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About Diabetes on Guam
What We Can Gain From the Statistics
What We Can Do
Find Out If You Have Diabetes, Get Tested!
Who is Helping Out

 

 

 

About Diabetes on Guam

Guam’s population is over 90% Asian and Pacific Islander in composition. Both of these ethnic groups have inherent genetic predisposition to Type II Diabetes so we would expect an increased prevalence on that basis alone. In addition, the population of Guam has a much greater incidence of obesity, which is another major risk factor for Type II Diabetes. In addition the ambient temperatures on Guam are high, and modern lifestyles are sedentary, further contributing to obesity and making it more difficult for the body to handle excess sugar loads. The end effect of all these factors is a “Perfect Storm” for Type II Diabetes.

 

 

Diabetes Prevalence from 2000 to 2007

  • Diabetes was the seventh leading cause of death on Guam in 2000, comprising 3.15 % of deaths.
  • The 2000 age-adjusted mortality rate for diabetes was 20% lower than the U.S. rate (25.2 vs. 22.6 per 100,000 populations). Diabetes has been ranked as one of the 10 leading causes of death from 1985 - 2000.
  • Behavioral Risk Factor Surveillance Survey (BRFSS) data from 2001 show Guam's overall prevalence of diabetes to be 95 per 1,000 adults. Based on population projections, the number of persons with diabetes at this prevalence rate in 2001 would be at least 8,987. The vast majorities of people with diabetes have type 2 diabetes; also know as non-insulin dependent diabetes.
  • Persons with diabetes aged 40 and above account for over 85% of self-reported diabetes cases in the 2001 BRFSS. Furthermore, diabetes is the most common cause of end stage renal disease and blindness.
  • Based on our Behavioral Risk Factor Surveillance System (BRFSS) Survey for 2007 Guam had one of the highest Diabetes Prevalence Rates at 9.2% while the United States and Territories had a Prevalence Rate of 8.1%.
  • Guam also had one of the highest Tobacco Prevalence Rates at 31% while the United States and Territories had a Prevalence Rate of 19.7%.

 

Click Here To View Frequency and Mortality for Diabetes per 100,000 Population Guam: 1992-2001


Diabetes Prevalence from 2001 – 2010

  • Diabetes was the fourth leading cause of deaths on Guam in 2005, comprising 4.74 percent of deaths.
  • Diabetes has been ranked as one of the 10 leading causes of deaths from 1985 – 2005.
  • Behavioral Risk Factor Surveillance Survey (BRFSS) data from 2003 show Guam’s overall prevalence of diabetes to be 101 per 1,000 adults. Based on population projections, the number of persons with diabetes at this prevalence rate in 2004 would be at least 10,522.
  • Based on the 2010 BRFSS, Guam has a diabetes prevalence rate of 11%.
  • 11% x 106,073 adult population = 11,668 estimated adults on Guam with Diabetes.

 

Click here to view Diabetes Prevalence BRFSS data on Guam from 2001 – 2010.

 

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What We Can Gain From the Statistics

The future for diabetic patients who are unable to control their disease, either through lifestyle changes or medical interventions, is not bright. Diabetic patients have much more disease than non-diabetic patients and therefore much higher mortality and associate disease states (Nephropathy-Kidney problems and failure: Retinopathy-Loss of vision or blindness: Neuropathy-Loss of feeling and sensation which can lead to falls, injuries, and infections due to lack of normal warning signs such as pain that something is happening, which in turn lead to amputations and other major medial interventions). All of these conditions mean greater monetary expenditures for those who suffer from Type II Diabetes. Since over 40% of our population is uninsured and since many of those who are insured are underinsured, this means that ALL of us are required to assume costs of Type II Diabetes through our tax dollars and economic losses which Hospitals, Medical Clinics, Insurance Companies, and others must pay to cover these costs.

 

The magnitudes of these costs are truly staggering and are not widely appreciated. Most of us know that Kidney Dialysis is not an uncommon complication of poorly controlled Type II Diabetes, but many do not realize that the costs are so high that most patients have their costs paid by Federal programs. In much of the world, Kidney Failure is a death sentence. In Singapore, if you cannot work, you die, as their society has decided they can only afford to prolong life for those who are productive. This is for only ONE of the complications of Type II Diabetes.

