Approximately 105,000 or 15 percent of American
Indians and Alaska Natives receiving care from the
Indian Health Service (IHS) have diabetes.
At the regional level, diabetes is least common
among Alaska Natives (5.3 percent) and most
common among American Indians in the
southeastern United States (25.7 percent) and in
certain tribes from the Southwest.
On average, American Indians and Alaska Natives are
2.3% more likely to
have diabetes than Caucasians and 6 times more likely to acquire ESRD.
In 1998, about 70,000 of the 2.3 million American Indians/Alaska Natives who
receive care from the IHS had diabetes.
From a study conducted in the United States in 1997, diabetes rates for American
Indians age 20 and older vary by tribal group, as shown in the following chart.
Group of Tribes
Geographic Area
Prevalence (%) - Per 100 persons
Alaska
Alaska
4.4
Atlantic
Alabama, Connecticut, Florida, Louisiana,
Maine, Mississippi, New York, North Carolina, Pennsylvania,
Rhode Island, South Carolina, Tennessee, Texas
21.0
Great Lakes
Michigan, Minnesota, Wisconsin
15.2
Northern Plains
Iowa, Montana, Nebraska, North Dakota,
South Dakota, Wyoming
16.3
Pacific Tribes
California, Idaho, Oregon,
Washington
7.0
Southern Plains
Kansas, Oklahoma
9.6
Southwest
Arizona, Colorado, Nevada, New Mexico,
Utah
13.9
Particularly, diabetes is common among
American Indians and Alaska Natives age 20 and
older. Its prevalence (per 100
persons) in American Indians and Alaska Natives, compared with that of
non-Hispanic whites by age group and sex, is shown in following chart.
Men
Men
Women
Women
All
All
Age Group (Years)
American Indians/ Alaska Natives
Non-Hispanic Whites
American Indians/ Alaska Natives
Non-Hispanic Whites
American Indians/ Alaska
Natives
Non-Hispanic Whites
20-44
3.2
0.6
4.1
1.3
3.7
0.9
45-64
17.8
5.4
21.7
5.1
19.9
5.2
65 and older
19.8
11.8
24.6
11.2
22.6
11.4
20 and older
8.1
3.9
10.6
4.5
9.4
4.2
Age-adjusted prevalence
10.2
3.8
12.6
4.0
11.5
3.9
The prevalence of type II diabetes was about 50% in the most widely studied
American Indian group, Pima Indians, ages 30 to 64.
For those over 19 years of age, prevalence of type II diabetes among Native
Americans in the United States is 12.2%.
Most cases of type I diabetes are found in people who have both
American Indian and Caucasian heritage. Relatively, type I diabetes is
rare in American Indians and Alaska Natives.
According to the Alaska Area Native Health Service, from 1986 to 1993, the death
rate for diabetes in Alaska Natives was 43.2 per 1,000 person-years of
diabetes.
Gestational Diabetes
Gestational diabetes is when blood glucose levels measure high above normal
during pregnancy.
The prevalence of gestational diabetes is 14.5% of pregnancies for Zuni Indians,
3.4% deliveries in Navajo Indians, and 5.8% of deliveries for Yup'ik Eskimos
Genetic Risk Factors
In the Choctaw Indians and the Pima Indians, compared with the more mixed
heritage individuals, the more full-blooded individuals were found to have the
highest prevalence of type II diabetes.
Lifestyle Risk Factors
There are increasing rates of obesity found in many American Indian and Alaska
Native communities. In Pima Indians, 95% of those with diabetes are overweight.
The location of the excess weight affects the degree to which obesity is a risk
factor for diabetes. Central or upper-body obesity is a stronger risk factor
for type II diabetes than excess weight carried below the waist.
In a study, Pima Indians living in Mexico had a lower prevalence of type II
diabetes than Pima Indians living in Arizona. It is because the Pima Indians in
Mexico consumed a more traditional diet that contained less animal fat and more
complex carbohydrates. In addition, Pima Indians in Mexico used up more
calories through activity.
Hypertension
In a national survey, the prevalence of hypertension was higher in American
Indians in Arizona and Oklahoma than non-Hispanic whites.
Renal Disease
American Indians with diabetes were six times more likely to experience
end-stage renal disease than non-Hispanic whites.
Certain groups have had high rates of kidney disease: Alaska Native, Cherokee,
Chippewa, Navajo, Oklahoma, Pima, Sioux, and Zuni tribes.
In 1989, end-stage renal disease was a leading cause of death among Pima Indians
with diabetes.
Compared to men, Alaska Natives women were more likely to develop end-stage
renal disease and more likely to die of renal failure.
2006 National Organization For
Renal Disease.
