Targeting the type 2 diabetes epidemic in Polynesia: historical perspective and rationale for exercise intervention trials

Abstract

The Polynesian people of New Zealand are particularly vulnerable to type 2 diabetes mellitus (T2DM) and related comorbidities, including obesity and cardiovascular disease. T2DM could potentially be managed and abated with appropriate and targeted exercise prescriptions; however, the uptake of such interventions by this cohort remains low. The purpose of this article is to present a rationale for the investigation of targeted exercise prescriptions for the management and potential remission of T2DM in Polynesian people. The diabetes epidemic will be contextualized by contrasting historical observations of health and physical fitness with current trends and statistics related to significant T2DM risk factors (ie, obesity and inactivity). Longitudinal trials that have prescribed lifestyle-related and exercise interventions in this cohort will be critically reviewed, and novel research avenues will be proposed. Studies are currently required to investigate many critically important hypotheses in this cohort. The outcomes of such studies may facilitate the investigation of exercise prescriptions in other indigenous populations, including indigenous Australians, Americans and Africans, who also suffer a severe burden of T2DM.