The high prevalence of impaired glucose tolerance and diabetes mellitus in an isolated Polynesian population, Manihiki, Cook Islands

An epidemiologic survey of 133 adult Polynesians of Manihiki Atoll, Cook Island group, revealed a high prevalence of diabetes mellitus (males 8.0 percent, females 10.3 percent) and impaired glucose tolerance (males 8.0 percent, females 31.0 percent). Those with abnormal glucose tolerance were older, more obese, and engaged in less physical activity than normals. The females had a higher prevalence of both diabetes and impaired glucose tolerance than the males. Although Manihiki is geographically isolated, the islanders have a good income from copra and pearl shell. The change from a traditional to a modern way of life in a population with an increase susceptibility to diabetes is the probable cause of the high prevalence of abnormal glucose tolerance. The change in living patterns is a consequence of change from a subsistence existence to involvement in the cash economy.