Related Experiment Video

Updated: Sep 26, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Glycemic control in diabetic American Indians. Longitudinal data from the Strong Heart Study

D Hu1, J A Henderson, T K Welty

  • 1MedStar Research Institute, Washington, DC 20010, USA. dxha@mhg.edu

Diabetes Care
|November 5, 1999
PubMed

Insights

Glycemic control remains poor for American Indians with diabetes. Factors like female sex, insulin use, and younger age correlate with worse HbA1c levels, indicating a need for improved interventions.

Area of Science:

  • Cardiovascular Disease Epidemiology
  • Diabetes Mellitus Research
  • American Indian Health

Background:

  • The Strong Heart Study is a longitudinal investigation of cardiovascular disease (CVD) risk factors in American Indians.
  • Diabetes mellitus is a significant health concern within this population, impacting CVD risk.
  • Understanding glycemic control is crucial for managing diabetes complications.

Purpose of the Study:

  • To characterize glycemic control in American Indians with diabetes.
  • To identify factors associated with elevated hemoglobin A1c (HbA1c) levels.
  • To inform strategies for improving diabetes management in this demographic.

Main Methods:

  • Analysis of baseline and follow-up data from 1,581 diabetic American Indian participants (aged 45-74) in the Strong Heart Study.
  • HbA1c levels measured at follow-up served as the primary indicator of glycemic control.
  • Cross-sectional and longitudinal relationships between potential correlates and HbA1c were assessed using ANCOVA and multiple regression.

Main Results:

  • Median HbA1c levels showed no significant change between baseline (8.4%) and follow-up (8.5%).
  • Female sex, younger age, and use of insulin or oral hypoglycemic agents were associated with higher HbA1c levels.
  • Baseline HbA1c predicted future levels, while insulin therapy demonstrated a significant decrease in HbA1c over time.

Conclusions:

  • Glycemic control is suboptimal among American Indians with diabetes in the Strong Heart Study.
  • Specific subgroups, including women, younger individuals, and those on medication, exhibit poorer control.
  • Enhanced therapeutic approaches are necessary to improve glycemic control and mitigate diabetes-related risks in this population.
Abstract

More Related Videos

Randomized Controlled Trial to Study the Acute Effects of Strength Exercise on Insulin Sensitivity in Obese Adults06:13

Randomized Controlled Trial to Study the Acute Effects of Strength Exercise on Insulin Sensitivity in Obese Adults

Published on: December 1, 2023

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes07:22

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

Published on: March 7, 2025

Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Diabetes Mellitus: Introduction01:26

Diabetes Mellitus: Introduction

Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...
Type I Diabetes I: Introduction01:12

Type I Diabetes I: Introduction

Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1 diabetes is an...
Type II Diabetes I: Introduction01:26

Type II Diabetes I: Introduction

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.