Microvascular and cardiovascular disease in South Asians: The emerging challenge

South Asians now constitute 4% of the UK population and represent a significant growing minority ethnic group with distinct health needs. Type 2 diabetes mellitus is already endemic and growing exponentially in this ethnic group. This presents a unique challenge to the overstretched resources of the NHS but, if action is not taken now, it is likely to prove highly expensive in the medium to long term. Type 2 diabetes is never mild and the microvascular and cardiovascular complications of diabetes appear to be more aggressive in the South Asians and threaten to match the exponential rise of the disease in them. Primary prevention through lifestyle changes to reduce obesity and improve diet with the aggressive reduction through pharmacological and non-pharmacological treatments of the reversible risk factors remains the cornerstone of a systematic strategy. In this review, we will describe the problem of microvascular and cardiovascular disease in South Asians and the known causes. Finally, we will describe the United Kingdom Asian Diabetes Study, a novel culturally centred approach using a community-based health care team in an attempt to improve microvascular and cardiovascular risk in South Asians