34 Table 20 Diabetes Survey: Preliminary Results, 1974 Diabetes No. No. Glycosuria with normal blood sugar No. Group people* cases %o Cases % Rongelap and Utrkk 375 103 27.5 29 7.5 Female Male 195 180 48 26.7 17 9.4 Obese 196 58 29.6 18 9,2 31 25.9 Non-obese 136 22 Utirik 201 37 28.4 Residing at** Majuro 120 37 30.8 Rongelap Ebeye Rongelap Utirik 174 116 38 81 46 16.2 10 10 5.1 7.4 26.4 2925.0 16 21 27.6 25.9 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 dependence on insulin treatment. The data do not suggest any differences between Rongelap and Uunk peopie (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 significantrole in pathogenesis. However, analysis of this factoris difficult because of the mobility of the people, who *Includes 10 subjects from other atolls, married to Rongelap and Unirik peopie . **Includes both Rongeiap and Utirik people residing at constantly move between homeisland and the 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.88-70 are considered to be of sufficient interest to warrant a more careful and completeinvestigation. Additional observations will be made to provide the missing informationand 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 someof the factors that might be importantin the etiology of diabetes in the MarshallIslands. these locations. The overall incidence of diabetics was 26%, and ~ % of these patients were unawareoftheir abnormality. The average age of the diabetics was considerably greater than thatof the nondiabetics. The disease appears to be as commonin males as centers; the place where an individual is exam- ined may not be where he has spent the major part of, say, the last 10 years. Despite the limitations, the preliminary results The examinations are by necessity restricted to in females, but a definite statement must await Rongelap and Utink people. When the Eniwetok and Bikini people return to their homeislands in sufficient numbers, the diabetes investigations may be expandedto cover these groups. subjects. Cataracts seemed to be much more common in the diabetics than in the nondiabetics, but H. CHROMOSOME AND GENETIC STUDIES completionofthe data analysis. Obesity was much _ More common in women than in men, and the data indicate an increased incidence amongobese this would certainly be influenced by the older age 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 percentof the dia- 5006131 betics than of the nondiabetics had neuropathy. but,because of age differences and otherfactors previously stated, covariance must beeliminated from the data before these observations can be 1. Studies of Chromosomes for Radiation Effects In 1964 chromosome preparations were ob- tained from lymphocytes cultured from the peripheral blood of 43 exposed (21, age <20; 22, age