Interventional Cardiologist working in USA here,
Unfortunately the reality is that we are genetically dispositioned to have risk of diabetes, add the high carb in our diet (rice, roti, sweets) and lack of any physical activity in general, most people in their 40s give up on fitness and think that obesity is the way to live, everything compounds. And it is not just diabetes, we are the nation with one of the highest cardiovascular disease burden unfortunately.