Robert Fujiwara, 76, lifts weights three times a week and watches what he eats, but still has to rely on daily injections of insulin and a peritoneal dialysis machine at home to treat his type 2 diabetes.

His advice is simple for anyone worried about developing diabetes: "Keep your weight down. The weight is the biggest factor for local people who love buffets."

Fujiwara, a landscape architect, drinks two or three beers per year now, gave up smoking and substitutes powdered protein shakes for his real love: roast pork and rice.

"It's a poor substitute," he said. "I love roast pork, kalua pig and all kinds of fatty meats like pork."