Tahiti, July 10, 2025 – If this report does not study the particular case of French Polynesia, it nevertheless sounds like a warning. In a document published in early July, the Court of Auditors Alert on the gaps in prevention and management of type 2 diabetes in mainland France. A strong growth pathology, expensive and deeply unequal. Findings that resonate particularly in Fenua, where obesity and precariousness feed an explosion of diabetes, which affects more than 45,000 people.
While French Polynesia has health competence, the alarming conclusions of the Court of Auditors on prevention and management of type 2 diabetes in mainland France resonate with particular acuity in Fenua. This report, published in early July, paints a portrait of an expanding, expensive, unequal and still too little anticipated pathology by the public authorities. An alarm signal to be seriously considered in Polynesia, a territory where obesity and precariousness make the diabetes bed. The Health Department announces that more than “45,000 people” would suffer from diabetes and that “3,000 new cases are identified every year”.
A chronic disease progression …
The report of the Court of Auditors explains that 92 % of diabetic persons have type 2 diabetes. However, the Court notes a continuous progression of this pathology, correlated with two factors: the increase in obesity and the aging of the population. In France, 3.8 million people were treated pharmacologically in 2023, a figure that has continued to grow since the early 2000s. To this total are added nearly a million affected but untreated, or not diagnosed. And this real figure is most likely underestimated, due to the lack of updated data.
Diabetes strikes precarious populations harder: the most modest 10 % have almost three times more likely to be affected than the wealthiest. This observation is even more marked in women. This very strong social gradient is also observed overseas, where the prevalence of “Treaty diabetes is up to 1.9 times higher than the national average”. If the data specific to Polynesia are not taken into account in this report, local health realities – massive obesity, rapid food transition, structural precariousness – leave little doubts about the relevance of the diagnosis.
Upward expenses
The direct cost of diabetes for health insurance (the equivalent of the CPS in France) is estimated at 10.2 billion euros in 2022 (1,214 billion francs), up 35 % since 2015. By integrating the care linked to other pathologies among diabetic persons, this invoice increases to 35.4 billion (4,213 billion francs). And yet, the health results do not progress at the same rate: follow -up exams stagnate, hospitalizations for complications barely decrease. Almost a third of new patients are diagnosed at an already advanced stage of the disease.
A call to reform of the care pathway
The Court therefore recommends to review in depth the management of type 2 diabetes, insisting on the concept of “early prevention ”. The key is to intervene as soon as the diagnosis is without delay the occurrence of complications. It offers a systematic care path including three non -drug pillars: patient therapeutic education, personalized nutritional intervention, and promoting suitable physical activity. In other words, healing otherwise than by prescription of drugs alone.
Today, these approaches exist but remain little spotted, unequally distributed in the territory, and often financed in an ad hoc basis. The Court therefore calls for a reform of the regime of long -term affections (ALD), in order to fully integrate these components into a “Care basket” Refunded, as soon as the diagnosis is announced.
Prevention above all
But the answer cannot be limited to the care system. Diabetes is first of all a product of our environment: industrial food, sedentary lifestyle, social inequalities. The Court urges the public authorities to intensify primary prevention policies. It therefore recommends, among other things, better advertising supervision for fatty, savory and sweet products, including on social networks; Reinforced behavioral taxation, extended to all added sugars products; A nutritional policy and ambitious, consistent and evaluated physical activity.
These levers must become real public policies, and no longer rest on the goodwill of industrialists. In Polynesia, where the food transition has been brutal and where ultra-transformed foodstuffs dominate the shelves, the establishment of such measures becomes urgent.
What is du fen?
If this report does not study the particular case of French Polynesia, it nevertheless sounds like a warning. This presupposes common mobilizations: local government, health professionals, associations, but also municipalities and schools. In short, and this is what runs from the report of the Court of Auditors, the battle against diabetes will not win neither in the office nor in the hospital, but in neighborhoods, schools and families.