We're in!

By Naomi Soto

Alaska Natives did not have a high risk of diabetes until the past two to three decades. Now, however, the prevalence of diabetes in Alaska is rising at an alarming rate.

From 2003 to 2005, more than 22,000 Alaska Natives suffered from diabetes, according to the Alaska Department of Health and Human Services. This is a 115 percent increase since 1990. In general, Alaska Natives have a lower rate of diabetes than American Indians, but state health officials say that now is the time to address and stop the growing epidemic.

"We have an opportunity because we have a lower prevalence of diabetes in the Alaska population, but it's moving faster than any other rates," said Dr. Terry Raymer, director of Head of the Alaska Area Diabetes Program. "There's a good opportunity to prevent that rate from moving any faster."

Most people diagnosed with diabetes have type 2, formerly called adult-onset diabetes. According to the National Diabetes Education Program, type 2 diabetes occurs when the body is unable to make enough insulin or the body cannot effectively use the insulin made. Symptoms include feeling tired or sick, frequent urination, blurred vision, unusual thirst, slow-healing wounds and weight loss.

Unfortunately, because type 2 diabetes develops more gradually than type 1 diabetes (or juvenile diabetes), symptoms are less noticeable. Some people show no symptoms at all.

There are many potential complications associated with diabetes. People who suffer from diabetes are more likely to suffer from heart disease, liver disease, problems with the nervous system, vision damage and stroke. Making matter worse, at least one-third of people suffering from diabetes in Alaska do not even know they have it.

Many experts say that as a result of genetic and family history and environmental factors, Alaska Natives are more than twice as likely as non-Hispanic whites to be diagnosed with diabetes. Obesity, high blood pressure, changes in diet and physical activity are factors leading to the increase of diabetes in Alaska.

"Most of the general population live in the urban centers, and as you get farther away, the people are more native. Western diet has taken a while to get there," said Gail Stolz at the Alaska Diabetes Prevention and Control Program. "Diet used to be subsistent. Fish and berries were collected. But now there are chips and junk food available in village stores. Vehicles started showing up everywhere starting in the 80s. People used to walk or use dogs or boats, but now everyone is riding a 4-wheeler."

There is also a growing concern about young people becoming susceptible to diabetes. There has been a 58% increase in diabetes prevalence among American Indians and Alaska Natives aged 20-29 from 1990 to 1998, as compared with 9.1% in the U.S. general population, according to the Indian Health Service Division of Diabetes Treatment and Prevention.

"The disease of grandparents is now a disease of our children," said Joan Chamberlain of the National Institute of Diabetes & Digestive & Kidney Disease.

Overall, families are affected by the increase in diabetes, too. Now, family elders are lost at an earlier time, families are impacted financially and the quality of life is diminishing. The prevalence of type 2 diabetes in Alaska Native families has affected children's perception of the disease as well.

"It's a destiny, instead of something they can prevent," said Raymer.

Type 2 diabetes can be prevented or delayed, even for overweight adults with only pre-diabetes symptoms. Pre-diabetes occurs when blood glucose levels are higher than normal, but are not quite high enough to diagnosis diabetes.

Families and youth are encouraged to take care of the "ABC's" of diabetes:
A: A1C or blood glucose should be at less than seven percent
B: Blood pressure should be less than 130/80 mmHg
C: LDL needs to remain less than 100 mg/dl

In addition to the ABC's, to prevent and offset the risk of diabetes, Alaska Natives are encouraged to make life-style changes. This includes losing 5-7 percent of body weight, exercising for at least 30 minutes, five days a week and limiting calorie and fat intake.

According to Raymer, making the switch to living and eating healthier, must be a family effort in order to be a multi-generational success.

"The things we recommend are for the whole family. It can't be that Grandma has diabetes, let's treat her differently," said Raymer. "Everyone has to be eating in a healthier fashion."

Links

The Diabetes Epidemic Among American Indians and Alaska Natives
http://ndep.nih.gov/diabetes/pubs/FS_AmIndian.pdf

National Diabetes Education Program
www.ndep.nih.gov

Facts At-a-Glance

Special Diabetes Program for Indians: General

Special Diabetes Program for Indians: Health Outcomes

Special Diabetes Program for Indians: Community-Directed Programs

Special Diabetes Program for Indians: Demonstration Projects

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