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