Photo by Brett Jordan on Unsplash
I don’t think people understand the layered nature of marginalisation. Some people have a broader understanding of intolerance, but it’s often assumed to be at the level of outright racism or obvious discrimination.
But behind the everyday interactions, there’s a whole layer of systems created based upon the mainstream assumptions. If you don’t fit in that mould, you often face an uphill struggle in many different areas of life.
My most recent blood test showed I have very high insulin resistance. This is not a surprise, but still quite disappointing to see. I feel like my body is healing, but it is doing it in a way where the results seem to be getting worse in the short term.
My glucose levels however are broadly fine. This probably means my pancreas is compensating for my insulin resistance by working overtime. When I asked what I should do to my Belgian GP, she did not believe that there is any intervention necessary because I’m not outright diabetic. The systemic response is to wait until I’m irreversibly sick before doing much about it.
What is very disappointing about this is that it was me who specifically asked to check my glucose and insulin levels. When my doctor spoke to me, she did not even mention my very high insulin resistance at all.
South Asians have a particular issue around high insulin resistance. It means that we are particularly prone to diabetes – it is extremely common in my family. If I were to do nothing about my insulin resistance, I would no doubt be diabetic in a decade or so.
One of the downsides of moving to Belgium is how little awareness there is around South Asian health. I imagine if that if I were in London, this would be taken a lot more seriously, and there’d be a more serious conversation around how to tackle it. Instead, it’s me who has to personally advocate for my health.
What is notable on the discourse around insulin resistance is how much of the advice is essentially victim-blaming style, saying that this is around diet and exercise. It ignores that actually there’s a lot more complex natures in play, particularly stress (which I imagine is for my case) which can often be the deeper root cause.
Having high insulin resistance also means that the body’s ability to regulate how much it wants food is distorted, so the idea of just dieting your way out doesn’t work in practice. Forced diets that a dieticien may recommend would just prompt my body into further stress. I would eventually have survival level hunger pains – eat like it was the last opportunity in your life. I’m pretty sure this made the problem worse, rather than better. If it was simply a question of diet and exercise, I would have dealt with this years ago.
There is medicine that can likely help me, but I’ll have to push for it. I’ve asked my doctor whether I can be referred to an endocrinologist. I first have to see whether she agrees, but I may have to wait many months before that happens.
There is a deeper, more existential level to all of this. Why, as a South Asian, am I more prone to these issues? Were we just born genetically worse? It’s pretty easy to fall into a sense of ethno-inferiority, which doesn’t help the morale, nor the stress.
The likely explanation doesn’t give much comfort. We are not genetically inferior. Instead, we have bodies that have genetically adapted to centuries of famine, which is rooted in colonialist extraction. It’s one thing to know about the history of colonisation. It’s another thing to see your health suffering to this day because of it.
I’m navigating a lower energy period, with increased stressed from societal disadvantages. At the same time, I need to navigate how to advocate what I need from my doctor, whilst also emotionally digesting the direct effect of historical atrocities are having on my health.