Increased waist size and weight in relation to consumption of Areca catechu (betel-nut); a risk factor for increased glycaemia in Asians in East London

Type 2 diabetes is commoner in Asians than Caucasians. Many nitrosamines ar e diabetogenic, causing both type 2 and type 1 diabetes. Of CD1 mice fed wi th betel-nut or associated nitrosamines 8.5 % develop glucose intolerance w ith marked obesity. Glycaemia and anthropometric risk markers for type 2 di abetes were therefore examined in relation to betel usage in 993 'healthy' Bangladeshis by one bilingual research-worker (N.M.). Of these, 12 % had kn own diabetes. A further 145 of 187 subjects 'at-risk' of diabetes (spot glu cose > 6.5 mmol/l < 2 h after food, or > 4.5 mmol/l > 2 h after food) had a second blood glucose sample taken; sixty-one were confirmed as 'at-risk', and had an oral glucose tolerance test; nine new diabetics were identified. Multiple regression analysis showed that spot blood glucose values decreas ed with time after eating (P = 0.0005) and increased independently with wai st size (P = 0.0005) and age (P = 0.0005) without relationships to other as pects of the diet, season or smoking. Waist size was strongly related to be tel usage independent of other factors such as age. Betel use interacted wi th sex, relating to increasing glycaemia only in females. Since waist and a ge were the major markers of increasing glycaemia we suggest that betel che wing, a habit common to about 10 % of the world population (more than 200 m illion people) may contribute to the risk of developing type 2 diabetes mel litus.