Diabetes mellitus in an urbanized, isolated Polynesian population. The Funafuti survey.

An epidemiologic study of diabetes in the urbanized Polynesian population of Funafuti has established a prevalence of 8 per cent in subjects aged 10 years and over. Of these, 0.9 per cent were known diabetics, and the remainder were diagnosed on the basis of a plasma glucose level of at least 160 mg./100 ml. two hours after a 75 gm. glucose load. A further 5.9 per cent had borderline diabetes as judged by a two-hour postload plasma glucose of 140-159 mg./100 ml. In those aged 20 years and over, the prevalence of diabetes was 10.1 per cent, similar to that reported in other acculturated Polynesian groups. The prevalence of both borderline diabetes and frank diabetes was twice as high in the females as in males. This difference appeared to be related to the greater degree of obesity in the females, but the prevalence was not related to parity. The increase in frequency of diabetes among these islanders coincides with a change of traditional island life style to that of urbanized Western populations. The results suggest that there may be 10 times the actual number of known diabetics in some Pacific populations.

Nutrient intake in a partly westernized isolated Polynesian population: the Funafuti survey.

Dietary data were obtained from 110 adult Polynesians (indigenous Funafutians) during a diabetes epidemiologic survey in Tuvalu. Funafuti (the main island of Tuvalu) was chosen as representative of partly urbanized population that has seen progressive socioeconomic changes in the previous 30 yr. The distribution of calories in the Funafuti diet is almost identical to that reported in the urbanized Micronesian population of Nauru and in Caucasian populations. Prevalence of diabetes was found to be five times higher than that reported in caucasian populations. Similarly, the prevalence of hypertension was 11% (equal to Caucasian figures), whereas hypertension is virtually unknown in traditional-living populations. Prevalence of diabetes, and degree of obesity, is significantly greater in women than in men. It is possible that this Polynesian group may have a genetic susceptibility to diabetes, which may have been unmasked by change from a traditional to western life-style. Marked obesity is now a characteristic of many Polynesian and Micronesian populations, and must rank as a major causative factor for the diabetes and hypertension explosion.

An improved method for the purification of retinal S-antigen using selective hydrophobic adsorption chromatography.

This paper describes the use of phenyl-Sepharose CL-4B as a solid-phase hydrophobic adsorbent in the purification of S-antigen from protein extracts of bovine, porcine and human retina. Chromatographic conditions were ascertained whereby the majority of contaminating proteins were bound to the adsorbent leaving S-antigen in the liquid phase. In combination with size fractionation on Ultrogel AcA, the method conveniently yielded porcine and bovine S-antigen preparations up to 100% purity. Immunogenicity of purified S-antigens was verified by induction of experimental autoimmune uveoretinitis in albino Lewis rats. The method is preparative in scale, fast in performance and yields S-antigen in high purity and antigenic potency.

Asthma management: how effective is it in the community?

BACKGROUND: The National Asthma Campaign (NAC) was launched in Australia in 1989 with the major objective of improving asthma management through the implementation of a six-step asthma management plan. AIM: The objective of the present study was to analyse the management of asthma in a cohort of adults with self-reported asthma 10 years after the commencement of the NAC. METHODS: The subjects were participants in the laboratory phase of a cross-sectional epidemiological study conducted in Melbourne in 1999-2000. Participants completed the detailed European Community Respiratory Health Survey, which included specific questions about their asthma management. Participants were included in this analysis if they had a positive response to the question 'Have you ever had asthma?'. This resulted in a total of 435 subjects. RESULTS: Of the subjects with self-reported asthma, over half of the participants reported that a doctor had ever measured their breathing (52.9%). However, only 10.1% of participants reported that they owned a peakflow meter (PFM) and only 13.3% reported that they had ever been given a written action plan. In comparison with data reported from 1993, doctor measurement of lung function has decreased significantly (P < 0.000 1), as has PFM ownership (P < 0.0001) and, importantly, possession of a written action plan (P = 0.0004). CONCLUSIONS: Asthma management among adults still falls well short of NAC guidelines. The decline in some key features over recent years suggests that new management and dissemination strategies are required.