Asian patients attending a diabetic clinic.

Patients of Asian origin comprised 8% of the patients attending a diabetic clinic. Of the 201 Asian patients (120 male), 110 had been diabetic for more than five years, and although 141 were 40 to 60 years old, over one quarter had been aged under 40 at diagnosis. Thirty patients were being treated with insulin, but only eight were truly dependent on insulin compared with 18% of the white patients attending the clinic. Insulin was stopped in eight patients who were receiving insulin inappropriately; control was achieved by diet plus oral hypoglycaemics or diet alone. Over three years 37 patients were admitted with ketoacidosis but none was Asian. During the same period, however, five Asians were admitted in hyperosmolar coma. Asian diabetics have a low prevalence of insulin dependence, possibly related to genetic and environmental factors, and some may be treated with insulin inappropriately.