Native American Research: Diabetes

Native Americans With Diabetes:


Diabetes is one of the most common diseases around the world, it is specifically prevalent in the Unites States and those native the United States. Diabetes is a number of diseases that occurs when the pancreas produces very little to no insulin, or when the body does not respond appropriately to insulin. According to the American Diabetes Association, in 2015 30.3 million Americans (9.4% of population) had diabetes. The same article mentions that diabetes remains the 7th leading cause of death in the United States. In the United States 15.1% of those with the Diabetes are Americans Indians and Alaskan Natives (greatest percentage makeup by race/ ethnicity).
            Native Americans have a greater chance of having diabetes than any other U.S. racial/ethnic group. Diabetes is often related to kidney failure, a condition in which the kidneys lose the ability to remove waste and balance fluids. Every 2 out of 3 Native Americans with kidney failure have diabetes. It is not entirely clear as to why the disease is more common among Native Americans during this century, but many think it could be due the lifestyle, social conditions of particular tribes, and their genetic susceptibility to the disease. It is evident that diabetes-related kidney failure in Native American adults has decreased 54 percent from 1996 to 2013. Although the rate of diabetes-related kidney failure in Native Americans has declined faster than any racial/ethnic group in U.S. it is import to remain aware of this disease and how and who it effects. It has decreased in Native Americans the past few decades, but it remains the most common in Native Americans. One can conclude that this decline has occurred because of the increase in information about the disease, and how to better prevent it, such as environmental and diet changes.
Many organizations have developed in order to provide help to those with diabetes, fund and make progress towards research, and improve treatments and outcomes. For instance the Indian Health Service (IHS) was established in the mid-1980s, it focuses on population-based approaches towards diabetes management, and improvements in clinical care. Examples of other associations affiliated with Native Americans and diabetes include; “The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center”, “Association of American Indian Physicians”, and the "National Indian Health Board”. K.M. Venkat Narayan mentions in an article that, "As the prevalence of diabetes has continued to grow, prevention of the disease has become an increasingly important goal for American Indian and Alaska Native communities." which reminds one the importance of awareness towards the disease.  

Facts vs Myths from American Diabetes Association
Diabetes in Native Americans 



Notes From Sources:

American Diabetes Association:|

-2015: 30.3 million Americans (9.4% of population) had diabetes
- "Diabetes should be considered a major public health problem among young American Indians and Alaska Natives"
- Many programs to provide; help to those with diabetes, fund and make progress towards research, and improve treatments and outcomes.
     - such as:
           -  The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center 
           - Association of American Indian Physicians
           - "National Indian Health Board
- 

diabetes: 
     -number of diseases that involve problems with hormone insulin
     - occurs when:
     - pancreas produces very little to no insulin
     - body does not respond appropriately to insulin
     - no cure

Centers for Disease Control and Prevention: 

Native Americans: 
- greater chance having diabetes than any other U.S. racial/ethnic group
- 2 out of 3 Native Americans with kidney failure have diabetes
- Rate diabetes-related kidney failure in Native Americans
    - declined faster any racial/ethnic group in U.S.
 - population-based approaches to diabetes management and improvements in clinical care
           - started by Indian Health Service (IHS) in the mid-1980s.
- diabetes-related kidney failure in Native American adults (American Indians/Alaskan Natives)
    - decreased 54 percent from 1996 to 2013
- IHS-supported care for Native Americans with diabetes improved:
    - Use of medicine to protect kidneys increased
          - 42% to 74% in 5 years
    - Average blood pressure those with hypertension 
          - well-controlled (133/76 in 2015)
    - Blood sugar control improved 
          - 10% between 1996 and 2014
     - over 60% Native Americans 65 years and older
           -  took urine test kidney damage (2015)
     - 40% of Medicare diabetes population (2013)
Diabetes: 
- leading cause of kidney failure in U.S. 
Kidney failure: 
    - devastating and costly 
    - requires regular dialysis or kidney transplant for survival
    - when related to diabetes- delayed or prevented by:
          - controlling blood pressure and blood sugar
          - using kidney-protective medicines and regular kidney testing
Quote: 
“The 54% decline in kidney failure from diabetes followed implementation of public health and population approaches to diabetes as well as improvements in clinical care by the IHS. We believe these strategies can be effective in any population. The patient, family, and community are all key partners in managing chronic diseases, including diabetes.”- Mary L. Smith (Indian Health Service Principal Deputy Director)

Diabetes and American Indians/ Alaska Natives: 

- American Indian/Alaska Native adults: 
     - 2.4 times more likely be diagnosed with diabetes than white adults
- American Indians/Alaska Native women in 2013:
     - twice likely die from diabetes than non-Hispanic white women 
- 2010 American Indians/Native Americans: 
     - 2.7 times more likely be diagnosed with end stage renal disease than non-Hispanic whites 
- Diabetes rare among Native Americans until middle part of twentieth century 
- most common serious diseases among many Native American tribes
- at least 72,000 Native Americans in US with diagnosed diabetes (Newman et al., 1990)
- "It is not entirely clear why the frequency has increased among Native Americans during this century, and the question is the subject of considerable research attention. "
- Could be due to genetic factors, environmental factors, obesity, diet and physical activity
- The Pima Indians in Arizona have the highest recorded prevalence of diabetes in the world
- 1979: Congress established IHS National Diabetes Program 
     - to address burden of diabetes among American Indians and Alaska Natives
     - Significant strides made (improving diabetes care, treatment, and surveillance)
          - American Indian and Alaska Native adults with diabetes receive care as good as or better than received by counterparts in US population
- "As the prevalence of diabetes has continued to grow, prevention of the disease has become an increasingly important goal for American Indian and Alaska Native communities."

Type II Diabetes, the Modern Epidemic of American Indians in the United States

- in 1990s almost every Native American involved personally with diabetes, or with family and friends 
- increase in disease caused "Indian Health Service, and American Indian communities to hold many conferences in an effort to identify the underlying factors and propose a solution."
- "It has been called the new smallpox. The difference is that smallpox killed swiftly, but diabetes "kills softly, one fry bread at a time" '(Hill, 1997:27)

- lifestyle, social conditions of particular tribes, and underlying genetic susceptibility= factors as to why it is more common in native americans 


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