Diabetes mellitus in the African is compared with the disease in Western populations, where secondary diabetes is uncommon, and primary diabetes is often familial, and can usually be classified as growth-onset and insulin-dependent, or as maturity-onset and insulin-resistant, and particularly liable to vascular complications.
In contrast, amongst 107 newly diagnosed African patients admitted consecutively to Harare Hospital during a 1-year period, five patients had diabetic relatives, and in thirty-four patients, diabetes was clearly secondary to pancreatic and hepatic disease. A high proportion (72%) of the remaining maturityonset patients were found to be insulin-dependent, so that their diabetes may also have been secondary to pancreatic disease. Vascular complications seldom occurred.
After standardizing this population for sex and age, the modal age for onset of diabetes remained earlier than in Britain. Male patients were underweight and female patients overweight compared with healthy contrast groups. The proportion of diabetic patients in skilled occupations, living in urban areas, and with large numbers of children was no greater than for agematched non-diabetic hospital inpatients.
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