Gk. Dowse et al., EXTRAORDINARY PREVALENCE OF NON-INSULIN-DEPENDENT DIABETES-MELLITUS AND BIMODAL PLASMA-GLUCOSE DISTRIBUTION IN THE WANIGELA PEOPLE OF PAPUA-NEW-GUINEA, Medical journal of Australia, 160(12), 1994, pp. 767-774
Objective: To determine the current prevalence of impaired glucose tol
erance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) in Me
lanesians of three coastal Papua New Guinean communities, to relate th
is to previous studies, and to investigate plasma glucose distribution
s in these populations. Design: Cross-sectional survey, using 75g oral
glucose tolerance tests and World Health Organization criteria. Setti
ng: Rural Papuan villages of Wanigela and Kalo, and Wanigela people of
the urban squatter settlement of Koki, Port Moresby. Subjects: All ad
ults aged 25 years or more living in the three communities were eligib
le. with response rates of 77.2% (Koki), 88.1% (Wanigela) and 72.5% (K
alo). Main outcome measures: Prevalence of abnormal glucose tolerance,
risk factor levels, fasting and two-hour plasma glucose concentration
. Results: Age-standardised prevalence of NIDDM in Koki Wanigelas was
27.5% in men and 33.0% in women; an additional 20.5% of men and 22.0%
of women had IGT. Even in the youngest age group (25-34 years), 36.5%
of subjects had abnormal glucose tolerance. The overall prevalences of
NIDDM and IGT in rural Wanigelas were 11.7% and 17.0% respectively. I
n Kalo both were uncommon. The prevalences of IGT and NIDDM in Koki ha
d doubled over a 14-year period. The age-standardised prevalence of ab
normal glucose tolerance in the Koki Wanigelas is the second highest i
n the world after the Arizona Pima Indians, and higher than in Microne
sian Nauruans, even though the latter are more obese. Both fasting and
two-hour glucose concentrations in all age groups in Koki were clearl
y bimodal, a mixture of two log-normal distributions. Conclusions: The
Wanigela people of Papua New Guinea have an extraordinary susceptibil
ity to glucose intolerance which is exposed after adoption of modern l
ifestyle habits. A ''founder effect'' may explain the high frequency o
f a diabetogenic genotype in this population.