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Wednesday, December 10, 2003

A study of young American Indians in Montana and Wyoming found that diabetes diagnoses among this critical population were only accurate about half of the time.

Based on an assessment of an Indian Health Service (IHS) database, researchers found that American Indians under the age of 20 were more likely to be misdiagnosed if they only received one health-care visit. Of 93 young Indians believed to have diabetes, 43 percent did not actually have it.

But for young Indians who received at least two health-care visits, the diagnoses were much more accurate, researchers discovered. Among this group of 61, only 20 percent did not have diabetes.

Misclassification doesn't have a major impact on the diabetes rates for young Indians nationally, the researchers noted. Even with the inaccurate diagnoses, the prevalence of Type 2 diabetes for Indians under the age of 20 remains less than 5 cases per 1,000.

But since Type 2 diabetes is increasing among young Indians, "accurate surveillance is important to monitor trends in diabetes prevalence," they wrote. Their study, a joint effort of the IHS in Billings and the Montana Department of Public Health and Human Services was published by the Centers for Disease Control and Prevention (CDC) last month.

Among adult American Indians and Alaska Natives, Type 2 diabetes shows up at incredibly high rates. For some tribes, most notably the Pimas of Arizona, upwards of half of the adult population has the disease, which can lead to kidney problems, amputation, blindness and other ailments.

In recent years, researchers have noticed that the disease is showing up in younger Natives. According to a 2000 CDC report, the prevalence rate was 4.5 per 1,000 young Indians. The rate among non-Native youth was 1.7 per 1,000.

At a recent consultation meeting with federal officials, Alvin Windy Boy, chairman of the Chippewa Cree Tribe of Montana, documented an explosion in the disease. He said there was a 25 percent increase among young Indians since 1990.

The rates will continue to rise, the American Academy of Pediatrics warned last month. Early diagnosis, preventive efforts and collaborative care are needed to combat the disease, the group said.

Diabetes is a condition that results when the body can't use energy from food properly, resulting in fatigue, increased appetite, nausea, increased thirst and blurred vision.

Until the early 1900s, it was almost unheard of among Native Americans. Health researchers believe an adequate diet, regular exercise and a healthy lifestyle are key to prevention and treatment.

Billings Area Study:
Diabetes Among Young American Indians --- Montana and Wyoming, 2000--2002 (November 21, 2003)

American Academy of Pediatrics Study:
Prevention and Treatment of Type 2 Diabetes Mellitus in Children, With Special Emphasis on American Indian and Alaska Native Children (October 2003)

Relevant Links:
Diabetes, Yahoo Health - http://health.yahoo.com/health/centers/diabetes

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