Endemic diabetes and obesity: a massive problem in the smallest country
Nearly half the population of Nauru are diabetic, and more than 95% are obese
Can you envisage a time when having diabetes is normal, when most of the population are obese, and when because of this, life expectancy is among the lowest in the world?1 This isn’t a hypothetical situation on Nauru, the world’s smallest island republic, in the Micronesian South Pacific, where the island is only 21 square kilometres and flights arrive just twice a week.2 The indigenous Nauruan people have Micronesian, Melanesian, and Polynesian ancestry. The island remained undiscovered by Europeans until 1798,3 when it was named Pleasant Island because of its lush, green vegetation. Nauru was extensively mined for its natural phosphate reserves from the early 20th century onwards; it was also a base for Japanese soldiers during the second world war and prospered in the 1970s when the mining industry on the island was at its peak. The phosphate reserves have run out, however, and the prosperous period is over.