Protocol 1974
Continued
Page Five
wo
Since only a limited number of people can be examined during the MarchApril visit, it is deemed advisable to concentrate on the Marshall
Island populations, principally the Rongelap people living at Rongelap
Island, Ebeye and Majuro,
Sampling of the Utirik population will be
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 this time.
Of course, other studies of diabetes in
Micronesian and other Pacific Island groups will be used for comparison.
Dr. Kasino, a Trust Territory practitioner, has a strong interest in
diabetes in the Marshalls and may assist Dr. Field in this survey. A
hematological technician (Nelson 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 numba of people can be tested in this fashion
since such samples must be obtained reasonably early in the day. At ‘ater
times the samples are subject to unctrtainty regarding food consumption.
Dr, Field believes that if 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 obtan lean-mass-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 the
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@J at the University of
Michigan who had been in charge of the ABCC studies for his opinion.
Though he agrees that it is quite unlikely that such studies in the
Marshallese will be froitful? 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
of 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. Ne&f{° also recommends that at the time of
the blood drawing a brief physical exam for gross abnormalities also be
carried out on the children.
I will attempt to conduct this study which