guidelines. Overweight and obese adults: diagnosis and management. Province of British Columbia; last updated May 7, 2026. Available from: https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/obesity
- Balakrishnan S, Benea C, Banerjee A, Mahajan A. Exploring the social determinants of health in nutrition care for South Asian communities: a narrative review. Canadian Journal of Dietetic Practice and Research. 2025 Jan 17. https://doi.org/10.3148/cjdpr-2024-024
- Jessa R, Murphy RA, Khan NA, Tang TS. Comparing dietary intake and cardiovascular risk factors in Vancouver’s South Asian community. Nutrients. 2025;17(12):1967. https://doi.org/10.3390/nu17121967
- Diabetes Canada. Glycemic Index Food Guide. Available from: https://www.diabetes.ca/DiabetesCanadaWebsite/media/Managing-My-Diabetes/Tools%20and%20Resources/glycemic-index-food-guide.pdf