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Diabetes among Alaska Natives: a review
J L Naylor1, C D Schraer, A M Mayer
1Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA. jnaylor@anmc.org
International Journal of Circumpolar Health
|February 18, 2004
Summary
Diabetes prevalence is increasing among Alaska Natives, though complications like amputation and kidney failure are lower than in other Native American groups. Lifestyle factors like diet and activity influence glucose tolerance.
Area of Science:
- Public Health
- Epidemiology
- Indigenous Health
Background:
- Diabetes mellitus and gestational diabetes pose significant health challenges for Alaska Native populations.
- Understanding the prevalence and trends of diabetes is crucial for targeted public health interventions.
Purpose of the Study:
- To review and synthesize existing data on diabetes mellitus and gestational diabetes among Alaska Natives.
- To examine the incidence of diabetes-related complications and mortality within this population.
- To identify factors associated with abnormal glucose tolerance and suggest preventive strategies.
Main Methods:
- Review of published literature and screening studies on diabetes in Alaska Natives.
- Analysis of patient registry data for incidence and prevalence rates.
- Examination of epidemiological data for complications (amputation, renal replacement therapy, stroke, MI) and mortality.
Main Results:
- Age-adjusted diabetes prevalence was 28.3/1000 in 1998, with evidence of a steady increase.
- Incidence of lower extremity amputation (6.1/1000) and renal replacement therapy (2.1/1000) were lower than in other US Native American populations.
- Stroke and MI incidence varied by ethnicity and gender; Eskimo women had the highest stroke rate (19.6/1000), Aleut men the highest MI rate (14/1000).
- Overall mortality among diabetic Alaska Natives (43.2/1000) was lower than in other US diabetic populations, with heart disease as the leading cause of death.
- Gestational diabetes prevalence was high (6.7%) in one region but declined after nutritional intervention.
- Abnormal glucose tolerance was associated with higher BMI and negatively associated with seal oil/salmon consumption and physical activity.
Conclusions:
- Diabetes mellitus and gestational diabetes represent a growing public health concern for Alaska Natives.
- While some complication rates are lower than in other Native American groups, continued monitoring and prevention efforts are essential.
- Lifestyle modifications, including diet and physical activity, are key factors in managing and preventing diabetes in this population.
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