Chapter 3. The history of diabetes mellitus in the Desert People

The Increasing Incidence of Coronary Artery Disease and Cardiovascular Risk Factors Among a Southwest Native American Tribe

“…11 Furthermore, in a 1993 study, Justice 15 found evidence supporting recent increases in diabetes rates among American Indians; a study of the Tohono O'odham Tribe in Arizona found that most patients with diabetes (62.8%) had a duration of disease of less than 10 years, and 42.4% of the patients with diabetes had a duration of disease of less than 5 years. Finally, although the age-adjusted diabetesrelated death rates increased 5% (to a rate of approximately 40 per 100000 population) for the general US population between 1988 and 1993, they increased by 15% (to a rate of approximately 60 per 100000 population) for American Indians, the largest increase of any ethnic group.…”

“…21 Although it has been proposed that there may be a genetic predisposition toward diabetes among some tribes, lifestyle factors seem to be a more significant contributor. 15 The marked increase in CAD and AMI and the high prevalence of cardiovascular risk factors among the White Mountain Apache in recent years requires aggressive intervention at a fundamental level. Primary prevention efforts should optimally begin in grade school to prevent, or at least delay, the onset of obesity and the subsequent development of diabetes, hypertension, and dyslipidemia.…”

Non-Insulin Dependent Diabetes Mellitus Among Aboriginal North Americans

“…By 1984, among properly diagnosed American Indian, Eskimo, and Aleut diabetic outpatients, 98% suffered from NIDDM, while the remainder exhibited IDDM (44). Evidence now shows that NlDDM is extraor dinarily common in some tribes (8, 16,60,65) and some regions of the United States (39, 44, 71), but in others prevalence is still lower than the United States national average (2.47% in 1980) (e.g. Alaskan Eskimos, Alaskan Atha paskan-speaking Indians; 120).…”

“…In all groups morbidity continues to increase (119,170). Prevalence rates often vary by sex, with a higher rate among women than men (14,16,28,60), although peak rates are attained earlier by men than by women (60).…”

“…Exceptions include the studies on diabetes etiology, epidemiology, and complications among Pima Indians of Gila River, Arizona, which have been ongoing for 30 years (60,64,89). Only in a handful of other communities has longitudinal investigation been attempted, and then over a shorter time period, on a more restricted range of topics than among the Pima (53, 136,141).…”