Native Americans and Their Fight Against Diabetes

Since the arrival of Columbus in 1492, American Indians have been in a continuous struggle with diseases. It may not be small pox anymore, but illnesses are still haunting the native population. According to statistics, Native Americans have much higher rates of disease than the overall population. This includes a higher death rate from alcoholism, tuberculosis, and diabetes than any other racial or ethnic group. Recent studies by Indian health experts show that diabetes among Indian youth ages 15-19 has increased 54% since 1996 and 40% of Indian children are overweight. Even though diabetes rates vary considerably among the Native American population, deaths caused from diabetes are 230 percent greater than the United States population as a whole. Diabetes is an increasing crisis among the Native American population.

Diabetes is a disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Diabetes falls into two main categories: type 1, or juvenile diabetes, which usually occurs during childhood or adolescence, and type 2, or adult-onset diabetes, the most common form of the disease, usually occurring after age 40. Type 1 results from the body's immune system attacking the insulin-producing cells in the pancreas. The onset of juvenile diabetes is much higher in the winter than in the summer. This association has been repeatedly confirmed in diabetes research. Type 2 is characterized by "insulin resistance," or an inability of the cells to use insulin, sometimes accompanied by a deficiency in insulin production. There is also sometimes a third type of diabetes considered. It is gestational diabetes, which occurs when the body is not able to properly use insulin during pregnancy. Type 2 diabetes encompasses nine out of 10 diabetic cases. Diabetes is the fifth-deadliest disease in the United States, and it has no cure. The total annual economic cost of diabetes in 2002 was estimated to be $132 billion, or one out of every 10 health care dollars spent in the United States. Diabetes risk factors can fall into three major categories: family history, obesity, and impaired glucose tolerance. Minority groups and elderly are at the greatest risk of developing diabetes.

Native Americans did not have a problem with this affliction until this past century. Diabetes is strongly affected by behavior. Due to a sudden change in diet and lifestyle, Native Americans have experienced a sharp and sudden rise in diabetes. When the Native Americans were forced onto reservations they stopped hunting and preparing their own food. Instead the United States government gave them food that their bodies were not used to digesting. Indians were not used to eating flour, lard, canned meats and poultry that are swimming in fat, and canned fruits and vegetables packed in sugary syrup.

Native Americans' bodies could not handle the extra fat and sugar in their diet. This, coupled with a decrease in intense exercise, increased obesity and brought on the rise of diabetes. The sudden lack of exercise resulted in a significant weight increase in the Native American community. Indians were used to roaming the countryside. They had to follow the buffalo or move to warmer weather. Now, they were put into permanent homes and bought their food. This created an overweight, obese group of people. Studies estimated that the overall occurrence of obesity among Native Americans was 13.7 percent for men and 16.5 percent for women. These are higher than the United States' rates of 9.1 percent and 8.2 percent, respectively. It is reported that the United States spends $93 billion a year on preventable obesity- related illnesses and diseases.

When most of us think of the great Indians of the last century, we think of a thin, well-defined figure standing stern and serious. When we think of a modern Indian, we have an image of a larger, more rounded type of person. Of course this is not the description of many Indians, but many would agree this is the image many people have. A rounded, non-chiseled face has replaced the classic Indian, high cheekbone, profile. Being overweight makes it harder for bodies of Native Americans to keep blood sugars at a normal level. The result is type 2 diabetes, which Native Americans most commonly get. Type 2 diabetes is not as serious as type 1, but still has serious affects if not properly attended.

Today, diabetes has become widespread among Native Americans. The problem seems to be growing faster than the resources for dealing with it. Complications from diabetes are a major cause of death and can cause serious health problems in most Native American populations. On average, Native Americans are 2.2 times more likely to have diagnosed diabetes as non-Hispanic whites of similar age. 12.2% of American Indians over 19 years of age suffer from type 2 diabetes. A tribe in Arizona, the Pimas, has the highest rate in the world. About 50% of Pimas between ages 30 and 64 have diabetes. According to Joe Jacobs, "The disease is real to our children. They've seen what it does to family members. Our leaders need to open their eyes and hearts and slow this disease." More and more young people are starting to realize the severity of this disease by watching their family members go through all of the effects. "My grandparents on both sides and both my mom and dad have it, so there are lots of points against me," says Donna Young, a 25 year old Pima Indian.

The biggest changes in the families with children who are at risk are a change in the diet and physical fitness, even though diabetes can be hereditary. "Women who were drinking sugar-sweetened soft drinks every day, or more than once a day, had an 80% increase in risk of diabetes compared with women who hardly ever drank sugared sodas," said Dr. Meir Stampher of Harvard School of Public Health in Boston, following the release of new national research. The consumption of too much sugar without proper exercise can lead to excess sugar in the blood cells causing poor circulation. This causes wounds to improperly heal, which can result in infection and possibly amputation. Diabetes is the most frequent cause of non-traumatic lower limb amputations. The risk of a leg amputation is 15 to 40 times greater for a person with diabetes. Each year 82,000 people lose their foot or leg to diabetes. Amputation rates among Native Americans are 3 to 4 times higher than that of the general population. In addition, diabetic subjects with amputation had a higher death rate than that among nonamputees.

Some of the earliest symptoms of diabetes include extreme thirst and frequent urination, caused by the body's attempts to flush out the accumulated glucose in the blood. Diabetics

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