Diabetes in American Indians: a growing problem

Area of Science:

• Public Health
• Epidemiology
• Diabetes Mellitus Research

Background:

• Non-insulin-dependent diabetes mellitus presents a substantial health burden within American Indian communities.
• The Indian Health Service (IHS) monitors health data, including outpatient visits, hospitalizations, and mortality, for American Indians and native Alaskans.

Purpose of the Study:

• To analyze the prevalence and impact of diabetes mellitus in American Indian and native Alaskan populations using IHS data.
• To highlight the significant morbidity and mortality associated with diabetes in this demographic.

Main Methods:

• Analysis of IHS outpatient visit data from fiscal year 1983 for patients aged 15 and older.
• Review of IHS discharge diagnoses to identify diabetes-related complications (microvascular and macrovascular).
• Examination of IHS hospitalization data for lower-extremity amputations and diabetes coding in fiscal year 1983.
• Comparison of age-adjusted diabetes death rates in 1982 for American Indians/native Alaskans versus the general US population.

Main Results:

• Diabetes was the second leading clinical impression for outpatient visits among patients 15+ years old in fiscal year 1983.
• Discharge diagnoses indicated both microvascular and macrovascular complications of diabetes.
• Diabetes was coded in 76% of all IHS hospitalizations for lower-extremity amputations during fiscal year 1983.
• The age-adjusted diabetes death rate was 19.9 per 100,000 for American Indians and native Alaskans in 1982, compared to 9.6 for all US races.

Conclusions:

• Diabetes mellitus is a leading cause of morbidity and mortality among American Indians and native Alaskans.
• Diabetes significantly contributes to severe complications such as lower-extremity amputations.
• The diabetes death rate in this population is disproportionately high, underscoring the need for targeted public health interventions.