Diagnosing and Managing Type 2 Diabetes in South Asian Individuals: A Clinician’s Guide

South Asian individuals experience increased rates of type 2 diabetes (T2D), especially at younger ages and lower BMIs. In this review, we evaluate the current pathophysiology and data to guide clinicians on diagnosing and providing clinical management tailored to the South Asian population living in the U.S. A narrative review was conducted using PubMed and Google Scholar to examine studies focusing on clinical practice recommendations and reviewing factors that contribute to the development of T2D in South Asian populations. We examined studies specifically conducted on South Asian populations because many studies do not differentiate between East Asian versus South Asian subgroups in Asian populations, despite the importance of this distinction given their differing genetic and metabolic risk profiles. South Asian populations have unique metabolic factors, such as β-cell dysfunction at a lower BMI threshold, insulin resistance, lower lean muscle mass, higher visceral adiposity, lifestyle factors, and lack of identification by standard diagnostic tools, all of which contribute to the earlier onset of T2D and disease progression. Our review analysis supports a lower BMI threshold for screenings, postprandial glucose measurement, culturally tailored lifestyle modifications, and individualized pharmacologic therapies to address increased blood glucose levels, cardiometabolic comorbidities, and weight reduction. South Asian individuals are at increased risk of T2D and underrepresented in cross-sectional studies, creating gaps in evidence needed for clinicians to provide population-specific management strategies. Individualized pharmacologic approaches and culturally tailored lifestyle recommendations could help improve long-term cardiometabolic outcomes.