Prior to the COVID-19 crisis, rates of diabetes and other chronic diseases were already high in the US-affiliated Pacific islands, regional health officials told the Rotary Club of Northern Guam on Wednesday.
But with many of the more than 100 deaths from COVID-19 in Guam linked to diabetes, the need to control diabetes has become much more urgent, they said.
Two officials from the Pacific Island Health Care Workers Association, or PIHOA, shared with Rotarians how prevalent diabetes, hypertension, cancer, heart disease, obesity and other non-communicable diseases are in the US-affiliated Pacific islands.
These islands include Guam, CNMI, American Samoa, Palau, Marshall Islands, and the Federated States of Micronesia.
There is well-established documentation in Guam that comorbidities such as diabetes and other chronic illnesses increase the risk of death from COVID-19, according to Janet Camacho, PIHOA deputy director of programs and operations for Honolulu.
From 2001 to 2019, the number of diabetes cases “has increased steadily” and has become one of the leading causes of death in Guam, said Cerina Mariano, PIHOA program and administrator of Guam operations.
This is based on data from the Guam Department of Public Health and Social Services, he said.
The behavioral risk survey, he said, also showed that 84% of respondents said they had never been told by a doctor that they had diabetes.
“Since this is a self-report, it is most likely underestimated,” said Mariano.
Risk factors
In Guam, diabetes risk factors include age, ethnicity, and education as well as income, he said.
According to the survey, more men than women have diabetes, and those 55 and over make up 50% of those with diabetes, Mariano said.
As far as ethnicity goes, being a Pacific islander – compared to white, black, American Indian or Native Alaskan and other ethnic groups – means a much higher risk of being diagnosed with diabetes, he said.
Socio-economic factors such as education and income also play a role due to limited access to health services and affordable healthy food.
Diabetes and other chronic diseases are not only common among adults on Guam, but also tend to start at a young age.
“About 40% of youth in Guam in 2019 reported being overweight or obese, and that number has been increasing over the years,” said Mariano.
A hybrid survey over the past five years among most of the US-affiliated Pacific islands shows that the prevalence of diabetes in adults on these islands is much higher than in the United States.
That’s mainly because of the island’s geographic isolation and limited resources, Mariano said.
1 in 4 people are treated
Only about one in four of those diagnosed with diabetes are on treatment, and of those on treatment, less than 10% are controlled on the islands, Mariano said.
“The situation is big enough to attract international attention,” he said.
Through partners such as the World Health Organization, Mariano said, FSM can receive more than 9,000 doses of insulin for diabetes from a company in Denmark.
But even just bringing insulin to the islands is a challenge. It had to be sent to Australia first, and then sent to San Francisco and then Guam, and finally to FSM, Mariano said.
Control diabetes
Hermie Queja, president of the Rotary Club of Northern Guam, said they plan to help raise awareness about diabetes among young people and look forward to partnering with entities like PIHOA.
PIHOA officials say diabetes awareness, prevention and treatment programs need more help.
The simplest steps a person can take to prevent diabetes or control it is to eat a healthy diet and be physically active, Mariano said.
