Diabetes in the Cook Islands: a clinical audit
Machaela Tepai 1 , Vili Nosa
1 * , Josephine Herman 1 , Yin Yin May 2 , Atefeh Kiadarbandsari 1 , John Sluyter 1
+ Author Affiliations
- Author Affiliations
1 Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand. Email: mttepai@gmail.com, aumeah@gmail.com, akia647@aucklanduni.ac.nz, j.sluyter@auckland.ac.nz
2 Ministry of Health, PO Box 109, Avarua, Rarotonga, Cook Islands. Email: yin.may@cookislands.gov.ck
Journal of Primary Health Care 15(2) 176-183 https://doi.org/10.1071/HC21138
Published: 1 June 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Introduction: The global burden of diabetes mellitus (diabetes) is significant and of increasing concern with more pregnant women being diagnosed with gestational diabetes mellitus (GDM). The Cook Islands face mounting pressures to address diabetes alongside competing population health needs and priorities. Cook Islands residents frequently travel to New Zealand to access health services. Inadequate information systems also make it difficult for countries to prioritise preventative measures for investment. In the absence of good data to inform effective diabetes preventative and treatment measures, people with diabetes are likely to progress to complications which will burden society and health systems in the Cook Islands and New Zealand.
Aim: To determine the prevalence of diabetes and prediabetes, and incidence of GDM, in the Cook Islands.
Methods: We analysed two Te Marae Ora Cook Islands Ministry of Health datasets, the Non‐Communicable Diseases (NCD) register examining demographic data for the period 1967 to December 2018 and same for the GDM register from January 2009 to December 2018.
Results: Of the 1270 diabetes cases, 53% were female and half were aged 45–64 years. There were 54 pre-diabetes cases and 146 GDM. Of the 20 GDM cases who developed type 2 diabetes, 80% were diagnosed before the age of 40 years. Data quality was poor.
Discussion: The Cook Islands diabetes registers provide important data to inform priorities for diabetes-related preventative and treatment measures. A data analyst has been employed to ensure quality, regularly audited data and information systems.
Keywords: Cook Islands, Cook Islands women, diabetes mellitus, gestational diabetes mellitus, non-communicable diseases, obesity, Pacific people, prediabetes.
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