Diabetes in Micronesia


Diabetes is a non-communicable (NCD) or non-infectious disease. It is incapable of being spread from one person to another through direct or indirect contacts. This condition is genetic and can also be a result of poor diet and lack of exercise.

Medically, it is when the pancreas doesn’t produce any or enough insulin. Insulin is a hormone that converts food into energy. In other words, diabetes is a condition that affects your body’s ability to break down and convert food into energy.

There are two types of diabetes, simply named type 1 & 2. Type 1 diabetes is when the body produces very little or no insulin at all. It is not as common and it usually affects younger people. Its exact cause is still unknown. People with type 1 diabetes need to inject insulin daily.

Type 2 diabetes is the more common form of diabetes and accounts for 90 percent of all cases of diabetes. It is most common in older people and those who are considered overweight or obese. Type 2 diabetics can control their condition through proper diet and exercise, but will require medicine in the future.

There is no cure for type 1 and type 2 diabetes, they can only be controlled.

Causes of diabetes include:

  1. Family history of diabetes, hereditary.
  2. Overweight
  3. Unhealthy diet
  4. Physical inactivity
  5. Aging
  6. High blood pressure
  7. Ethnicity
  8. Impaired glucose tolerance (IGT)  
  9. History of gestational diabetes
  10. Poor nutrition during pregnancy

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Diabetes in Micronesia

The International Diabetes Federation (IDF) produced a list in 2012 of the top countries with the largest percentage of diabetics. Standing at the top of the list, with 37.2% prevalence is the FSM, followed by Nauru at 30.1%, the RMI at 27.1%, and Kiribati at 25.5%.

A closer look shows that the FSM has around 35,000 people with diabetes. One out of three FSM citizens is likely diabetic.

Most diabetics in Micronesia are type 2 diabetics. This is a result of poor diet and inadequate exercise. Micronesian countries also rank highly in global obesity statistics. In fact, it has been said that Micronesian countries have the most “overweight populations in the world”.

These alarming rates have had fatal effects. Diabetes is the leading cause of death in Kosrae and the Marshall Islands. It is the second leading cause of death in Pohnpei and the third leading cause in Chuuk.

What led to these alarming rates? Have Micronesians always been susceptible to diabetes?

A Brief History

The history of colonization in this region spans 500 years. But, the start or escalation of weight gain and diabetes in Micronesia can be linked to the birth of the Trust Territory of the Pacific Islands (TTPI) in 1947. In fairness, we do not have records for diabetes and obesity in the islands as far back as 500 years ago. However, since record keeping started, data shows a rise in these conditions that correlate to a switch in diet and lifestyle prompted by our trusteeship partner, the USA.

After World War II, the world viewed colonialism much more negatively. Territorial expansion was a thing of the past. But after suffering heavy losses during the war, the United States saw the strategic importance of the Micronesian islands. For the sake of US national security, they wanted to control the Micronesian region. The question then became, how could the US control the area without colonizing it?

The adoption of importing goods, was in many ways promoted by US “development programs” during the trusteeship. The infamous “Solomon Report” detailed plans for the United States to effectively make Micronesian countries dependent on America. Under the Kennedy administration in the early 1960’s, the US schemed to retain control over the region without formally “colonizing” it.

In simpler terms, the plan was (is?) for the United States to throw millions of dollars into Micronesian territories to make them dependent. When dependent, the Micronesian countries would in effect ask for a "permanent relationship" with the USA.

This devious plan had adverse effects. Its promotion of imports abruptly slowed the practice and need for traditional farming and fishing. Readily available canned foods or processed foods were now preferred.

In addition to this, since most physical activities were directly related to the cultivation of land for farming and the vigorous practices of fishing, the US plan for dependence inadvertently resulted in obesity and weight gain issues in the islands.

Using FSM imports as an indication of dependence; an estimated 40 percent of imports to the FSM are food items. First on the list at 12.4 percent is “homogenized preparations of meat” or canned meat. Second is “prepared or preserved fish” at 11 percent.  


Diabetes and weight gain continue to grow, along with dependence on foreign aid. So how can we respond to these facts?

This is not to say that we should place full blame on the USA for our conditions. According to business owners in Micronesia, “…it’s the consumer who dictates what we sell.”

A return to traditional practices could help. But is that possible seeing the direction of “development” we’ve chosen?

In summation, to ensure a healthier future it is important to understand diabetes and weight gain to know how to control them. In addition, It is just as important to understand the history of how these health conditions developed in the islands.



  1. http://piccom.org/news_posts/announcing-pic-s-media-fund-online-application-next-deadline-11-01
  2. http://www.idf.org/worlddiabetesday/toolkit/gp/facts-figures?language=en
  3. http://atlas.media.mit.edu/country/fsm/
  4. http://www.idf.org/sites/default/files/5E_IDFAtlasPoster_2012_EN.pdf
  5. http://www.the4rthbranch.com/articles/2011/3/6/the-fourth-branch-interviews-deal-fair-store-general-manager.html
  6. http://www.micsem.org/diabetes/
  7. http://www.the4rthbranch.com/articles/2012/3/25/basic-health-hawaii-broken-spirits-healing-souls-by-keola-di.html
  8. http://www.who.int/bulletin/volumes/88/7/10-010710/en/
  9. http://www.globalizationandhealth.com/content/2/1/10
  10. http://www.cdc.gov/media/presskits/aahd/diabetes.htm.