Prevalence of diabetes and impaired glucose tolerance in the biracial (Melanesian and Indian) population of fiji: A rural-urban comparison

Zimmet P. (WHO Collaborating Centra for the Epidemiology of Diabetes Mel-Iitus, Melbourne, Australia), R. Taylor, P. Ram, H. King, G. Sloman, L R. Raper and D. Hunt. Prevalence of diabetes and Impaired glucose tolerance In the blraclal (Melaneslan and Indian) population of FIJI: a rural-urban comparison. Am J Epidemiol 1983; 116: 673-88.Rural-urban and ethnic comparisons of impaired glucose tolerance and diabetes mellitus were made in the biracial population of FIJI in 1980. No statistically significant differences existed In age-standardized impaired glucose tolerance prevalence between rural and urban groups or between Melaneslans and Indians. The age-standardized prevalence of diabetes in the rural Melanesian male population was one-third that of the urban male population (1.1 vs. 3.5%). In females, there was a sixfold rural-urban difference (1.2 vs. 7.1%). By contrast, rural and urban Indians had similar rates (12.1 vs. 12.9% for males; 11.3 vs. 11.0% for females). Standardization of two-hour plasma glucose for age and obesity did not eliminate the rural-urban difference in plasma glucose concentration for Melaneslan males and females. The results in Melaneslans confirm previously reported rural-urban diabetes prevalence differences, and suggest that factors other than obesity, such as differences in physical activity, diet, stress, or other, as yet undetermined, factors contribute to this difference. The absence of a rural-urban difference in diabetes prevalence in Indians may suggest that genetic factors are more Important for producing diabetes in this ethnic group, or that causative environmental factors such as diet operate similarly upon both the rural and the urban populations.