title: Diabetes in the Melanesian and Indian peoples of Fiji: a study of risk factors.
abstract: Epidemiological risk factor patterns for diabetes mellitus determined by hemoglobin A1 and fasting blood glucose criteria were compared in the biethnic (Melanesian and Indian) nation of Fiji. The 2 diagnostic criteria elicited essentially similar risk factor patterns in Indians but ranking of predictors was altered in Melanesians. By either criterion age was a dominant risk factor for diabetes in both ethnic groups with age2 a predictor in Indians of elevated hemoglobin A1 (chi 2 = 7.8, P less than 0.005) and fasting blood glucose (chi 2 = 25.3, P less than 0.0001). Age- and sex-adjusted prevalence of diabetes was higher in Indians than in Melanesians [RR = 2.5 (1.9-3.3)]. A positive family history was associated with increased risk of diabetes in both ethnic groups by the hemoglobin A1 criterion [pooled RR = 2.3 (2.0-2.6)] but was not significant in Melanesians under the fasting blood glucose criterion. A positive family history was a strong predictor of severe hyperglycemia in both ethnic groups. The relative risk for diabetes was greater in females [1.5 (1.2-9.1)], with no ethnic difference. There was no urban-rural difference in either ethnic group. The similar risk factor patterns for diabetes diagnosed by hemoglobin A1 and severe hyperglycemia suggest that elevated hemoglobin A1 may constitute a useful screening test for 'high risk' diabetic subjects.
authors: Diabetes Centre, Royal Prince Alfred Hospital, Camperdown, Australia.
authors: P L
authors: PL
authors: Hoskins
authors: D J
authors: DJ
authors: Handelsman
authors: T
authors: T
authors: Hannelly
authors: M
authors: M
authors: Silink
authors: D K
authors: DK
authors: Yue
authors: J R
authors: JR
authors: Turtle
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D005006:Ethnicity; D005260:Female; D005367:Fiji; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin