Prevalence of diabetes among Native Americans and Alaska Natives, 1990-1997: an increasing burden.

Abstract

OBJECTIVE: To determine trends in diabetes prevalence among Native Americans and Alaska Natives. RESEARCH DESIGN AND METHODS: From 1990 to 1997, Native Americans and Alaska Natives with diabetes were identified from the Indian Health Service (IHS) national outpatient database, and prevalence was calculated using these cases and estimates of the Native American and Alaskan population served by IHS and tribal health facilities. Prevalence was age-adjusted by the direct method based on the 1980 U.S. population. RESULTS: Between 1990 and 1997, the number of Native Americans and Alaska Natives of all ages with diagnosed diabetes increased from 43,262 to 64,474 individuals. Prevalence of diagnosed diabetes increased by 29%. By 1997, prevalence among Native Americans and Alaska Natives was 5.4%, and the age-adjusted prevalence was 8.0%. During the entire 1990-1997 period, prevalence among women was higher than that among men, but the rate of increase was higher among men than women (37 vs. 25%). In 1997, age-adjusted prevalence of diabetes varied by region and ranged from 3% in the Alaska region to 17% in the Atlantic region. The increase in prevalence between 1990 and 1997 ranged from 16% in the Northern Plains region to 76% in the Alaska region. CONCLUSIONS: Diabetes is common among Native Americans and Alaska Natives, and it increased substantially during the 8-year period examined. Effective interventions for primary, secondary, and tertiary, prevention are needed to address the substantial and rapidly growing burden of diabetes among Native Americans and Alaska Natives.

Health Promotion and Diabetes Prevention in American Indian and Alaska Native Communities — Traditional Foods Project, 2008–2014

“…Sharing and documenting food sovereignty efforts continues to be a priority. A collection of stories told by tribes about their traditional foods systems is published on the NDWP website (47). Underpinning the stories are long-sighted lessons for sustainability, steeped in cultural significance and emotional attachment (68) and inspired by agency (i.e., capacity of acting or of exerting power), self-determination, and hope, for the health of the people.…”

“…Many local foods, (e.g., wild turnips, berries, beans, wildlife, and medicinal plants) were lost as the bottomlands were flooded (43)(44)(45). By 2000, the prevalence of diagnosed diabetes in the area was approximately three times the rate for non-Hispanic whites (47).…”

Metabolic Syndrome: Prevalence among American Indian and Alaska Native People Living in the Southwestern United States and in Alaska

“…Among American Indian people in the southwestern region included in the Navajo EARTH Study, the prevalence rate for type 2 diabetes is over twice that of Alaska, and mortality rates from diabetes are approximately four-fold higher. [23][24][25][26] Within Alaska, the lowest prevalence rates of diabetes have been found among the Yupik people of Western Alaska. 27,28 However, the rates of diabetes have been increasing in all American Indian and Alaska Native populations, and the rate of increase has been largest for Alaska.…”

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

“…These were accompanied by social, economic and cultural changes in the past decades, which might have had an impact on the observed increase in hospitalization for coronary artery disease (50). With the increasing incidence of diabetes that accompanies the transition from traditional to urban lifestyles (51,52), it is anticipated that the incidence of CVD and HF will also increase.…”