34 betics than of the nondiabetics had neuropathy. but, because of age differences and otherfactors Table 20 previously stated, covariance must be eliminated Diabetes Survey: Preliminary Results, 1974 7 Diabetes Glvcosuria with normal blood sugar Group No. people* No. cases % No. cases % Rongelap and Utirik 375 103 27.5 29 7.5 Female Male 195 180 48 26.7 17 9.4 Obese Non-obese 196 136 58 22 29.6 16.2 18 10 9.2 7.4 Utirik 201 37 28.4 Residing at** Majuro Ebeye Rongelap Utink 120 116 38 81 37 29 16 21 30.8 25.0 27.6 25.9 Rongelap 174 51 25.9 46 10 5.1 26.4 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 evidencefor increased retinopathy or peripheralvascular disease among the diabetics. The disease more closely resembles maturity onset diabetes with absence of acute symptoms, ketosis, and absolute dependenceon insulin treatment. The data do not suggest any differences between Rongelap and Utirik people (genetics) or between places of residence (environmentalinfluence), and there is no evidence that radiation exposure has played a part in the pathogenesis. The differences in diet and general living conditions between the “outer islands” and the district centers are considerable and might well play a significant role in pathogenesis. However, analysis of this factor is difficult because of the mobility of the people, who *Includes 10 subjects from other atolls, married to Ron- gelap 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.®# Although some previous reports haveindicated a high incidence3diabetes in somePolynesian. populations,®-69 ‘others have suggested a_ low. incideri¢e.68-70 * Theoverall incidenteof cialwas 2d, and ~ % ofStesgpperiontsWire u ab- normality. The ave age oF Ss was considerably greater jp that ofchigsnotidfabetics. The disease ap take asc thmales a in femalacone definite, statement “musta await completion of thedata anafysis. Obéiity was much more common in womenthanin from the data before these observations can be ren, and the data indicate an inéreasedindidenice:amgpg 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 preliminaryresults are considered to be of sufficient interest to warrant a more careful and complete investigation. Additional observations will be madeto provide the missing information and to obtain moreobjec- tive data regarding the incidence of neuropathy, cataracts, and retinopathy in these patients. The insulin response to a glucose challenge would also be of interest in assessing someofthe factors that might be importantin the etiology of diabetes in the Marshall Islands. The examinations are by necessity restricted to Rongelap and Utink people. When the Eniwetok and Bikini people return to their homeislands in sufficient numbers, the diabetes investigations may be expanded to cover these groups. obese subjects. riers thaip vite beghuch FforeGom-~ i Song tl bug H. CHROMOSOME AND GENETIC STUDIES of the diabetic population. No definite difference was 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 percent of the dia- 1. Studies of Chromosomesfor Radiation Effects monin the didBetics ; this would¥ertairffy bein Rekted In 1964 chromosome preparations were obtained from lymphocytes cultured from the pen ph- eral blood of 43 exposed (21, age <20: 22. age