High blood glucose levels are a hallmark of diabetes, a chronic metabolic illness that may seriously harm the heart, blood vessels, eyes, kidneys, and neurones, among other essential organs. Type 2 diabetes (T2DM) is the most common disease, primarily affecting adults and brought on by insulin resistance or inadequate insulin synthesis. In all economic categories, the incidence of T2DM has significantly grown during the last thirty years. Insulin synthesis by the pancreas is either insufficient or non-existent in type 1 diabetes, also known as juvenile or insulin-dependent diabetes. To live, people with diabetes need accessible treatment choices like insulin. By 2025, there is a general agreement to stop the rise in diabetes and obesity. An estimated 422 million people globally, primarily in low- and middle-income nations, suffer from diabetes, which causes 1.5 million deaths yearly.

Diabetes mellitus is a severe problem to Fiji in terms of rising prevalence, prevention, and treatment. Pacific countries are in the top five in the world for the prevalence of diabetes in people aged 20 to 79. Tokelau has the highest prevalence rate, at 37.5%. Seven Pacific Island Countries (PICs) are expected to maintain their position in the top 10 worldwide for diabetes prevalence by 2035. Forty one percent of Fijians who were 40 years of age or older had an adjusted prevalence rate of diabetes. It is estimated that 60% of Fijians do not have a diabetes diagnosis. There are notable regional differences in this frequency, with those in rural areas having a lower likelihood of receiving a diagnosis. 

Traditional whole-food diets have been replaced globally by processed foods, which has hurt health, especially non-communicable illnesses. In Fiji, this change is becoming more common among adults, kids, and teenagers, which will raise the prevalence of non-communicable illnesses in the future. With less than a million people, Fiji has one of the highest prevalence rates of diabetes globally, at 16%, compared to the global incidence of 8.5%. It is possible that the public healthcare system has not adequately adjusted to economic expansion and westernisation, given the high incidence of T2DM. Urbanisation presents barriers to the traditional Pacific lifestyle, marked by low-calorie, health-conscious diets and social and physical exercise. These problems include the availability of harmful foods and sedentary jobs. 

Reducing the incidence of diabetes and improving treatment accessibility for its geographically distributed, semi-rural population are essential challenges facing Fiji. Given the severity of the condition in the tiny island country of Fiji, it is anticipated that the incidence of T2DM would increase by 48% by 2020. The complexity of addressing T2DM problems will increase along with Fiji’s urbanisation, obesity incidence, and fall in physical inactivity. This will lead to higher healthcare costs and a worse standard of living. 

A portion of the population in Fiji suffers fromT2DM, characterised by markedly uncontrolled blood glucose levels, a high rate of complications related to diabetes, and inadequate resource utilisation by healthcare professionals. Visual impairment, nerve damage, renal issues, amputations, pruritus, and a slow rate of wound healing are among the consequences. Significantly high rates of sight-threatening retinopathy and diabetic foot amputations suggest a severe burden of the illness. 

A restricted range of oral antidiabetic drugs is available via Fijian healthcare systems. In addition to cultural customs and beliefs, patients experience financial hardship, stress, noncompliance with exercise programs, and drug unavailability. Insufficient understanding of diabetes and its associated consequences results in inadequate self-care. For improved treatment results, it is essential to improve patient education and the healthcare infrastructure. 

Adopting a healthy diet, quitting smoking, and engaging in regular physical exercise are examples of preventive interventions. Moreover, Fijians use medicinal plants (MPs) to control and avoid the side effects of T2DM. These plants can stop the enzymes that break down carbohydrates, making them possible natural guardians against T2DM. 

Fiji has to increase treatment accessibility and lower the diabetes prevalence immediately. Significant complications and a high rate of uncontrolled blood glucose are obstacles to the treatment of T2DM. A comprehensive strategy incorporating patient education, enhanced healthcare infrastructure, and cultural sensitivity is necessary for effective management.

Community-based health clubs might be established to improve diabetes awareness and healthcare services. Early therapy for diabetes, which might save long-term consequences, depends on timely diagnosis. It is crucial to practice scalable, affordable health promotion initiatives that can work with other tactics. Enhancing people training, resources, and infrastructure in the healthcare industry will enable the system to provide high-quality treatment. For healthcare to be accessible and inexpensive, there must be effective communication at all levels of care. 

Achieving local ownership and sustainability requires including stakeholders in research and keeping lines of communication open. Project longevity may be supported by collaborations with national and international organisations. To evaluate the effectiveness of Diabetes Fiji’s programs and guarantee ongoing progress, regular data collecting, quality improvement projects, and patient feedback surveys are essential. 

References 

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Lubega, M., Ogwok, J., Nabunya, B. and Mbalinda, S. N. (2023) ‘Role of community-based health clubs in promoting patients’ health education for diabetes self-care management: An interventional qualitative study in a Ugandan urban setting’, BMJ Open Quality, 12(4).

 

Mala, P., Khan, G. A., Gopalan, R., Gedefaw, D. and Soapi, K. (2022) ‘Fijian medicinal plants and their role in the prevention of Type 2 diabetes mellitus’, Bioscience Reports, 42(11).

 

Marzban, S., Najafi, M., Agolli, A. and Ashrafi, E. (2022) ‘Impact of Patient Engagement on Healthcare Quality: A Scoping Review’, Journal of Patient Experience, 9.

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Ram, S., Mohammadnezhad, M., Ram, K., Prasad, K., Pal, M. and Dalmia, P. (2022) ‘Increasing and sustaining diabetic retinopathy screening in Fiji by leveraging community health workers (CHWs) services: A qualitative study’, Heliyon, 8(11).

 

World Health Organisation (2024) Diabetes. Available at:  https://www.who.int/health-topics/diabetes#tab=tab_1 (Accessed: 07 June 2024).

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