title: Describing the burden of non-communicable disease risk factors among adults with diabetes in Wallis and Futuna.
abstract: BACKGROUND
  The South Pacific Territory of Wallis and Futuna has a high burden of non-communicable diseases (NCD): 18% of adults have diabetes mellitus (DM) and 87% are classified as overweight or obese.
  
  
  OBJECTIVE
  To characterise the burden of additional World Health Organization (WHO) recognised NCD risk factors, such as smoking, obesity, high blood pressure, eating less than five fruit or vegetable servings per day and a sedentary lifestyle, among adults with DM.
  
  
  METHODS
  Re-analysis of cross-sectional data from a 2009 national survey. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
  
  
  RESULTS
  Of 487 adults sampled, 87 (18%) had DM. Nearly 99% of individuals with DM had at least one additional NCD risk factor, and 62% had three or more concurrent NCD risk factors. Individuals with DM were more likely to be obese (OR 1.66, 95%CI 1.01-2.74) and had a much higher prevalence of high blood pressure (OR 3.02, 95%CI 1.87-4.86).
  
  
  CONCLUSIONS
  DM is rarely identified in the absence of other NCD risk factors. We recommend an integrated approach to the management of DM and other NCD risk factors in routine care rather than a disease-specific approach.
authors.affiliation: Secretariat of the Pacific Community, Noumea, New Caledonia.
authors.forename: N
authors.initials: N
authors.lastname: Girin
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA ; Hawaii Department of Health, TB Control Program, Honolulu, Hawaii, USA.
authors.forename: R
authors.initials: R
authors.lastname: Brostrom
authors.affiliation: Fiji National University, Suva, Fiji.
authors.forename: S
authors.initials: S
authors.lastname: Ram
authors.affiliation: Secretariat of the Pacific Community, Noumea, New Caledonia.
authors.forename: J
authors.initials: J
authors.lastname: McKenzie
authors.affiliation: The International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India.
authors.forename: A M V
authors.initials: AM
authors.lastname: Kumar
authors.affiliation: Regional Public Health, Hutt Valley District Health Board, Lower Hutt, New Zealand.
authors.forename: C
authors.initials: C
authors.lastname: Roseveare
keywords: NCD; Pacific; high blood pressure; obesity; smoking