Glucose tolerance in Papua New Guinea: past and future studies

The ethnic and geographic diversity to be found in Papua New Guinea provide unique opportunities for the study of the epidemiology of glucose intolerance and diabetes. Whereas coastal populations have been influenced by successive waves of migrants of Austronesian origin, the Papua New Guinea highlanders were not influenced genetically by these people, and now represent one of the few non-Austronesian populations in the Pacific. Early studies in Papua New Guinea suggested that diabetes was not uncommon in coastal communities. Austronesian populations in other regions of the Pacific are also susceptible to glucose intolerance. Of particular interest, however, were the results of a diabetes survey conducted in a highland population in 1983. No diabetic subjects were discovered among over 300 examined. Further studies have now been planned, which aim to determine whether the apparent resistance of Papua New Guinea highlanders to glucose intolerance is genetically determined, or whether modernization of lifestyle will lead to the emergence of diabetes as a health problem in this region, as it already is in other areas of the Pacific. The future studies have been carefully designed, so as to define the relative importance of genetic and environmental components in the variability of glucose tolerance.