Quality Standards for Diabetes Care Toolkit

The impact on Pacific peoples

According to Foliaki and Pearce (2003), diabetes prevalence has increased rapidly over time in the indigenous people of the Pacific region (Polynesian, Melanesian, Micronesian), both in the Pacific Islands and in countries such as New Zealand. Pacific peoples experience greater morbidity and more complications than New Zealand Europeans with diabetes. This was confirmed by Statistics NZ based on 2002–2004 data, where it is stated the incidence of cardiovascular disease, diabetes, and respiratory illness is significantly higher among Pacific peoples than other ethnic groups. In addition, type 2 diabetes occurs earlier in Pacific peoples, about 10 years before New Zealand Europeans, including a growing number of children and adolescents, and young people with type 2 diabetes are at greater risk of morbidity and mortality (Constantino 2013).
In the 2013 report on the Adult Nutrition Survey, Coppell et al found that diabetes was prevalent among Māori and Pacific peoples, and particularly high among Pacific peoples. One-third or more of Pacific people aged 45 years and over had diabetes. Age-specific rates of undiagnosed diabetes were highest among Pacific peoples, for whom the ratio of diagnosed to undiagnosed diabetes was 5:4 compared with 10:3 for Māori and 10:1 for New Zealand Europeans. The highest prevalence of diabetes was observed among Pacific peoples, with rates among Māori in-between that observed for Pacific and the NZ European/Other (NZEO) groups. Rates increased with age, with the highest prevalence observed for those aged 75 years and over. Some helpful recommendations for working with Pacific peoples with diabetes can be found in the booklet prepared for the Medical Council of New Zealand by Mauri Ora Associates – Best health outcomes for Pacific peoples: Practice implications. It can be accessed at: www.mcnz.org.nz/assets/News-and-Publications/Statements/Best-health-outcomes-for-Pacific-Peoples.pdf