American Indians, Alaskan Natives, and Diabetes

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American Indians, Alaskan Natives, and Diabetes
May 13, 2008
dLife

n 2000, American Indians and Alaska Natives numbered about 4.1 million people, or 1.5% of the U.S. population. American Indians comprise about 96 percent of this ethnic/minority group. There are over 500 tribal organizations in the United States, with many differences in language and culture.

Type 1 diabetes, which usually occurs in childhood or adolescence, is relatively rare in American Indians and Alaska Natives. Type 2 diabetes, which usually occurs after age 45, is the most common form of diabetes in this group of people.

The overall prevalence of diabetes among American Indians and Alaska Natives combined is nine percent (approximately 176,000 cases). On average, they are 2.8 times as likely to have diagnosed diabetes as non-Hispanic whites of similar age. Available data may underestimate the true prevalence of diabetes in American Indians. For example, data from the Navajo Health and Nutrition Survey, published in 1997, showed that about 23 percent of Navajo adults had diabetes, one-third of whom had not yet been diagnosed.

Diabetes is particularly common among middle-aged and older American Indians and Alaska Natives. Among the Pima Indians of Arizona, about 50 percent of people between the ages of 30 and 64 have diabetes. Diabetes rates are highest in Pima children whose parents developed diabetes at an early age. Until recently, type 2 diabetes was rarely diagnosed in children and adolescents. However, it is becoming increasingly common among American Indian children ages 10 and older.

From 1984 to 1986, diabetes was the sixth leading cause of death among American Indians and Alaska Natives. Between 1986 and 1988, the death rate for diabetes in American Indians was estimated to be 4.3 times the rate in non-Hispanic whites. Diabetes contributes to several of the leading causes of death in American Indians: heart disease, cerebrovascular disease, pneumonia, and influenza.

The rate of complications Ò kidney, eyes, amputation, periodontal disease Ò is also higher for this group. From 1987 to 1990 the rate of end-stage renal disease (the final stage of kidney disease associated with kidney failure and dialysis) in American Indians with diabetes has been estimated to be six times higher than in non-Hispanic whites. In Pimas, it is the leading cause of death. One study showed a 49.3 percent prevalence of diabetic retinopathy in Oklahoma Indians. Diabetic retinopathy is a deterioration of the blood vessels in the eye caused by high blood glucose levels and can lead to impaired vision and, ultimately, to blindness. Rates of lower extremity amputation are high in some American Indians but vary by tribe. The incidence of periodontal disease is 2.6 times higher in Pima Indians with diabetes than in those without it.