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  • 1
    Electronic Resource
    Electronic Resource
    The prevalence of diabetes mellitus and impaired glucose tolerance in melanesians and part-polynesians in Rural New Caledonia and ouvea (Loyalty Islands) (1982)
    Springer
    Diabetologia 23 (1982), S. 393-398 
    Details
    ISSN: 1432-0428
    Keywords: Impaired glucose tolerance ; diabetes mellitus ; prevalence ; Melanesian ; Polynesian ; glucose tolerance ; genetics ; environment ; rural ; urban
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The study of different ethnic groups living in the same physical environment provides the opportunity to examine interaction of genetic and environmental factors in the aetiology of diabetes mellitus. In rural New Caledonia, the prevalence of diabetes was higher in part-Polynesians than in Melanesians: males — 6.6 versus 0.5%; females — 6.3 versus 3.5% respectively. The prevalence of abnormal glucose tolerance (impaired glucose tolerance and diabetes) was 11.5 and 15.7% in part-Polynesian males and females, respectively, and 4.7 and 9.2% in Melanesian males and females. Mean age and degree of obesity in these ethnic groups were sufficiently similar to suggest that these factors played no significant role in the difference in diabetes prevalence. Furthermore, adjustment of relative risk of impaired glucose tolerance and diabetes for age and obesity indicated that the modest differences between groups were not responsible for the observed variation in diabetes prevalence. The differences in prevalence of impaired glucose tolerance and diabetes between Melanesians and part-Polynesians may be genetically determined, although the role of certain environmental factors other than obesity, e.g. differences in physical activity or qualitative aspects of diet, cannot be excluded.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00260949
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  • 2
    Electronic Resource
    Electronic Resource
    Familial predisposition to renal disease in two generations of Pima Indians with Type 2 (non-insulin-dependent) diabetes mellitus (1990)
    Springer
    Diabetologia 33 (1990), S. 438-443 
    Details
    ISSN: 1432-0428
    Keywords: Type 2 (non-insulin-dependent) diabetes mellitus ; American Indians ; diabetic renal disease ; genetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied the occurrence of renal disease by measuring serum creatinine and urine protein concentrations in the diabetic members of 316 Pima Indian families with Type 2 (non-insulin-dependent) diabetes in two successive generations to determine if diabetic renal disease aggregates in families. After adjustment for sex and other risk factors, proteinuria occurred among 14.3% of the diabetic offspring if neither parent had proteinuria, 22.9% if at least one diabetic parent had proteinuria, and 45.9% if both parents had diabetes and proteinuria. Among male offspring, an elevated serum creatinine concentration (≥177 μmol/l) was present in 11.7% if the parent had an elevated creatinine and in 1.5% if the parent did not. Thus, proteinuria and high serum creatinine aggregated in diabetic families, suggesting that susceptibility to renal disease is inherited independently of diabetes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00404096
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Diabetic nephropathy: a risk factor for diabetes mellitus in offspring (1995)
    Springer
    Diabetologia 38 (1995), S. 221-226 
    Details
    ISSN: 1432-0428
    Keywords: Familial aggregation ; diabetes mellitus ; nephropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Both non-insulin-dependent diabetes mellitus and diabetic nephropathy show familial aggregation. If diabetes and renal disease have independent determinants (genetic or otherwise), offspring of parents with diabetic renal disease should have a similar risk of diabetes to those offspring of parents with diabetes alone. To test this hypothesis, the prevalence of diabetes was examined in a population-based pedigree study in Pima Indian offspring of three mutually exclusive parental types: 1) diabetic with renal disease, 2) diabetic, but without renal disease and 3) non-diabetic. Among offspring of one diabetic parent and one non-diabetic parent (n=320) the prevalence of diabetes at ages 15–24 years and 25–34 years was 0% and 11%, respectively if the diabetic parent did not have renal disease compared with 6% and 28% respectively if the diabetic parent did have renal disease. Corresponding rates for offspring of two diabetic parents (n=121) were 10% and 17%, respectively if neither