Diabetes is a health risk with Pacific Islanders in Utah

Story and photo by JANICE ARCALAS

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Jake Fitisemanu Jr., chair of the Utah Pacific Islander Health Coalition.

Type 2 diabetes is a health risk among Pacific Islanders in Utah. According to a Pacific Islander report done in 2011 by the Utah Department of Health,  the rate of Utah Pacific Islanders is at 13.7 percent. This is nearly double the statewide rate in Utah, which is at 6.5 percent.“The biggest risk factor for diabetes is being overweight or obesity which is a huge problem in Pacific Islanders,” said Dr. Kalani Raphael, a University of Utah associate professor of internal medicine, in an email interview. “Of course obesity is related to poor diet quality and low physical activity, so these factors contribute.”

According to the 2011 report, 63.6 percent of Pacific Islanders in Utah were considered obese. Researchers  defined obesity to be a body mass index of over 30. Poor diet and sedentary lifestyle are the main factors that contribute to Pacific Islanders getting diabetes, said Jake Fitisemanu Jr., chair of the Utah Pacific Islander Health Coalition, in an email interview.

Rice is a common food that is in a Pacific Islander’s diet. Rice has lots of carbohydrates, which can spike blood sugars. “Rice is a huge one and is an unfortunate staple of the diet,” Raphael said. “Potato or macaroni ‘salad’ is another one and lots of processed foods.  I also suspect that there is a low proportion of fruits and vegetables.”

Many Pacific Islanders think that since their family members have diabetes there is nothing they can do about it. “My experience is that it is one of the toughest things to deal with. There is a lot of fatalism meaning that a lot of Pacific Islanders think that since their family members had diabetes that there is nothing they can do about it when there is a lot that can be done to lower their risk,” Raphael said. “Same thing for the complications like kidney failure. I hear a lot of people say that they don’t think they can prevent kidney failure because their family had it.”

One complication with Pacific Islanders who have diabetes is language barriers. According to the report, those interviewed in English had lower obesity rates than those interviewed in Tongan and Samoan. The Utah Department of Health also found that those interviewed in English were more likely to perceive themselves as overweight compared to Samoan and Tongan speakers. “Language barriers for providers that don’t speak the language or have access to an interpreter are an issue. Also providers who don’t understand the culture make it challenging,” Raphael said.

A traditional Polynesian diet wasn’t always like this. “The traditional Polynesian diet was plant-based, varied, and very healthy. This was a protective factor that was further strengthened by the very active lifestyle the ancestors lived. Fast forward to today, that healthy lifestyle and wholesome diet has been replaced by modern sedentary lifestyles and sugary diets that increase the likelihood of developing diabetes.” Fitisemanu said.

Resources are available to Pacific Islanders in Utah who have diabetes. “The Utah Department of Health’s Office of Health Disparities developed a brief video in English, Samoan, and Tongan languages that mention some overall health tips that can help prevent diabetes and promote overall wellness,” Fitisemanu said. “There is also a diabetes pamphlet in Samoan that the UDOH Diabetes program has published. Local health providers from our Pacific communities are also good resources, including Dr. Kalani Raphael, Dr. Liana Kinikini, Dr. Kawehi Au, Uaisele Panisi, [and] Karen Mulitalo.”

Raphael mentioned community resources such as the National Tongan-American Society, which assists with diagnosing diabetes and counseling. It is located at 3007 S. West Temple, Bldg. H, in Salt Lake City. Another resource is the American Diabetes Association of Utah, located at 986 W. Atherton Drive, Suite 220, in Taylorsville.

The report of the health needs of Pacific Islanders advises limiting sugary drinks to help control obesity, which is a factor that causes diabetes.

“Our communities need to be aware of the risk factors and symptoms of diabetes so that they can try to reduce their risks and be able to identify diabetes early on, before serious complications occur,” Fitisemanu said. “Our families, social groups, and churches need to take more proactive roles in encouraging healthy living while providing support for those who seek treatment, and acknowledge and incentivize those who comply with treatment and make improvements. Apathy and normalization are the two worst enemies in this fight against diabetes. Because it’s so prevalent in some families and communities, it can become normalized and ‘accepted’ as an inevitable fact of life, and that notion is not only false but also incredibly dangerous to us as a community.”

Diabetes can be overwhelming but there is hope. “Diabetes is a complicated disease that requires a lot of self-care, but the motivated and informed patient can be successful,” Raphael said.