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[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC – safer, healthier people.

[Dan Hazlewood] Welcome to this podcast on the Rising Tide of Diabetes Among Pacific Islanders. I’m your host, Dan Hazelwood. With me today is Dr. Jane Kelly from the National Diabetes Education Program, a joint program of the Centers for Disease Control and Prevention and the National Institutes of Health. Dr. Kelly, tell us about diabetes and Pacific Islanders.

[Dr. Kelly] Diabetes is on the rise all over the world. Almost 21 million Americans have diabetes. And if you look at how diabetes is devastating Native Hawaiians and Pacific Islanders in the U.S., the numbers are really shocking. For example, diabetes prevalence is two and a half times higher among Native Hawaiians compared to white residents of Hawaii. In the Marshall Islands, almost 30 percent in adults age 25-64 have diabetes. And in America Samoa, diabetes affects about 50 percent of the adults in this age group.

[Dan Hazlewood] Joining us by phone is Dofi Faasou, a Tongan Somoan woman living in Utah whose family has been deeply affected by diabetes. Dofi, tell us about your family’s experience.

[Ms. Faasou] Well, I guess I would say it’s hereditary. We saw how it affected my grandparents, then my parents. And unknowingly, growing up we just thought it’s just another, in our community, we considered it another old folks illness and it wasn’t until our, my own siblings got it, and they got it in their early twenties, that we finally took notice of it and saw the real effects of having diabetes. Every one of my siblings have it. And then my my two sisters are also being “dialysized.” I have my other relatives, first cousins that have gone blind. Which we thought a brother of ours would go blind first, but just recently, he got his leg amputated, not once, but they had to amputate his legs, that one leg, his left, leg three times. And we’re trying to put together some kind of documentary of what it has done to the lives, to my family, and the lives of my siblings. We wish that someone had educated us more, and raised an awareness when we were younger. And so we wanted to share this message with our youngsters. Change your diet. And our people they love to eat. Their theory is “Eat drink and be merry for tomorrow we die.” That type of thinking has got to be modified now. To live longer, we need to eat right. The people in our Pacific Islanders love buffets, they’ll go to buffets. We have to really change our diets. Go back to the way our ancestors used to eat: fish, taro, at its natural form not with the coconut milk. And it’s the coconut – the richness in this milk that is literally killing our people. If we just go back to the diet of our ancestors and allow that, you know, eat it in its natural form. Exercise is another thing. And people are walking less than they ever done before. If we go back to our lifestyles which our ancestors had lived. Walk a little bit more, eat a little less, eat right, and eat a lot of fruits and vegetables. Greens, fresh greens. My people have got to know that life’s too short and they are only cutting it short if they do not watch out what they eat, if they do not exercise, and most especially, if you really love your loved ones, if you see someone that’s not eating right, you know, talk to them, and tell them – it’s all about raising this awareness.

[Dan Hazlewood] Thank you, Dofi, for sharing your story with us. Dr. Kelly, why is there such an epidemic of diabetes among Pacific Islanders?

[Dr. Kelly] It’s a combination of several factors. The U.S. Navy did a health survey in the Pacific just after World War II, and found no cases of diabetes among Pacific Islanders - zero. Now, Pacific Islanders have one of the highest rates of diabetes in the world. So what happened? Before World War II, Pacific Islanders lived traditional lifestyles, with diets high in fish, fruits and vegetables, with lots of physical activity from fishing, farming, and simply walking. Many Pacific Islander communities underwent radical, rapid changes in diet and physical activity after the war. Fried food, imported high fat canned meats, processed food snacks, and sweetened drinks became a way of life and replaced healthier choices. Pacific Islanders now have some of the highest rates of obesity in the world.

[Dan Hazlewood] Does obesity cause diabetes?

[Dr. Kelly] Well, not everyone who is overweight or obese develops diabetes and not everyone with diabetes is overweight, but the two do seem to go hand-in-hand. Overweight, unhealthy food choices, low physical activity, and family history of diabetes are all risk factors for developing diabetes.

[Dan Hazlewood] So how serious is diabetes?

[Dr. Kelly] Diabetes is the number one cause of amputations, kidney failure, blindness in working age adults, and a big contributor to heart attack, the number one cause of death in America. Diabetes is devastating Pacific Islander communities. Many people have had to face a terrible choice: leave their Pacific Island homes to move to Hawaii or the mainland because they need dialysis for diabetic kidney disease, or stay home and die. Even those who do move to the mainland for better health care services may suffer complications because of poor control of blood glucose - or blood sugar, blood pressure, and cholesterol, and because they don’t get the preventive care services they need, such as dilated eye exams and comprehensive foot exams.

[Dan Hazlewood] Dr. Kelly, this is so overwhelming. What can be done?

[Dr. Kelly] While the statistics and stories are truly frightening, there is some good news. Most diabetes complications can be prevented. Keeping your blood glucose as close to normal as possible greatly reduces your risk of eye, kidney, and nerve disease. Blood pressure and cholesterol control are also very important in diabetes. If you think of diabetes as just a “sugar” disease you miss the big picture. High blood pressure and high cholesterol also contribute to cardiovascular disease, such as heart attack and stroke. We encourage people with diabetes to ask their health care team what they can do to control blood glucose, blood pressure, and blood cholesterol.

[Dan Hazlewood] Is it really possible to prevent diabetes?

[Dr. Kelly] Yes. Diabetes can be prevented or delayed; it is possible to turn back the rising tide of diabetes. People at high risk for diabetes are able to prevent or delay the disease by making some changes in what they eat and by walking more. This is true in people of all ethnicities, including Pacific Islanders.

[Dan Hazlewood] Tell us more about these lifestyle changes.

[Dr. Kelly] People who want to prevent diabetes need to be physically active. You might choose gardening, or swimming, or simply brisk walking. By walking 30 minutes a day, 5 days a week, and choosing to eat more lower fat foods, like fruits and vegetables, you can lose weight and prevent diabetes.

[Dan Hazlewood] You just told us that Pacific Islanders have some of the highest rates of obesity in the world. How much weight do you have to lose to prevent or delay diabetes?

[Dr. Kelly] Studies have shown that if you are overweight and at high risk for diabetes, you can prevent or delay the disease by losing just 5 percent of your weight. If you weigh 300 pounds, that’s just 15 pounds. You don’t have to lose huge amounts of weight to prevent or delay diabetes.

[Dan Hazlewood] But it’s not that easy to lose weight, even just 15 pounds.

[Dr. Kelly] No, it’s not easy to lose weight, but it can be done. And it must be done if we’re going to protect our children from a huge epidemic of diabetes in their generation. Many Pacific Islander communities are embracing a return to traditional foods: fruits and vegetables, fish, and drinking water – remember water? Kids can drink water instead of soda and sweetened juice drinks. And traditional activities, like dancing, swimming, walking, gardening, playing outside – these physical activities help to protect Pacific Islanders from diabetes.

[Dan Hazlewood] What’s the one take-home message you’d like to leave with our listeners?

[Dr. Kelly] Diabetes is devastating Pacific Islander communities. But there are things a person can do to prevent diabetes complications, and prevent or delay diabetes in the first place. We owe it to our children to stop the rising tide of diabetes. Find out what you can do. The National Diabetes Education Program has FREE materials on diabetes prevention and control in English and in 15 Asian and Pacific Islander languages, such as Samoan, Tongan, Chuukese, and Chamorro. Visit our website at www.YourDiabetesInfo.org or call toll-free 1-888-693-NDEP.

[Announcer] For the most accurate health information, visit www.cdc.gov or call 1-800-CDC-INFO, 24/7.