Diabetes Rampant Among Native Americans

Disease relatively new to population, but manageable

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HealthDay Reporter

MONDAY, Aug. 30, 2004 (HealthDayNews) -- Sally Van Haren was adopted out of her native San Carlos Apache tribe as an infant and raised by a white family.

"I was always kind of bummed that I missed out on the culture, traditions and language," she said. "When I participated, I felt odd."

Now 36, van Haren has unexpectedly discovered a common bond with the rest of her tribe: diabetes.

Type 2 diabetes is rampant among Native American populations, with as many as half of the adults in some tribes suffering from the disease, said Dr. Donald Warne, a clinical professor in the School of Health Management and Policy at Arizona State University's W.P. Carey School of Business in Tempe. Warne, who is a Lakota Indian from South Dakota, treats patients on a reservation south of Phoenix that has the highest rate of type 2 diabetes in the world.

According to the National Institutes of Health, roughly 15 percent of Native Americans in the United States have this disease, which can rob them of their eyesight, their limbs, their kidneys and eventually their lives. They are 2.6 times more likely to have diagnosed type 2 diabetes than non-Hispanic whites.

That is a radically changed picture from the early part of the 19th century, when health surveys of Southwestern tribes found only one documented case of diabetes, Warne said.

He blamed the current epidemic more on environmental changes than on genetics.

In the 1920s and 1930s, rivers in the Southwest were dammed up to make way for large cities such as Phoenix. That effectively wiped out traditional farming for tribal communities. Fish, game and farm foods were replaced with government commodities such as lard and flour. The activities associated with fishing and farming were suddenly gone as well.

"There wasn't a huge genetic shift between the 1930s and the 1970s," Warne said. "Focusing on genetics is a mistake. It's a way to disempower people, making it seem fatalistic that you have to get a disease. We have the power to prevent it."

Poverty and inadequate government funding are primary obstacles to preventing and effectively treating diabetes in Native American populations, Warne claimed.

He said he has been to Indian schools where the most popular breakfast item is a giant cinnamon roll.

"It's a bad formula, because we have poverty in which the children are dependent on the schools for breakfast and lunch -- and also because of underfunded federal programs, they're eating terrible food and don't have physical education," he said.

Still, Warne acknowledged, "there is some degree of personal choice involved in how people get diabetes. We could all make better decisions to improve our health."

Both weight management and exercise can help prevent and manage diabetes, as Van Haren has discovered.

Van Haren was diagnosed with type 2 diabetes six years ago, when her vision became blurry. Her blood sugar levels were an astronomical 435 (the normal level after fasting is between 70 and 100). She started on medications and within a couple of weeks her eyes cleared up. "I didn't realize that it would make that big an effect," she said.

Van Haren has now cut down on snacks, pays strict attention to portions, and walks 30 to 40 minutes five days a week with her husband and two children. (Her 13-year-old daughter already has problems with blood sugar and seems to be on the road to diabetes.)

She is also an "A1c Champion," educating people on the importance of hemoglobin A1c, a blood test that provides an average of blood glucose levels over a two-to-three month period. Ideally, people should have A1c levels under 7; van Haren's is 6.5. She will be speaking on the issue at a national Native Americans and diabetes conference in Santa Rosa, Calif., this week.

Van Haren has also been urging her biological brother, who was diagnosed with type 2 diabetes just this month, to start exercising.

Most of Van Haren's health-care needs are taken care of for free on her nearby reservation. "I see the faces change, and I see them younger than when I first started," she said. "I was amazed at how many people who were San Carlos Apache were in that clinic."

More information

Visit the National Diabetes Information Clearinghouse for more on diabetes in the Native American population.

SOURCES: Sally van Haren, Willcox, Ariz.; Donald Warne, M.D., clinical professor, School of Health Management and Policy, W.P. Carey School of Business, Arizona State University, Tempe

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