A study of diabetes in Asians.

The thesis is a clinical study of diabetes mellitus in Asians. CHAPTER 1: The subject is introduced and the literature reviewed. Aims are presented. CHAPTER 2: The prevalence of known insulin dependent diabetes is ascertained in Asian children. Although lower than that in White Caucasian children, this did not reach statistical significance. The prevalence of known diabetes in adults is ascertained and found to be higher in Asians, rising significantly above the age of 45 years. Asians in all age bands are also at significantly greater risk for developing non-insulin dependent diabetes. CHAPTER 3: The prevalence of diabetic complications is studied in a population attending the hospital diabetic clinic. Asians are shown to be at significantly higher risk for developing cataracts and kidney disease, and at lower risk for developing peripheral vascular disease and retinopathy. It is noted that heart vascular disease is higher, and cerebrovascular disease lower in Asians. CHAPTER 4: Non diabetic Asians (first degree blood relatives of non-insulin dependent diabetics, and those without such a family history) are shown to have lowered insulin sensitivity and hyperinsulinaemia. Possible mechanisms in the pathogenesis of diabetes in Asians are discussed. CHAPTER 5: Asian women are shown to have a significantly higher prevalence of gestational diabetes. A significant linear trend in the proportions of maternal complications is shown in Asians, across the glycaemic range following a third trimester oral glucose tolerance test. Foetal complications are shown to be higher at the extreme ends of the maternal glycaemic range. CHAPTER 6: The acute metabolic effect of an Asian meal in normal volunteers is shown as a significantly higher and prolonged degree of glycaemia and insulinaemia when compared to an equicaloric European meal. A high consumption of sweets and snacks is shown in Asian diabetics attending a clinic in general practice, and the sociocultural implications of eating habits are discussed. CHAPTER 7: Summary and conclusions are presented.