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The diabetes project at Fort Totten, North Dakota, 1984-1988
W P Newman1, J J Hollevoet, K L Frohlich
1Fargo Veterans Medical Center, North Dakota.
Objective:
To characterize demographic, therapeutic, and complication features of patients in the Fort Totten Diabetes Project and to assess the longitudinal impact of intervention strategies.
Research Design And Methods:
Individuals (n = 215) of varying American Indian ethnic origin and a quantum of mean age 53 yr (range 14-86 yr), 62% women, with type II diabetes of 9 yr average duration were studied. Annual chart audits of the complete diabetic population were conducted from 1984 to 1988.
Results:
Obesity is a major problem complicating diabetes management (average BMI 32 +/- 0.9), but BMI does not correlate with glucose control as assessed by total GHb (r = 0.014, NS). Individuals lost an average of 3.7 kg (P < 0.001) during the audit years. Mean GHb declined for the population (11.3-9.7%, P < 0.025) during the interval, but no significant decline was evident when values for individuals were considered. Complication rates for retinopathy, nephropathy, and neuropathy paralleled those rates published for urban populations.
Conclusions:
Diabetes mellitus in American Indians living in a rural, economically deprived area can be identified and cared for with success similar to that published for urban populations.
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