Prevalence of diagnosed diabetes in American Indian and Alaska Native adults, 2006–2017

Abstract

IntroductionThe objective of this study was to examine recent trends in diagnosed diabetes prevalence for American Indian and Alaska Native (AI/AN) adults aged 18 years and older in the Indian Health Service (IHS) active clinical population.Research design and methodsData were extracted from the IHS National Data Warehouse for AI/AN adults for each fiscal year from 2006 (n=729 470) through 2017 (n=1 034 814). The prevalence of diagnosed diabetes for each year and the annual percentage change were estimated for adults overall, as well as by sex, age group, and geographic region.ResultsAfter increasing significantly from 2006 to 2013, diabetes prevalence for AI/AN adults in the IHS active clinical population decreased significantly from 2013 to 2017. Prevalence was 14.4% (95% CI 13.9% to 15.0%) in 2006; 15.4% (95% CI 14.8% to 16.0%) in 2013; and 14.6% (95% CI 14.1% to 15.2%) in 2017. Trends for men and women were similar to the overall population, as were those for all age groups. For all geographic regions, prevalence either decreased significantly or leveled off in recent years.ConclusionsDiabetes prevalence in AI/AN adults in the IHS active clinical population has decreased significantly since 2013. While these results cannot be generalized to all AI/AN adults in the USA, this study documents the first known decrease in diabetes prevalence for AI/AN people.

Hospitalizations for COVID-19 Among American Indian and Alaska Native Adults (≥ 18 Years Old) — New Mexico, March–September 2020

“…Diabetes mellitus has been associated with COVID-19 hospitalization, intensive care unit admission, and mortality [13][14][15][16]. Although diabetes mellitus prevalence among AI/AN has decreased in recent years nationwide [17], the AI/AN population continues to have the highest prevalence of diagnosed diabetes mellitus (15%) compared to other racial groups (Hispanic/Latino: 13%; non-Hispanic Black: 12%; non-Hispanic Asian: 9%; non-Hispanic White: 8%) [18], which may partially explain this population's susceptibility to COVID-19 hospitalization, but does not seem to account for it fully.…”

“…Factors that compromise individual health or delay early intervention may result in more severe disease including hospitalization, intensive care unit admission, and death. The disproportionate prevalence of chronic conditions such as diabetes is secondary to factors such as poverty, lack of access to nutritious foods, and lack of access to healthcare [17]. Delays in diagnosis and care for both chronic conditions and COVID-19 may be caused by fear of COVID-19 exposure, large geographic distances to health care facilities, lack of transportation, insufficient public health infrastructure, and limited access to specialty medical care on tribal lands.…”

An American Perspective of the Dental and Public Health Initiatives in Cuba

“…The United States government also has established similar initiatives, such as the Indian Health Service, an agency within the Department of Health and Human Services responsible for providing federal health services to Native American and Alaska Natives. 28 The key difference between these systems is that the United States aims to increase access to care to civilians, while Cuba's NHS aims to provide care to all civilians.…”

Social Support and Diabetes Management Among Older American Indians

“…Age-adjusted prevalence of diabetes has experienced a significant increase, rising from 9.5% in 1999–2002 to 12.0% in 2013–2016 in the general U.S. population ( 2 ). An examination of the Indian Health Service patient population found a significant increase in diabetes prevalence among American Indian and Alaska Native (AI/AN) people from 2006 to 2013, followed by a significant decrease from 2013 to 2017 ( 3 ). Despite this decrease, AI/AN people continue to have the highest rates of T2D in the U.S.…”