Diabetes and Native Americans

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among Native Americans. Complications from diabetes are major causes of death and health problems in most Native American populations. This information on Native Americans and Diabetes is taken from the American Diabetes Association.

What is Diabetes?

Diabetes is a disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, which usually occurs during childhood or adolescence, and type 2, the most common form of the disease, usually occurring after age 45.

Diabetes is a chronic disease that has no cure.

How Does it Affect Native Americans?

Prevalence :

Prevalence of type 2 diabetes among Native Americans in the United States is 12.2% for those over 19 years of age. One tribe in Arizona has the highest rate of diabetes in the world. About 50% of the tribe between the ages of 30 and 64 have diabetes.

Today, diabetes has reached epidemic proportions

Of equal concern is the fact that type 2, or adult-onset diabetes, is increasingly being discovered in Native American youth.

Diabetes Rapidly Increasing Among Native Americans, Alaskans

Reported in the December, 2000 issue of Diabetes Care: Diabetes has been growing in prevalence among Native Americans and Alaskan Natives,according to a recent study by the federal Centers for Disease Control and Prevention. The study found a nearly 30 percent increase in diabetes diagnoses among these populations between 1990 and 1997. During this time period prevalence among women was higher than among men, but the rate of increase was higher among men than women (37 percent v. 25 percent). The increase in prevalence was highest in Alaska, where it rose 76 percent during the 1990s, and lowest in the Northern Plains region of the United States, where it rose by 16 percent during this time period.

Obesity and Native Americans:

According to the National Institute for Diabetes and Digestive and Kidney Diseases, the "thrifty gene" theory proposes that African-Americans, Hispanic-Americans, Asian Americans and Native Americans inherited a gene from their ancestors which enabled them to use food more efficiently during "feast and famine" cycles. Today there are fewer such cycles; this causes certain populations to be more susceptible to obesity and to developing type 2 diabetes.

Native Americans and Diabetic Complications:

The serious complications of diabetes are increasing in frequency among Native Americans. Of major concern are increasing rates of kidney failure, amputations and blindness.

Ten to twenty-one percent of all people with diabetes develop kidney disease. In 1995, 27,900 people initiated treatment for end stage renal disease (kidney failure) because of diabetes. Among people with diabetes, the rate of diabetic end stage renal disease is six times higher among Native Americans.

Diabetes is the most frequent cause of non-traumatic lower limb amputations. The risk of a leg amputation is 15 to 40 times greater for a person with diabetes. Each year 54,000 people lose their foot or leg to diabetes. Amputation rates among Native Americans are 3-4 times higher than the general population.

Diabetic retinopathy is a term used for all abnormalities of the small blood vessels of the retina caused by diabetes, such as weakening of blood vessel walls or leakage from blood vessels. Diabetic retinopathy occurs in 18% of Pima Indians and 24.4% of Oklahoma Indians.

What is Needed?

In ideal circumstances, Native Americans with diabetes will have their disease under good control and be monitored frequently by a health care team knowledgeable in the care of diabetes.

Patient education is critical. People with diabetes can reduce their risk for complications if they are educated about their disease, learn and practice the skills necessary to better control their blood glucose levels, and receive regular checkups from their health care team.

People with diabetes, with the help of their health care providers, should set goals for better control of blood glucose levels, as close to the normal range as is possible for them. Health care team education is vital. Because people with diabetes have a multi-system chronic disease, they are best monitored and managed by highly skilled health care professionals trained with the latest information on diabetes to help ensure early detection and appropriate treatment of the serious complications of the disease. A team approach to treating and monitoring this disease serves the best interests of the patient.

Knowledge is power. Learn what you can, talk to your health care provider and use what you learn to help yourself beat this horrible disease.