Continued Protocol 1974 Page Five Since only a limited number of pcople can be examined during the March- April visit, it is deemed advisable to concentrate on the Marshall Island populations, principally the Rongeclap people living at Rongelap Sampling of the Utirik population will be Island, Ebeye and Majuro. carried out to the extent possible. In order to evaluate the genetic component, sampling of other ethnic groups would be desirable but the logistics and time involved in a study at a distant island preclude feasibility at chis time. Of course, other studies of diabetes in Micronesian axa other Pacific Island groups will be used for comparison. Dr. Kasino, a Trust Territory practitioner, has a strong interest in diabetes in the Marshalls anc wy assist Dr. Field in this survey. A hematological techni - «. (Neison Zeditka) will also assist. From discussions with Dr. Field the following procedures are being considered: Ideally a fasting blood sugar specimen would be drawn followed by a glucose meal and 2 hrs later another sample drawn for blood sugar, However, only a limited numbaof people can be tested in this fashion since such samples must be obtained reasonably early in the day. At later times tuc samples are subject to uncertainty regarding food consumption. Dr. Field believes that iz sampling only after the glucose meal means substantially larger numbers of people sampled (which seems likely), then this procedure should be considered at Utirik and where extra numbers of people are wanted. He believes the results using the l-stick method may tend to slightly underestimate the incidence of diabetes. It is hoped that urine samples for sugar test can be obtained before and after the glucose meal. Obesity and cataract formation as related to diabetes will be evaluated. Obesity may be further evaluated in a limited number of cases by whole-body counting of 40K measurements to obtdn lean-rass-fat ratios on those people with positive urine sugars. In the Rongelap series cholesterol and triglycerides will be run on plasma samples returned to BNL. Samples of diet being obtained for radiochemical analysis and iodine content may also be examined for carbohydrate, protein, fat content, Dr. Field is working on a questionnarie to be filled out by all subjects in this study concerning family history of diabetes, dietary habits, etc. Genetic Effects of Radiation: The generally negative results of rhe ABCC genetic studies of first generation children Japanese exposed to the A-bombs quelled our interest in such studies on the small Rongelap population. However I recently wrote Dr. James Ne@} at the University of Michigan who had been in charge of the ABCC studies for his opinion. Tnough he agrees that it is quite unlikely that such studies in the Marshallese will be fruitful) Since he is carrying out a battery of tests for metabolic defects in the red cells and serum of blood in the Japanese children, he is willing to carry out these same tests on the Marshallese children of exposed parents and the parents and also on an equal number o. children of unexposed parents and their parents. In addition he recommends analysis for sex chromosome aberrations in buccal smears. We would obtain the smears and they would be analyzed by Dr. Arthur Bloom, also at the U. Michigan. Dr. Neef also recommends that at the time of the blood drawing a brief physical exam for gross abnormalities also be carried out on tne children. I will attempt to conduct this study which sor3els