BMJ  2003;327:437-439 (23 August), doi:10.1136/bmj.327.7412.437

Education and debate

Prevention and control of diabetes in Pacific people

¹ Centre for Public Health Research, Massey University, Wellington Campus, Private Bag 756, Wellington, New Zealand

Diabetes is a major problem worldwide. Among Pacific people, prevention and control of diabetes lies in counteracting rapid changes in lifestyle and must take account of political and economic factors and social structure

The first 150 words of the full text of this article appear below.

Early studies clearly showed that while diabetes was virtually non-existent in populations indigenous to the Pacific maintaining a traditional lifestyle, the reverse was true for the urbanised Pacific populations.¹ In recent decades diabetes prevalence has increased rapidly over time in the indigenous people in the Pacific region (Polynesian, Melanesian, Micronesian), both in the Pacific islands and in countries such as New Zealand.² Epidemiological evidence indicates that prevalence is generally lowest in traditional Pacific environments, and is higher in both urban Pacific and adopted metropolitan environments; in the latter environments, prevalence is markedly higher in Pacific people than in white people. Prevalence has been increasing rapidly in all three environments, and Pacific people experience greater morbidity and more complications than white people with diabetes.

Genetic factors alone cannot explain these patterns, which are due to rapid changes in lifestyle and risk factors such as obesity, unhealthy diets, and physical inactivity that . . . [Full text of this article]

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