Addressing Diabetes in Global Communities through the Practical Implementation of Lifestyle Education: Lessons Learned from the Pacific Islands

It is well known that chronic diseases are strongly liked to poor lifestyle practices. These conditions are especially striking among low income, minority communities who bear a disproportionate burden of disease. Though practice guidelines for chronic disease prevention and management recommend that treatment begin with evidence-based lifestyle medicine, many physicians cite inadequate confidence and lack of knowledge and skill as the major barriers to counseling patients about lifestyle interventions. Furthermore, time constraints, clinical and administrative demands often make it challenging for primary care providers to deliver appropriate lifestyle related recommendations. Current changes in the healthcare climate and reimbursement structure, however, demand that we rethink current healthcare delivery models and prioritize preventive and lifestyle interventions so that sustainable positive health outcomes can be attained especially among vulnerable communities. Lifestyle medicine, defined as the evidence-based therapeutic approach to prevent, treat and reverse lifestyle-related chronic diseases. It offers promise in achieving this goal through community based offering and primary care integration utilizing multidisciplinary teams. Lifestyle education, among minority populations, however, requires thoughtful cultural considerations and adaptations. This article highlights strategies learned from international work among Pacific Islanders who suffer from a disproportionate burden of noncommunicable diseases; and offers recommendations on how diverse populations can be positively engaged to curb the rising diabetes epidemic both locally and internationally.