Determinants of Diabetes Mellitus in the Pima Indians

Knowler, William C.; Saad, Mohammed F.; Pettitt, David J.; Nelson, Robert G.; Bennett, Peter H.

doi:10.2337/diacare.16.1.216

Cited by 89 publications

(70 citation statements)

References 49 publications

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“…This finding should be interpreted with caution because it is potentially a proxy variable for a wide range of social and cultural variables (e.g., degree of genetic risk for diabetes, degree of traditionalism, level of education, degree of discrimination experienced, acculturation stress, exposure to historical trauma, age, and fear and distrust of medical providers), some of which have been shown to affect glycemic control in other minority populations. 26,27 The degree to which these factors are interrelated may make it difficult to analyze them separately. This finding must be explored with sensitivity to the potential for misrepresentation and misuse of data regarding such variables.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Motivational Interviewing for Improving Self-Care Among Northern Plains Indians With Type 2 Diabetes

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Motivational Interviewing for Improving Self-Care Among Northern Plains Indians With Type 2 Diabetes

et al. 2010

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“…It has a strong effect on the development of type 2 DM (Bjorntorp, 1992;Haffner et al, 1992) as it is found in Western countries (NDDG, 1979;Wilson et al, 1981) and some ethnic groups such as Pima Indians (Joffe et al, 1992;Knowler et al, 1993). Obesity is more than just a risk factor; it has a causal effect in the development of type 2 DM against a genetic background.…”

Section: Pathogenesis Of Type 2 Diabetesmentioning

confidence: 98%

The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus

Ozougwu¹,

Obimba²,

Belonwu³

et al. 2013

J. Physiol. Pathophysiol.

486

310

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The aim of this paper is to review the information on type 1 and type 2 diabetes with emphasis on its etiology, pathogenesis and pathophysiology via literature review. Diabetes is a group of metabolic disorders characterized by a chronic hyperglycemic condition resulting from defects in insulin secretion, insulin action or both. Type 1 diabetes is the result of an autoimmune reaction to proteins of the islets cells of the pancreas while type 2 diabetes is caused by a combination of genetic factors related to impaired insulin secretion, insulin resistance and environmental factors such as obesity, overeating, lack of exercise and stress, as well as aging. The pathogenesis of selective β-cell destruction within the islet in type 1 diabetes mellitus is difficult to follow due to marked heterogeneity of the pancreatic lesions. At the onset of overt hyperglycemia, a mixture of pseudoatrophic islets with cells producing glycogen, somatostatin and pancreatic polypeptide, normal islets and islets containing both β-cells and infiltrating lymphocytes and monocytes may be seen. The autoimmune destruction of pancreatic β cells leads to a deficiency of insulin secretion that leads to the metabolic derangements associated with type 1 diabetes. The main pathophysiological features of type 2 diabetes are impaired insulin secretion and increased insulin resistance. The impairment of pancreatic β cell function notably shows progression overtime in type 2 diabetes although aging, obesity, insufficient energy consumption, alcohol drinking, smoking, etc are independent risk factors of pathogenesis of type 2 diabetes mellitus.

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“…Residents of the Gila River Indian Community of Arizona, most of whom are Pima or closely related Tohono O'odham Indians, participate in a longitudinal population-based study of diabetes and its complications conducted by the National Institute of Diabetes and Digestive and Kidney Diseases (7). Approximately every 2 years, each member of the community aged Ն5 years is invited to participate in a standardized examination (biennial examination) that includes a medical history, physical examination, and measurement of BMI, blood pressure, plasma glucose level, HbA 1c level, serum cholesterol concentration, and albuminuria.…”

Section: Population Study and Medical Examinationmentioning

confidence: 99%

Periodontal Disease and Mortality in Type 2 Diabetes

et al. 2005

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OBJECTIVE—Periodontal disease may contribute to the increased mortality associated with diabetes. RESEARCH DESIGN AND METHODS—In a prospective longitudinal study of 628 subjects aged ≥35 years, we examined the effect of periodontal disease on overall and cardiovascular disease mortality in Pima Indians with type 2 diabetes. Periodontal abnormality was classified as no or mild, moderate, and severe, based on panoramic radiographs and clinical dental examinations. RESULTS—During a median follow-up of 11 years (range 0.3–16), 204 subjects died. The age- and sex-adjusted death rates for all natural causes expressed as the number of deaths per 1,000 person-years of follow-up were 3.7 (95% CI 0.7–6.6) for no or mild periodontal disease, 19.6 (10.7–28.5) for moderate periodontal disease, and 28.4 (22.3–34.6) for severe periodontal disease. Periodontal disease predicted deaths from ischemic heart disease (IHD) (P trend = 0.04) and diabetic nephropathy (P trend < 0.01). Death rates from other causes were not associated with periodontal disease. After adjustment for age, sex, duration of diabetes, HbA1c, macroalbuminuria, BMI, serum cholesterol concentration, hypertension, electrocardiographic abnormalities, and current smoking in a proportional hazards model, subjects with severe periodontal disease had 3.2 times the risk (95% CI 1.1–9.3) of cardiorenal mortality (IHD and diabetic nephropathy combined) compared with the reference group (no or mild periodontal disease and moderate periodontal disease combined). CONCLUSIONS— Periodontal disease is a strong predictor of mortality from IHD and diabetic nephropathy in Pima Indians with type 2 diabetes. The effect of periodontal disease is in addition to the effects of traditional risk factors for these diseases.

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Determinants of Diabetes Mellitus in the Pima Indians

Abstract: The Pimas and many other American Indian populations suffer from a high incidence of diabetes and its characteristic disabling or fatal complications, and would benefit from continued research on the pathogenesis and prevention of the disease.

Cited by 89 publications

References 49 publications

Effectiveness of Motivational Interviewing for Improving Self-Care Among Northern Plains Indians With Type 2 Diabetes

Effectiveness of Motivational Interviewing for Improving Self-Care Among Northern Plains Indians With Type 2 Diabetes

The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus

Periodontal Disease and Mortality in Type 2 Diabetes

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