Background: No systematic comparison has been conducted in Fiji using all
suitable surveys of type 2 diabetes mellitus (T2DM) and obesity prevalence after
standardizing methodology and definitions.
Methods: Unit records from six surveys of Fiji adults were variously adjusted
for age, ethnicity (Fiji Melanesians, i-Taukei, and Fijians of Asian Indian descent
[Indians]) and urban–rural by sex to previous censuses. Trends were
assessed using meta-regression (random effect models) and estimates projected
to 2020. Poisson regression of strata was used to assess the effect of body mass
index (BMI) increases on T2DM period trends.
Results: Over 1980–2011, T2DM prevalence increased in i-Taukei men (3.2%
to 11.1%; 1.32%/5 years) and women (5.3% to 13.6%; 1.40%/5 years) and
Indian men (11.1% to 17.9%; 1.24%/5 years) and women (11.2% to 19.9%;
1.71%/5 years). Projected T2DM prevalence in 2020 is 13.3% and 16.7% in
i-Taukei men and women, and 23.4% and 24.1% in Indian men and women,
respectively. Obesity prevalence increased in i-Taukei men (12.6% to 28.9%;
2.99%/5 years) and women (30.1% to 52.9%; 3.84%/5 years) and in Indian
men (2.8% to 9.4%; 1.21%/5 years) and women (13.2% to 26.6%; 2.61%/
5 years). Projected obesity prevalence in 2020 is 34.0% and 60.0% in i-Taukei
and women, and 11.4% and 31.0% in Indian men and women, respectively.
After age-adjustment, an estimated 27%, 25%, 16% and 18% of the T2DM period
trend is attributable to BMI in i-Taukei men and women and Indian men
and women, respectively.
Conclusions: Prevalence of T2DM in Fiji is projected to continue increasing,
driven by rising obesity, with consequences for premature mortality and life
expectancy.