The prevalence of diabetes mellitus and impaired fasting glucose/glycaemia (IFG) in suburban Katmandu : Ethnic aspect of a community-based study of native Nepalese and Tibetan immigrants during the democratic movements in 1990

To clarify the role of ethnicity and lifestyle in Type 2 diabetes, we reanlyzed the results of a study originally done in 1990 at the Jawalakhel Tibetan refugees camp and suburban Bhadrakali in Katmandu. A total of 539 Tibetan immigrants in Jawalakhel 20 years old or greater participated in this study, consisting of 236 males and 303 females, vs 121 males and 165 females who are native Nepalese (ethnic composition, Newar and Parbate Hindu) in Bhadrakali. BIood samples after overnight fasting were frozen for analysis in Japan. Not only the anthropometric status, total energy intake, and maximal oxygen uptake (V02 max), but also the fasting insulin and fructosamine were recorded. A diagnosis of diabetes was determined based on the new criteria of ADA-1997. Remarkably lower rates of diabetes and impaired fasting glucose (IFG) were found in Jawalakhel and Bhadrakali in 1990 (diabetes and IFG; 1.9 O/o and 1.3 O/o vs 1.4 O/o and 2.5 O/o, respectively) than were found in a more recent survey done by Singh and Bhattarai (2003). Fructosamine was in the normal reference range for all subjects. The fasting insulin and homeostasis model assessment of insulin resistance (HOMA"IR) did not differ between the sexes, however, the HOMA'IR values were significantly higher in Jawalakhel than in Bhdrakali. The total energy intake was significantly higher in Bhadrakali than in Jawalakhel. However, the prevalence of obesity was significantly higher in Jawalakhel than in Bhadrakali despite similar V02 max values in both communities. Our newly analyzed results provide baseline features for planning health care measures and establishing medical priorities for the modern citizens of Katmandu.