 

In trying to compute cost, it is difficult to predict what costs might be and economic models can be disputed, but no one can dispute that millions of dollars will be necessary to cover the increased costs of this disease. In looking at one old study from Minnesota in 1988 which was reported in the Centers for Disease Control (CDC) Morbidity and Mortality Weekly Report (MMWR) on April 12, 1991, they estimated that the direct and indirect cost for diabetes in Minnesota in 1988 was $301,470,165.00.  This is in a society where the prevalence of diabetes was at about 3% at the time of this study. Translating these figures to Guam, with its reported 9.2% prevalence in a population of about 150,000 into 2007 dollars comes to $2,346,944.00 without questioning any of the underlying assumptions which went into the making of any of these figures (For instance-The cost of a physician visit in this study was set at $26.00). Also, many would feel that the true prevalence of Type II Diabetes on Guam is 2-4 times the published 9.2%. In any case, we are looking at huge sums which we cannot afford today, let alone in the future. As money matters continue to tighten their grip on the governments of both Guam and the USA, it seems clear to me that those with Type II Diabetes are going to suffer more and die earlier that those without the disease and its complications. As current political leaders have been saying, “We need change!”

 

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What We Can Do

Change is always difficult, and is even harder when it involves cultural beliefs and practices. Here on Guam, the prevalence of Fiestas, Parties, and Rosaries make dietary management of Diabetes much more difficult as there is ALWAYS pressure to eat and a desire to not offend by not eating. When few reasonable alternatives are available to those who choose to eat, it is even more difficult. Exercise is also difficult to fit into a modern technological society, which demands many hours a day of sedentary activity. Diabetes is also often associated with other diseases (Co-morbidities) such as Arthritis, Vascular Diseases, etc, which may make exercise difficult. Also, one of the islands greatest possibilities for exercise (swimming and water activities) cannot be engaged in by the majority of the island’s inhabitants, as they do not know how to swim. This is a tragedy as heat does not play such an important role in swimming as do exercises which occur on land. In addition, dog leash laws are poorly enforced on Guam, making even walking, an exercise in danger, especially for the infirm.

 

Could we change all of that? Of course we could, BUT it would require considerable effort by ALL of the island’s inhabitants. We could install secure walking and bicycle paths such as are available on Saipan and other islands. We could impose severe economic penalties for importation of foods which are not healthy for Diabetics (Or even others), such as Yap has done for items such as Spam and other processed meats. We could place greater restrictions and economic penalties on smoking which have a huge adverse effect on patients with Type II Diabetes. We could make Dietary Consultation available to ALL of the island’s inhabitants, instead of only those who have the money to pay for it and the increased costs of following such diets. We could put Physical Education back into our schools and make dietary instruction a part of the curriculum. We could encourage adult exercise programs and a greater range of adult physical activities through tax incentives and subsidized organized sports and exercise programs. All of these would help, and most would probably be cost effective in the long run, but considerable money will be necessary before many of these programs are instituted.

 

In the meantime, it is necessary for those who have Type II Diabetes, and those who know they are at risk for Type II Diabetes, to begin changing their own lifestyles including activities and eating habits. These approaches WORK! For those who are not convinced of this, I would suggest you consult with the SDA Wellness Center and ask to see the statistics on those patients who have completed their course of instruction and compare it to their pre-instruction condition. The difficulty is that many are unable to adhere to such a structured and stringent regimen for any length of time. However, with modifications, many are able to live comfortably and still enjoy the benefits of a healthier lifestyle.

 

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Find Out If You Have Diabetes, Get Tested!

One of the most important things you can do for yourself is to check to see if you have diabetes. The sooner you know, the faster you can get help.

 

Visit these places and ask to get tested:

 

American Dialysis Center

  • Street Address: 1406 N. Marine Corps Dr. Upper Tumon GU, 96913
  • Tel: (671) 646-ESRD (3773)
  • Fax: (671) 647-2026

 

Health Services of the Pacific

  • Street Address: 384 Gov. Carlos Camacho Rd.

 

Don’t forget you can also visit your doctor at your public health and ask where you can get tested!

 

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Who Is Helping Out

Knowing the situation of diabetes on Guam is not enough; you must also know how to get help. There are a lot of places that can aid you, here are three of those places that help control and prevent diabetes.


Help these organizations help you by contacting them to learn more about diabetes:


Guam Diabetes Prevention and Control Program, Bureau of Professional Support Services, Division of Public Health & Social Services

A local government agency, headed by Patrick S. Luces, Program Coordinator, the Guam Diabetes and Control Program is working hard to create programs to decrease prevalence of diabetes on Guam. They were helpful enough to provide us with the latest statistics regarding diabetes on Guam, and welcome anyone willing to lend a hand in the control and prevention of diabetes.

 

Guam Diabetes Association

A local association of volunteers, headed by Carl Butler, the association’s President.  Guam Diabetes Association holds annual public conferences and village meetings in an effort to educate and inform the public of diabetes.

“Guam Diabetes Association has been a great community service with much of hospitality and is an organized Association.”


              - Dr. Robert L. Hanson, MD, MPH

 

For more help, please click here to go to our Help Center

 

Guamdiabetes.org

The guamdiabetes.org plays an important role in helping out, by providing an online portal dedicated solely to helping the people on Guam by informing them of the necessary information needed to help control and prevent diabetes.

 

Click here view About Us

 

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