Diabetes in the melanesian and indian peoples of Fiji: a study of risk factors

Summary Epidemiological risk factor patterns for diabetes mellitus determined by hemoglobin A 1 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 age 2 a predictor in Indians of elevated hemoglobin A 1 ( χ 2 = 7.8, P χ 2 = 25.3, P 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 A 1 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 A 1 and severe hyperglycemia suggest that elevated hemoglobin A 1 may constitute a useful screening test for ‘high risk’ diabetic subjects.