Teju Lakkundi
By Teju Lakkundi
Imagine going to see your doctor for a routine physical with lab results, feeling fine – no unusual symptoms and your doctor mentions, your blood sugar “is a bit high.” He says nothing to worry, lose 20 pounds and return after a year. You think it’ll go away, and go about your day, not realizing that your body just whispered the arrival of prediabetes.
What is prediabetes?
Prediabetes is a condition in which blood sugar levels are higher than normal, but not yet high enough as Type 2 Diabetes. It is like a yellow traffic light, not red yet, but a clear signal to slow down.
With the right action, prediabetes can be reversed. That window of opportunity is the gift most people never realize they have been given.
South Asians’ high risk
Compared to Caucasian populations, South Asians can develop prediabetes at a lower body weight. We can develop insulin resistance and metabolic problems at a BMI as low as 21–23. A major cause for this is that most South Asians carry a disproportionately high amount of visceral fat, the dangerous fat stored around the organs.
Second, we have a strong genetic predisposition to insulin resistance, and this is not a matter of lifestyle alone. Research shows that South Asians have a naturally lower capacity for insulin secretion compared to other ethnic groups, meaning the pancreas must work harder to manage blood sugar even under normal conditions.
Third, genes that regulate how the body processes carbohydrates, stores fat, and responds to insulin behave differently in South Asian populations. This means that even a modest increase in caloric intake, a slight reduction in physical activity, or the natural metabolic slowdown that comes with aging can trigger blood sugar imbalances that might not affect someone of a different ethnic background in the same way.
Fourth, a diet rich in carbohydrates (rice, wheat, millets, maida, biscuits, fried namkeen, savory snacks, sugary sweets) with increasingly sedentary lifestyles, you have a community that is silently but rapidly developing prediabetes.
The silent whisper
Listen to your body whisper: Prediabetes is, for most people, completely asymptomatic. You will not feel it like a sore throat or a fever. You may forget your doctor even mentioned it. Some people notice subtle clues like feeling unusually tired after a meal, increased thirst, occasional brain fog, or unexplained weight gain around the midsection, but these are easy to dismiss as stress or simply getting older. If prediabetes is not reversed, it will turn into Type 2 Diabetes.
With over 5.2 million Indian Americans now living in the United States, current estimates from the MASALA (The Mediators of Atherosclerosis in South Asians Living in America) study show that roughly 1 in 3 South Asians in the US has prediabetes, and 1 in 4 already has Type 2 diabetes. Applied to our community of 5.2 million, that potentially means over 1.7 million Indian Americans who could be one of our parents, a spouse, colleagues, friends or our neighbors.
Who should get checked
For the general Caucasian population, diabetes screening is typically recommended starting at age 45. But for South Asians, screening should begin earlier — ideally in your 30s — especially if you have a family history of diabetes, carry extra weight (BMI>23), have sedentary lifestyle, or experienced gestational diabetes during pregnancy.
Ask your doctor for a fasting blood glucose test, A1C test and a fasting insulin test. You could have normal glucose while your insulin levels are elevated. This is because in the early stages of prediabetes, the pancreas compensates by producing more insulin to force blood sugar into normal range, masking the problem. Do not wait for symptoms. Symptoms can mean the whisper has become a roar.
How to reverse prediabetes
Here is the hopeful truth: Ask your doctor if you have prediabetes, and it is reversible. According to the DPP study, losing 7-10% of body weight (roughly 14-20 pounds for a 200-pound person) combined with modest lifestyle changes can reduce the risk of progressing to Type 2 Diabetes by more than 58%.
For South Asians, this means rethinking some familiar dietary habits like swapping white rice for smaller portions of brown rice, quinoa or millets. Cauliflower rice can supplement dishes like fried rice, puliogare, bissibelebhaat and helps significantly lower the glycemic load of a meal. Increase portions of dal, legumes, and raw vegetables. Cutting back on large portions of rotis, idlis, dosas, parathas, bhakris, sugary chai or coffee, juices, and fried snacks all make a measurable difference.
One of the most powerful and underutilized tools? A 15–20-minute walk after meals. This short walk can reduce blood sugar spikes for free!
But general nutrition advice is just that, it is general. I often hear patients praising millets as a superfood for diabetes, but this is a myth. What works brilliantly for one person may or not work for another so let’s not generalize. This is where working with a Registered Dietitian Nutritionist (RDN), specifically a Certified Diabetes Care and Education Specialist (CDCES), becomes truly transformative.
Choose the right expert
A CDCES is a healthcare professional with advanced, specialized training in diabetes prevention, management, and education. They do not simply hand you a generic meal plan. They meet you where you are — understanding your cultural preferences, likes and dislikes, daily schedule, personal goals – and build a plan tailored to your real life.
What I witness, time and again, is that personalized guidance, not a sample menu plan, is what creates lasting, meaningful change. When someone truly understands why certain foods affect their blood sugar the way they do, and when they have a practical, culturally sensitive roadmap to follow, everything shifts.
In over a decade, I have heard many things from clients — fear, frustration, determination. What stuck with me was when a patient (with diabetes) said: “I have diabetes — diabetes DOES NOT have me.” That mindset is everything. If your blood sugar is high and you are reading this, you have heard the whisper early. Now don’t let it roar.
Teju Lakkundi is a registered dietitian nutritionist, licensed dietitian nutritionist and a certified diabetes care and education specialist. She is based in Cary, NC. Contact: nutriforu@gmail.com
Website: nutriforu.com
