Health Profiles of Marshallese With and Without a Type 2 Diabetes Diagnosis in the Republic of the Marshall Islands
Jennifer A Andersen, Holly C Felix, Joseph R Malhis, Erin Gloster, Pearl A McElfish- General Medicine
Background:
The Republic of the Marshall Islands (RMI) faces a high prevalence of type 2 diabetes (T2DM).
Objectives:
The aim of the study is to document the health of Marshallese with and without a T2DM diagnosis to inform future interventions.
Design:
Data are from screenings collected in preparation for a diabetes education intervention. Data, including HbA1c, random glucose, cholesterol, weight, and self-rated health, were collected.
Methods:
Kruskal-Wallis and Fisher’s exact tests were used to identify differences in participants with and without T2DM diagnosis.
Results:
There were significant differences in both HbA1c level ( P ⩽ .0001) and glucose level ( P ⩽ .0001) between the diagnosed T2DM and non-diagnosed T2DM groups, as well as diastolic blood pressure ( P = .0179), systolic blood pressure ( P = .0003), and pulse pressure ( P = .0023). There were no differences in weight, body mass index (BMI), high density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol, or self-rated health. Marshallese without a T2DM diagnosis have signs of insulin resistance, including elevated glucose and triglyceride levels.
Conclusion:
The results indicate a need for a socioecological approach to T2DM interventions, and interventions in the RMI should consider inclusion of blood pressure and cholesterol management. There is a need for interventions to prevent prediabetes and its progression to T2DM.