34
betics than of the nondiabetics had neuropathy,
Table 20
Diabetes Survev: Preliminary Results, 1974
Glycosuria
Diabetes
Grqup
No.
No.
with normal
blood sugar
No.
people*
cases
%e
cases
%
375
103
27.5
29
7.5
Male
Female
180
195
48
51
26.7
25.9
1?
10
9.4
3.1
Obese
Non-obese
196
136
38
22
29.6
16.2
18
10
9.2
7.4
Uurtk
Rongelap
201
174
37
46
28.4
26.4
Residing at**
Majuro
Ebeye
Rongelap
Uank
120
116
38
81
37
29
16
21
30.8
25.0
27.6
25.9
Rongelap
and Utirik
*Includes 10 subjects from otheratolls, married to Rongelap and Utirik people.
** Includes both Rongelap and Utirik people residing at
these locations.
Marshall Islands is considerable and is probably
greater than in any other population groups except possibly certain American Indian groups.§4
Although someprevious reports have indicated a
high incidence of diabetes in some Polynesian
populations,§5-69 others have suggested a low
incidence.68-70
.
Theoverall incidence of diabetics was 26%, and
—~ % of these patients were unawareoftheir abnormality. The average age of the diabetics was
considerably greater than that of the nondiabetics.
The disease appears to be as commonin males as
in females, but a definite statement must await
completion of the data analysis. Obesity was much
more common in women than in men, and the
data indicate an fcreased incidence among obese
subjects. Cataracts seemed to%e much more common in the diabetics than in the nondiabetics, but
this would certainly be influenced by the older age
of the diabetic population. No definite difference
Wax seen in the incidence of cataracts amongindividuals known to have diabetes compared with
those in whom the diagnosis was made duringthis
survey. A significantly higher percentof the dia-
but, because of age differences and otherfactors
previously stated, covariance must be eliminated
from the data before these observations can be
evaluated. (Neuropathy was evaluated on the
basis of history of paresthesias and/or objective
abnormalities in reflexes and sensory perception.)
The limited data available did not suggest evidence for increased retinopathy or peripheral vascular disease among the diabetics. The disease
more closely resembles maturity onset diabetes
with absence of acute symptoms, ketosis, and absolute dependence on insulin treatment.
The data do not suggest any differences between
Rongelap and Uunikpeople (genetics) or between
places of residence (environmental influence), and
there is no evidence that radiation exposure has
played a part in the pathogenesis. The differences
in diet and generalliving conditions between the
“outer islands” and the district centers are considerable and might well play a significant role in
pathogenesis. However, analysis of this factoris
difficult because of the mobility of the people, who
constantly move between homeisland and the
centers; the place where an individual is examined may not be where he has spent the major part
of, say, the last 10 years.
Despite the limitations, the preliminary results
are considered to be of sufficient interest to warrant a morecareful and complete investigation
Additional observations will be made to provide
the missing information and to obtain more objective data regarding the incidence of neuropathy,
cataracts, and retinopathyin these patients. The
insulin response to a glucose challenge would also
be of interest in assessing some ofthe factors that
might be importantin the etiology of diabetes in
the Marshall Islands.
The examinations are by necessity restricted to
Rongelap and Utirik people. When the Eniwetok
and Bikini people return to their home islands in
sufficient numbers, the diabetes investigations
may be expanded to coverthese groups.
H. CHROMOSOME AND GENETIC STUDIES
1. Studies of Chromosomesfor Radiation Effects
In 1964 chromosome preparations were obtained from lymphocytes cultured from the periph-
eral blood of 43 exposed (21, age <(20; 22, age