NON-INSULIN-DEPENDENT DIABETES-MELLITUS I N POPULATIONS AT RISK - THEPIMA-INDIANS

Pima Indians have the highest prevalence of non-insulin-dependent diab etes mellitus reported in the world. reaching 70% in the 55-64 year ag e-group. Although obesity is also quite prevalent in this population, it cannot in itself be held responsible for the high frequency of the disease. Profound changes in the way of life of the Pima Indians durin g the past century have been associated with the emergence of diabetes . A genetic susceptibility in this population probably explains why di abetes became an ''epidemic''. Compared to Caucasians with similar deg rees of obesity and glucose tolerance, Pima Indians are insulin-resist ant. This characteristic, which is a strong predictor of diabetes, see ms to be genetically determined in this population, and an active sear ch for the gene(s) involved has started. Surprisingly, for an insulin- resistant population, cardiovascular mortality is low in Pima Indians. An understanding of the similarities and differences between diabetic Caucasians and Pima Indians is one means of advancing our knowledge o f non-insulin-dependent diabetes mellitus and insulin resistance.