Introduction

The Deccan Famine (1876–78) claimed millions under British colonial rule. But its legacy might stretch far beyond mortality—it may have seeded metabolic vulnerabilities that persist in today’s South Asian population. This article examines how prenatal undernutrition—what the thrifty phenotype hypothesis refers to as early-life nutritional programming—may contribute to the region’s high rates of insulin resistance and diabetes.

Deccan Famine → Thrifty Phenotype: How It Works

Thrifty Phenotype Hypothesis: Suggests that fetal undernutrition triggers metabolic adaptations aimed at maximising energy storage. However, when calories are plentiful later, these adaptations can manifest as insulin resistance and an increased risk of diabetes. In simple terms, a child born small due to maternal famine may grow up with a metabolism primed to store more fat and resist insulin.

Diabetes in the Deccan Today: The Data

I have always been intrigued by the condition of Diabetes Mellitus. In the past, I have written about how added sugar was responsible for the condition. You can read the article here.

But this research shows the issues go deeper than that. Let’s look at the current scenario.

• Andhra Pradesh & Telangana: Around 18% of adults have high blood sugar levels, one of the highest in India.
• Hyderabad: A 2016 report showed 22% of adults have diabetes.
• South India overall: Diabetes prevalence ranges from 5–17%, with urban areas particularly affected; southern states often surpass 12%.
• National context: India has ~212 million people with diabetes, nearly 25% of the global burden.

This cluster—Telangana, Andhra, Karnataka (the historical Deccan)—consistently ranks above national averages.

Connecting the Dots: Famine → Insulin Resistance Today

1. Prenatal undernutrition during the 1876–78 famine would have impacted thousands of Deccan-born infants.
2. These individuals likely developed adaptations: enhanced fat retention, insulin sensitivity.
3. Over generations, descendants carry these thrifty phenotypes—a form of metabolic ‘memory.’
4. When exposed to modern calorie-rich, sedentary lifestyles, these adaptations raise diabetes susceptibility.

Multiple Perspectives

• Thrifty Phenotype (Developmental Origins): Focuses on prenatal programming, not DNA sequence change. Well-supported by global famine studies—e.g., Dutch Hunger Winter.
• Genetic / Thrifty Genotype: Proposes inherited gene variants favouring fat storage due to repeated famine pressure. Less direct evidence—no genetic signature tied to specific famines yet.
• Critics / Alternative Explanations: Strong drivers include urbanisation, processed food, and inactivity. Environmental factors like pollution also contribute—recent Delhi/Chennai air pollution study showed PM2.5 exposure raised diabetes risk 22% per 10 μg/m³.

5. Why the Data Matters

Highlighting 18–22% diabetes prevalence in Deccan states grounds the thrifty phenotype theory in modern reality. These aren’t rare cases—they reflect a deeper, ongoing legacy of past deprivation combined with current lifestyle shifts.

Next Steps & Implications

So what can we do to tackle the situation? I look at this from two angles. One is our research priorities and the other is how to handle it through public health actions.

• Research Priorities:
  – Birth-cohort studies targeting families in historically famine-affected areas.
  – Epigenetic profiling to detect metabolic programming markers.
• Public Health Actions:
  – Early nutritional interventions for pregnant women.
  – Community screening in high-prevalence areas (18–22%).
  – Lifestyle programs emphasising diet, exercise, and pollution control.

Conclusion

The Deccan Famine may have left more than historical scars—it potentially shaped metabolic pathways across generations. Today, up to 1 in 5 adults in the region are diabetic—a reminder that early-life environments cast a long shadow. The thrifty phenotype hypothesis provides a compelling lens, but we need more targeted studies to confirm the link and shape effective interventions.

I have used the following sources for the article; this is just a hypothesis. I have concluded any cohort-based field testing for this as yet.

Sources

1. Hales, C. N., & Barker, D. J. P. (1992). Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. *Diabetologia*, 35(7), 595–601.
2. Anjana, R. M., et al. (2011). Prevalence of diabetes and prediabetes in urban and rural India: Phase 1 results of the ICMR–INDIAB study. *Diabetologia*, 54, 3022–3027.
3. Radha, V., & Mohan, V. (2007). Genetic predisposition to type 2 diabetes among Asian Indians. *Indian Journal of Medical Research*, 125(3), 259–274.
4. Patel, V., et al. (2011). Chronic diseases and injuries in India. *The Lancet*, 377(9763), 413–428.
5. Davis, M. (2001). *Late Victorian Holocausts: El Niño Famines and the Making of the Third World*.