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Dave BaldridgeBack to OpinionDave Baldridge

Combating diabetes in the American Indian community

Nearly one in four U.S. teens has diabetes or pre-diabetes. The number of those affected has raced out of control, from 9.9 percent in 2000 to 23 percent in 2008, according to the June issue of Pediatrics.

This news doesn’t bode well for kids throughout America, who are losing ground daily to the disease. The Centers for Disease Control and Prevention reported last year that 8.3 percent of the U.S. population or about 25.8 million Americans, now have diabetes and more than one-third of U.S. children born in 2000 will suffer from the disease if current trends continue. Unfortunately, no one seems to have found the brake pedal for this runaway epidemic.

Good news, however, appears to be coming from — of all places — Indian country. Despite the fact that American Indians and Alaska Natives still suffer from Type 2 diabetes at a rate more than twice the national average, new evidence indicates that tribes, the Indian Health Service and urban Indian clinics are beginning to successfully combat the disease. The Special Diabetes Program for Indians in particular is reporting some remarkable outcomes.

Since 1998, when the first special diabetes grant programs were funded, the availability of diabetes clinics for American Indians and Alaska Natives has more than doubled, from 31 to 71 percent. Now, more than three-fourths of these clinics provide services by registered dieticians, and nearly 9 out of 10 offer nutrition services. Remarkably, diabetes clinical teams now exist at 94 percent of these reservation and urban-based programs — more than three times the rate of just 13 years ago.

The real story lies in the program’s growing record of sustained clinical improvements. Some of the diabetes’ programs health outcomes — including reductions in blood sugar and LDL or bad cholesterol — are approaching or have exceeded national Healthy People 2020 goals. These goals are established each decade by the Department of Health and Human Services to monitor the nation’s progress toward better health.

Additionally, between 1995 and 2006, the incidence rate of end-stage renal disease in American Indians and Alaska Natives with diabetes fell 27.7 percent. This is a rate in decline greater than lowered rates seen in any other racial or ethnic group. The Indian Health Service believes preventing end-stage kidney disease has saved millions of dollars for the federal government in dialysis costs. In 2009, for example, the average cost per patient for dialysis was $82,000.

If these marked improvements are to continue, Congress will need to re-authorize and provide adequate financial support for the Indian special diabetes project this fall — a $200 million budget request that would fund about 400 programs. The investment will not only result in healthier and more productive lives for American Indians, but will ultimately reduce federal expenditures.

According to Buford Rolin, co-chairman of the Tribal Leaders Diabetes Committee, “Tribes have shown that we can change the diabetes landscape. Now we can create success stories that were unimaginable 13 years ago when these programs started.”