Diabetes Mellitus

The prevalence of diabetes among Native Hawaiian elders is 19.6%, more than twofold the prevalence among Caucasian elders (9.4%) (Salvail FR et al, 2003). Data on diabetes among other elderly populations by race is sparse. However, the prevalence of diabetes among nearly all Pacific Islander racial groups (all ages) is higher compared to the overall prevalence of 7% for the general U.S. population (American Diabetes Association, Accessed August 22, 2007). In the NHHR Project, the prevalence of Type 2 diabetes mellitus and impaired glucose tolerance among Native Hawaiians (ages > 30 years of age) was found to be 22.4% and 15.6%, respectively (Grandinetti et al., 1998). Among the elderly participants in the NHHR Project, the prevalence of diabetes and impaired glucose tolerance was found to be 33% and 22% respectively.

For the reported prevalence of diabetes mellitus among other Pacific Islanders groups please see the table below.

The Prevalence of Diabetes Mellitus
Among Other Pacific Islander Ethnic Groups

Pacific Islander Ethnic Group Prevalence of Diabetes
Chamorros (all age groups) 16.2% diagnosed with diabetes (Chiem et al., 2006).
Melanesians Prevalence of Type 2 diabetes in men 28% and in women 33% (Dowse et al., 1994).
Prevalance of  impaired glucose tolerance  was 21% in men and 22% in women. (Dowse et al., 1994).
Marshallese on the island of Ebeye Age-adjusted prevalence of diabetes was 27% (Yamada, Dodd, Soe, Chen, & Bauman, 2004).
Fijians Prevalence of diabetes was 12% (Okihiro & Harrigan, 2005).

Diabetes is currently recognized as a global health problem and this is consistent with the rising burden of diabetes reported among Polynesians (including Native Hawaiians) and Micronesians. For example, in Western Samoa, the incidence of diabetes increased from 0.1% to 5.3% among men residing in the rural community of Poutasi between 1978 and 1991 (Okihiro & Harrigan, 2005). Studies have also found that diabetes is especially on the rise among Polynesians, Micronesians and Melanesians who have prolonged exposure to more acculturated or westernized lifestyles compared to more traditional subsistence-based lifestyles (Okihiro & Harrigan, 2005; Papoz, Barny, & Simon, 1996). Unfortunately, nearly all of the published literature excluded the elderly and surveyed individuals between 30-64 years of age; thus, one must be cautious to generalize these data in the elderly population.


Summary

  • The prevalence of diabetes in Native Hawaiians and other Pacific Islander populations is higher than that seen in the general US population and is linked to several risk factors including but not limited to a westernized lifestyle.
  • Population-based studies among Native Hawaiians living in Hawaiii, found that among Native Hawaiian elders the prevalence of DM and impaired glucose tolerance was 33% and 22% respectively.