Hawaiʻi Health Data Warehouse


Diabetes is a chronic health condition that is characterized by high blood sugar. Blood sugar is usually regulated by the hormone insulin. In type 1 diabetes, blood sugar level rises because the body does not create insulin. In type 2 diabetes, blood sugar level rises because the body does not create enough insulin or because the body does not use the insulin properly. Another common type of diabetes is gestational diabetes, which develops during pregnancy. Common diabetes symptoms include increased thirst, frequent urination, fatigue, blurry vision, tingling, and numbness. Proper management through education, medication and lifestyle changes are critical to preventing or delaying complications as there is no cure for diabetes.1

Why It’s Important

Unmanaged diabetes can lead to serious health complications such as cardiovascular disease, nerve damage, kidney damage, eye damage, and hearing impairment. In fact, diabetes is the leading cause of kidney failure, lower-limb amputations, and adult blindness. Medical costs for people with diabetes are twice as high as for people who don’t have diabetes. Diagnosed diabetes costs an estimated $1.5 billion in Hawai’i each year.2

What Is Known

In the last 20 years, the number of adults with diabetes has more than tripled as the American population has aged and become more overweight. Over 37 million adults in the United States have diabetes, and 1 in 5 of them do not know they have it.3 In Hawai’i, close to 130,000 adults (11.2% of the adult population) have been diagnosed with diabetes. This does not include the additional estimated 39,000 people who have diabetes but are not aware. Over a third of adults in Hawai’i have prediabetes, which means their blood sugar levels are higher than normal but below the threshold of diabetes diagnosis.2 People with prediabetes are at high risk for developing diabetes, but they can delay or prevent diabetes onset through weight loss and increasing physical activity.

Nearly 1 in 3 people with diabetes have chronic kidney disease (CKD) and 9 out of 10 people with CKD don’t know they have it.4  Many people with CKD aren’t aware they have the disease until it’s advanced, requiring dialysis or a kidney transplant.

Who Is at Risk

No one is immune from diabetes, but risk factors vary by type:

  • Type 1 diabetes: Family history (grandparents, parents, or siblings) of type 1 diabetes and young age (more likely to develop in children, teens, and young adults).
  • Type 2 diabetes: Overweight, age of 45 years or older, family history of type 2 diabetes, physical inactivity, and history of gestational diabetes.
  • Gestational diabetes: Previous diagnosis of gestational diabetes, previous birth to a baby weighing more than 9 pounds, overweight, age of 25 years or older, family history of type 2 diabetes, having polycystic ovary syndrome, and race (African American, Hispanic/Latino American, American Indian/Alaska Native, or Pacific Islander).5

How To Reduce Risk

Type 1 diabetes is largely genetic and thus cannot be prevented. Risk of type 2 diabetes can be reduced by following these guidelines:

  • Maintain a healthy weight
  • Exercise regularly. Get at least 30 minutes of physical activity 5 days a week.
  • Eat healthy, nutritious food. Eat smaller portions, increase fruit and vegetable consumption, avoid highly processed foods, and drink mainly water.
  • Do not smoke or use tobacco products.
  • Abstain from alcohol or drink only in moderation.6

Page last updated August 1, 2022

Indicator Reports


A health indicator is a measure designed to summarize information about a given topic in population health or health systems performance.  Indicator reports provide numeric data for a health indicator as well as public health context (such as why it is important and what is being done to improve it).

How It’s Tracked


1 What is diabetes? National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes. Published December 2016.
2 American Diabetes Association, 2021. The Burden of Diabetes in Hawaii. [online] Available at: <https://diabetes.org/sites/default/files/2021-11/ADV_2021_State_Fact_sheets_Hawaii_rev.pdf> [Accessed 26 July 2022].
3 Diabetes quick facts. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/quick-facts.html. Published December 17, 2021.
4 Kidney Disease Statistics for the United States, Fast Facts on Kidney Disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease [Accessed August 1, 2022]
5 Diabetes risk factors. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/risk-factors.html. Published April 5, 2022.
6 Diabetes prevention: 5 tips for taking control. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-prevention/art-20047639. Published June 25, 2021.