South African Indians Show a High Prevalence of NIDDM and Bimodality in Plasma Glucose Distribution Patterns

doi:10.2337/diacare.17.1.70

South African Indians Show a High Prevalence of NIDDM and Bimodality in Plasma Glucose Distribution Patterns

Mahomed A K Omar, MD, FRCP, FCP,
Mahomed A Seedat, MB, BS, FRCP,
Robin B Dyer, MB, CHB, MRCP,
Ayesha A Motala, MB, CHB, MRCP,
Lucinda T Knight, BAPPSC and
Peter J Becker, PHD

Diabetes Unit, Department of Medicine, University of Natal Congella, South Africa International Diabetes Institutes Caulfield, Australia Department of Biostatistics, South African Medical Research Council Congella, South Africa

Address correspondence and reprint requests to Mahomed A.K. Omar, MD, FRCP, FCP, Department of Medicine, University of Natal, P.O. Box 17039, Congella, 4013 South Africa.

Abstract

OBJECTIVE To determine the prevalence of diabetes mellitus and impaired glucose tolerance (IGT) and to test for bimodality in the plasma glucose distribution in South African Indians.

RESEARCH DESIGN AND METHODS Subjects were selected by systematic cluster sampling in various areas of Durban. They underwent a modified glucose tolerance test whereby fasting and 2-h postglucose (75 g) plasma glucose levels were measured. The program MIX was used to test for bimodality in the plasma glucose distribution.

RESULTS We tested 2,479 subjects (1,441 women and 1,038 men). Based on the revised World Health Organization criteria, the crude prevalence of diabetes mellitus was 9.8%, and the crude prevalence of IGT was 5.8%; the age- and sex-adjusted prevalence was 13.0 and 6.9%, respectively. IGT was significantly more common in men (7.6%) than in women (4.4%). Obesity was a feature of both diabetes mellitus and IGT, particularly in women. Both fasting and 2-h plasma glucose values did not conform to a single normal distribution pattern in any age-group, whereas unequivocal evidence of bimodality was seen in the 55- to 74-year age-group of both sexes for fasting and 2-h glucose and also in the 2-h levels of men in the 25- to 34-year age-group.

CONCLUSIONS This study has highlighted a high prevalence of non-insulindependent diabetes mellitus in South African Indians and bimodality in the plasma glucose distribution.