“Diabetes affects nearly 26 million Americans, but the Native Hawaiian and Pacific Islander community is at particular risk. ” The Waianae Coast’s burden of diabetes falls unequally on the Native Hawaiians that constitute 60% of the Leeward community, a burden that brings disability and early death to a people whose adoption of the Western diet over the years has led to obesity and other conditions that risk both diabetes and cancer.
Leanna has diabetes. So does her son and daughter as well as many of her friends. She is Native Hawaiian and has seen brothers and sisters who have suffered blindness and amputations. The struggle is one that takes discipline as well as education, the latter of which is difficult for people to access on a regular basis if they work, which most people do in Waianae. In addition, the fact that most diagnoses occur after an individual has reported significant symptoms of the disease, means many people may believe they are free of the risk if they do not have major signs of it. By the time they learn they have diabetes, many people may have already have had a stroke, heart attack or other serious emergency.
The tragic state of health affairs in Waianae is underlined with the statement in the first paragraph of this article, from Dr. Howard Koh, who, in his position as the Assistant Secretary for Health, wrote about diabetes and the awful burden of this disease on the people of the Leeward community, 60% of which are Native Hawaiian and Pacific Islanders.
This same pattern of diabetes in this vulnerable population also occurs in the States of Idaho, Oregon, Washington, Utah and Nevada where Native Hawaiians and Pacific Islanders have settled.
The Waianae Coast Comprehensive Center offers a vigorous health maintenance and protection program with a heavy emphasis on dietary guidelines to prevent diabetes. But often it is not until an individual shows serious signs of the disease before an in-depth evaluation takes place in order for a diabetic patient to receive the diagnosis and guidance necessary to maintain some modicum of good health.
The Comp Center or WCCC, as the Waianae Coast Comprehensive Center is called by locals in Waianae, has yoga and other physical fitness classes, a beautiful arrangement of walkways and shelters made from natural woods, plants and flowers so that patients have peaceful surroundings in which to meditate, and a cafe on the site that brings a nutritious meal every weekday for patients, staff and visitors. The local grocery stores, such as Tamura’s and the Waianae Store, have foods especially for the health-conscious patients who suffer from diabetes or for whom a program of prevention has been recommended. Yet the population of diabetics continues to grow in Waianae.
The saddest commentary on the growth of diabetes in the Native Hawaiian population is that it is considered a potential risk factor for pancreatic cancer. In fact not only do Native Hawaiians have a higher risk for diabetes than other ethnic groups, they also have a higher risk for pancreatic cancer. So as diabetes is often not diagnosed until an individual is an adult, and sometimes delayed until the symptoms are acute, pancreatic cancer is the silent killer that makes early detection and treatment of diabetes especially important.
It is yet unclear if diabetes causes pancreatic cancer or the cancer produces diabetes. The Pancreatic Cancer Action Network declares, “In pancreatic cancer patients who have had diabetes for less than five years, it is unclear if the diabetes contributed to the cancer or if the precancerous cells caused the diabetes.”
Pancreatic cancer kills most of its victims. The link between diabetes and pancreatic cancer reveals the vulnerability that Franklin has had, particularly given the fact she is African American. Both pancreatic cancer and diabetes affects more African Americans than any other ethnic group.
A study done in 2008 by the Mayo Clinic revealed that diabetes was present in patients many months before a pancreatic cancer diagnosis. Researchers concluded that the cancer caused the diabetes to develop. They suggested that onset of diabetes after age 50 should elicit an evaluation for pancreatic cancer as well. Since pancreatic cancer patients seldom have symptoms until the disease has progressed too far for surgery to be an option, the diagnosis of diabetes is seen as significant enough for doctors to follow up with their patients and screen for pancreatic cancer.
The relationship between diabetes and the onset of pancreatic cancer, along with the fact that Native Hawaiians, along with other groups such as African Americans and Asian Americans, are at particular risk for diabtes, allows the public to know the dynamics of diagnosis and how vital it is for risk factors to be assessed, as the Mayo Clinic suggests. Diabetes is a deadly disease in that it causes many other problems such as heart attack, stroke, blindness, liver or kidney disease or pancreatic cancer.
Diabetes is Waianae’s health burden. Diabetes is now Leanna’s burden as well. As one of the beautiful people of Oahu, whose Native Hawaiian ancestry dates back more than a century, it is a burden of grief shared by everyone who loves Hawaii and the Polynesian people who were its original settlers.