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