Mand Study Shows Serious Problems of Diabetes

by Amy Levendusky

Out of 84 males and 85 females sampled from randomly selected households, a total of 41 new cases of possible diabetes was identified. The fasting blood sugar of each participant was measured to determine the prevalence of diabetes in Mand as part of the on-going project, "Documentation of the Traditional Food System of Pohnpei", sponsored by the Island Food Community of Pohnpei and other local agencies in conjunction with Mand Community and the Centre for Indigenous Peoples' Nutrition and Environment.

The criteria used for identification as a possible diabetes case was a fasting blood sugar level over 120 mg/dl. All participants who had measurements of fasting blood sugar > 120 mg/dl and who had not been previously diagnosed were counseled and advised to go for further checks.

The fasting blood sugar was measured with the Accu-check instrument provided by the Pohnpei Public Health Division. All participants were asked whether they had taken any food or drink after midnight prior to the test. All those not fasting were asked to return on a later date for a check when fully fasting. Blood sugar levels were defined as normal (<120 mg/dl), borderline (120-150 mg/dl), and diabetes (>150 mg/dl).

The mean fasting blood sugar levels increased with age from a mean of 94 mg/dl for females 15-19 years and 105 mg/dl for males 15-19 years increasing to a mean of 172 mg/dl for females over 60 years and 191 mg/dl for males over 60 years. For one case the fasting blood sugar level was greater than the instrument could measure (>500 mg/dl).

Diabetes is a serious problem on Pohnpei and is related to poor diet and lack of exercise. There has been a change in the diet from locally grown staple crops and seafood to a diet with increasing levels of imported foods including rice and other processed, refined foods and high levels of sugar, salt, and fat. There has also been a change in activity level. These days people are not as active physically, along with lifestyle changes and modern conveniences. People are not working on their land as much as in the past. Those that are most at risk for diabetes are people over the age of 45 years, people who are overweight, and people who are sedentary or inactive.

In order to help prevent diabetes, you should eat balanced meals with food from all three food groups which include energy foods such as breadfruit (mahi), banana (uht), yam (kehp), taro (sawa de mwahng), tapioca (kehp tuhke) and sweet potato (pedehde); protective foods such as fruits and vegetables, including green leafy vegetables; and body building foods such as fish and seafood, chicken, eggs, beans, and nuts. You should work and exercise to be fit and keep your weight at a healthy level. It is recommended to do some kind of physical activity such as working on your land, walking, or swimming at least 5 days a week for 30 minutes at one time or spread throughout the day.

The IFCP thanks the Mand community and our collaborating partners and support agencies, including the Pohnpei Office of Economic Affairs, Department of Health, Department of Land and Natural Resources, COM/FSM Land Grant, Centre of Indigenous Peoples' Nutrition and Environment (CINE), Pacific German Regional Forestry Project (PGRFP) and Sight and Life.