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

doi:10.1177/11795514231183595

Health Profiles of Marshallese With and Without a Type 2 Diabetes Diagnosis in the Republic of the Marshall Islands

Clin Med Insights Endocrinol Diabetes. 2023 Aug 23:16:11795514231183595. doi: 10.1177/11795514231183595. eCollection 2023.

Authors

Jennifer A Andersen¹, Holly C Felix², Joseph R Malhis³, Erin Gloster⁴, Pearl A McElfish¹

Affiliations

¹ College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA.
² Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
³ College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
⁴ Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA.

Abstract

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.

Keywords: Republic of the Marshall Islands; health profiles; intervention; prediabetes; type 2 diabetes.