parent had renal disease compared with 30% and 50%, respectively if one parent did have renal disease. The presence of renal disease in a parent with diabetes relative to diabetes alone was associated with 2.5 times the odds of diabetes (95% confidence interval 1.4–4.3) in the offspring controlled for age, age at onset of parental diabetes and diabetes in the other parent using logistic regression. These findings provide support for parental diabetic renal disease, independent of age at onset of parental diabetes, conferring an increased risk for diabetes in the offspring. The results are compatible with the hypothesis that the susceptibility to renal disease in the parents and to diabetes in the offspring are due to shared familial environmental factors or to the same gene or set of genes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400098
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  • 4
    Electronic Resource
    Electronic Resource
    Diagnosing diabetes mellitus – do we need new criteria? (1997)
    Springer
    Diabetologia 40 (1997), S. 247-255 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Diabetes mellitus ; diagnosis ; oral glucose tolerance test ; fasting plasma glucose ; 2-h plasma glucose ; haemoglobin A1c ; retinopathy ; nephropathy ; complications.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The current classification and diagnostic criteria for diabetes mellitus were introduced by the United States National Data Group in 1979 and endorsed by the World Health Organization in 1980, with modifications in 1985 and 1994. The criteria, chosen to reflect the risk of complications, were the synthesis of considerable thought and expertise and represented a consensus which, it was hoped, would prove helpful to all those involved with diabetes – practising clinician, research scientist and epidemiologist alike. The inconvenience, variability and nonphysiological nature of the oral glucose tolerance test (OGTT) are well-recognised. In spite of these limitations the 2-h post-load plasma glucose has remained the standard against which all other tests have been evaluated. This article reviews the original justification for the OGTT, and in the light of more recent epidemiological research seeks to place the current diagnostic criteria for diabetes into a pathophysiological, diagnostic and prognostic perspective. [Diabetologia (1997) 40: 247–255]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050671
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  • 5
    Electronic Resource
    Electronic Resource
    HLA-A2 and Type 2 (insulin independent) diabetes mellitus in Pima Indians: An association of allele frequency with age (1981)
    Springer
    Diabetologia 21 (1981), S. 460-463 
    Details
    ISSN: 1432-0428
    Keywords: Type 2 diabetes ; HLA-A2 ; age association ; Pima Indians ; diabetes ; genetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In Pima Indians with Type 2 (insulin independent) diabetes mellitus, HLA-A2 allele frequencies were inversely associated with age, (0.72, 0.59, and 0.52 in those less than 35, 35 to 54, and 55 years old and over, respectively). This suggests that there may be a gene closely linked with the HLA-A locus which plays a role in the expression of diabetes in the Pimas by contributing to an earlier age of onset. HLA-A2 was found in 65% of 69 non-diabetic and 81% of 191 diabetic subjects (relative risk = 2.2).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00257786
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  • 6
    Electronic Resource
    Electronic Resource
    Increasing prevalence of Type II diabetes in American Indian children (1998)
    Springer
    Diabetologia 41 (1998), S. 904-910 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Prevalence ; epidemic ; children ; Type II diabetes ; obesity ; diabetic pregnancy.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Until recently, Type II diabetes was considered rare in children. The disease is, however, increasing among children in populations with high rates of Type II diabetes in adults. The prevalence of Type II diabetes was determined in 5274 Pima Indian children between 1967 and 1996 in three 10-year time periods, for age groups 5–9, 10–14 and 15–19 years. Diabetes was diagnosed using World Health Organisation criteria, based on an oral glucose tolerance test. The prevalence of diabetes increased over time in children aged 10 years and over: in boys from 0 % in 1967–1976 to 1.4 % in 1987–1996 in the 10–14 year old age group, and from 2.43 % to 3.78 % for age group 15–19 and in girls from 0.72 % in 1967–1976 to 2.88 % in 1987–1996 in the 