Hawaii is one of three states with the lowest rates of new diabetes cases, according to a federal study, but the trend is increasing with obesity, isle health officials say.

The U.S. Centers for Disease Control and Prevention study also doesn't present the whole picture, they point out.

Hawaii has high-risk ethnic and socioeconomic groups, said Valerie Ah Cook, coordinator of the state Health Department's Diabetes Prevention and Control Program. “;Even though we're showing in general we're healthy (in Hawaii), we have populations at higher risk like Pacific Islanders coming over with complications and higher health needs.”;

The CDC study said the rate of new diabetes cases nearly doubled in the United States in the past 10 years with the highest levels in the South. About 1.6 million new cases were diagnosed last year in people 20 or older, making a total of more than 23 million Americans with the disease, CDC said.

West Virginia had the highest rate of increase, with about 13 in 1,000 adults diagnosed with the disease. Minnesota, Hawaii and Wyoming had the lowest rates. Minnesota was the lowest with a rate of 5 cases per 1,000 adults and Hawaii had 6 in 1,000.

Majken Meching, executive director of the American Diabetes Association in Hawaii, said it is sticking to a figure of 10 percent of Hawaii's people with diabetes—an estimated 100,000 cases, including about 26,000 undiagnosed.

“;A good chunk of our people are walking around undiagnosed,”; she said. “;The numbers are significantly on the rise and, in our community, disproportionate because of our ethnic mix.”;

CDC said about 90 percent of the increased cases are type 2 diabetes, linked to obesity.

Hawaii has been consistently ranked one of the lowest states on people reporting they're obese in the Behavioral Risk Factor Surveillance System Survey, an annual telephone survey of adults in all states and territories to assess risk factors for leading diseases causing deaths.

Hawaii's overall prevalence rates last year of 7.7 percent for diabetes and 21.7 percent for obesity are lower than national rates. But, the Department of Health says, “;Once you begin looking at diabetes (or obesity) by socioeconomic status or ethnicity, then the disparities are revealed.”;

Ann Pobutsky, a Health Department chronic-disease epidemiologist, said poverty and low education are linked with diabetes. People with low income living on a Spam-and-rice diet are likely to be overweight, she said.

The highest proportion of people with diabetes, nearly 13 percent, have low incomes and nearly 12 percent have low education, she noted.

Native Hawaiians last year made up 11.4 percent of islanders with diabetes, and they have the highest obesity and mortality from the disease, Pobutsky said. Japanese had a diabetes rate of 9.1 percent; Filipinos, 7.8 percent; whites, 4.7 percent; and others, 8.4 percent.

The increase in the statewide diabetes rate—from about 5.2 percent in 1989 to 7.7 percent last year—is on a parallel track with increasing obesity, Cook said.

The Health Department's Diabetes Prevention and Control Program worked with many people and organizations statewide in 2004 to draft a Hawaii Diabetes Plan 2010 with goals and objectives to improve the health-care system for people with diabetes.

Cook said the CDC-funded program is working with community health centers and others to provide technical assistance and improve self-management for diabetics to prevent complications.