Progress of impaired glucose tolerance to diabetes mellitus among Niueans.

Noninsulin dependent diabetes mellitus (NIDDM) is a major public health problem among Polynesians in the South Pacific. The prevalence of NIDDM on Niue Island is higher than other Pacific Islands and is increasing. NIDDM is preceded by a state of impaired glucose tolerance in some cases. Progress to NIDDM is associated with certain factors that are modifiable. In 1980, the South Pacific Commission conducted a metabolic disease survey on Niue. Sixty-one people were diagnosed as having impaired glucose tolerance. In 1985, 48 of these people (all those still on the island) were reexamined. Demographic, biological and indicators of westernisation were recorded. Thirty-one percent (6% per year) had progressed to diabetes mellitus. This was higher than rates described elsewhere but comparable with the rates described among the Pima Indians. Younger age, skilled occupations, high socioeconomic status and higher overall modernity were associated with progression to NIDDM.