10–14 year old age group, and from 2.73 % to 5.31 % for age group 15–19 years. Along with the increase in the prevalence of Type II diabetes (p 〈 0.0001), there was an increase in weight (calculated as percentage of relative weight, p 〈 0.0001), and in frequency of exposure to diabetes in utero (p 〈 0.0001). The increasing weight and increasing frequency of exposure to diabetes in utero accounted for most of the increase in diabetes prevalence in Pima Indian children over the past 30 years. Type II diabetes is now a common disease in American Indian children aged 10 or more years and has increased dramatically over time, along with increasing weight. A vicious cycle related to an increase in the frequency of exposure to diabetes in utero appears to be an important feature of this epidemic. [Diabetologia (1998) 41: 904–910]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250051006
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  • 7
    Electronic Resource
    Electronic Resource
    Changing glomerular filtration with progression from impaired glucose tolerance to Type II diabetes mellitus (Short Communications) (1999)
    Springer
    Diabetologia 42 (1999), S. 90-93 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Diabetic Renal Disease Study ; glomerular filtration rate ; impaired glucose tolerance ; Type II diabetes ; Pima Indians.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Glomerular filtration rate (iothalamate clearance) was measured serially for 48 months in 26 Pima Indians with impaired glucose tolerance and 27 with normal glucose tolerance. At baseline, the mean glomerular filtration rate (SEM) was 133 ± 8 ml/min in subjects with impaired glucose tolerance and 123 ± 5 ml/min in those with normal glucose tolerance (p = 0.12). In the 12 subjects with impaired glucose tolerance who progressed to Type II (non-insulin-dependent) diabetes during follow-up, mean glomerular filtration rate increased by 30 % (p = 0.011). Among the remaining 14 subjects with impaired glucose tolerance, 12 reverted to normoglycaemia. The glomerular filtration rate both at baseline and after 48 months in this subgroup exceeded the values of subjects with normal glucose tolerance by 20 % (p = 0.008) and 14 % (p = 0.013), respectively. A pronounced rise in the glomerular filtration rate occurs at the onset of Type II diabetes but a trend to hyperfiltration is also present in those with impaired glucose tolerance. [Diabetologia (1999) 42: 90–93]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250051118
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    Paper (German National Licenses)
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  • 8
    Electronic Resource
    Electronic Resource
    Fasting and two-hour post-load glucose levels for the diagnosis of diabetes (1979)
    Springer
    Diabetologia 16 (1979), S. 373-379 
    Details
    ISSN: 1432-0428
    Keywords: Two-hour plasma glucose ; fasting plasma glucose ; bimodality ; oral glucose tolerance tests ; Pima Indians ; diagnosis ; diabetes ; sensitivity ; specificity ; misclassification ; retinopahy ; nephropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The frequency distributions of both the fasting and two-hour post-load plasma glucose levels were bimodal in the Pima Indian population aged 25 years and over. The hyperglycaemic component of this distribution represents those with diabetes mellitus, as some 30 percent of this group had evidence of the specific vascular complications of the disease, whereas these abnormalities were virtually absent in those with lower glucose levels. The bimodal characteristics of the frequency distributions were utilized to define optimal criteria to separate those with and without diabetes. The sensitivity and specificity of these criteria for fasting and two-hour glucose levels were compared and were found to be similar. The fasting glucose determination, however, was more reproducible and stable, as well as being easier to obtain, indicating that it is the better measurement for diagnostic purposes. The optimal level for diagnosis of 7.5 mmol/l (136 mg/dl) for the fasting glucose and the equivalent two-hour value of 14 mmol/l (250 mg/dl), were higher than many previously recommended diagnostic levels. Nevertheless, there was no evidence that subjects with lower levels were at appreciable risk of developing the specific complications of diabetes. Subjects with impaired glucose tolerance (IGT), but without fasting hyperglycaemia, shouldnot be diagnosed as having diabetes mellitus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01223157
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