Diabetes in Guam

Diabetes is one of Guam’s biggest health problems, and it has been getting worse. Depending on how it is counted, somewhere between about 1 in 8 and 1 in 5 adults on Guam are living with diabetes, and many more have prediabetes without knowing it.

The trend is going the wrong way

Guam’s Behavioral Risk Factor Surveillance System, the local health survey run with the CDC, found the share of adults who have been told they have diabetes rose from about 9.9 percent in 2011 to 14.7 percent in 2020. More recent survey figures put it near 1 in 8 adults. International estimates that also count undiagnosed cases, from the World Bank and the International Diabetes Federation, put it closer to 1 in 5. The gap between those numbers is mostly undiagnosed diabetes. A lot of it on Guam has not been caught yet.

Roughly 4 in 10 adults on Guam are living with obesity, the single biggest driver of type 2 diabetes.

Guam loses more people to diabetes than the mainland

Diabetes is among the top four or five leading causes of death on Guam, alongside heart disease, cancer, and stroke. The Guam Community Health Assessment found that people on Guam die from diabetes at a rate about 78 percent higher than the United States overall, and from stroke and hypertension at a rate about 83 percent higher. The International Diabetes Federation lists Guam among the highest places in the world for the share of deaths connected to diabetes.

Chamorro families carry more of it

University of Guam researchers Rachael Leon Guerrero and Yvette Paulino, in a study of Chamorro and Filipino adults on Guam, found that Chamorros had markedly higher obesity (about 49 percent, compared with about 20 percent among Filipino adults) and that Chamorros on Guam have higher diabetes rates than Asian and Caucasian residents. Chamorros with diabetes were also at greater risk of heart disease and stroke than those without. This mirrors a wider Pacific pattern, tied to genetics and to a shift over a few generations away from local foods and daily physical activity toward imported, processed food.

What diabetes does over time

When blood sugar stays high for years, it damages small blood vessels and nerves. That shows up as:

• Eyes: diabetic eye disease, a leading cause of vision loss in working-age adults. How diabetes can affect eye health.
• Kidneys: diabetes is a top cause of kidney failure and dialysis.
• Feet and legs: nerve damage and poor circulation cause slow-healing wounds and, in serious cases, amputation. Longer time with diabetes and poor blood-sugar control both raise that risk.
• Heart: higher risk of heart attack and stroke.

The important part: caught early and managed, most of this can be prevented or slowed a great deal. That is the point of the run, the screening, and these pages.