1. Native American’s and Type 2 Diabetes

2. Diabetes Prevalence  Native Americans (NA) are 2.1 times more likely to be diagnosed with Type 2 Diabetes (DM) than Whites.  NA are almost 2 times as likely to die from DM.  Pima Indians have approximately 50% incidence of DM. (The Office of Minority Health, 2010)

3. Percentage of persons 18 years of age and over with diabetes (2008) Native AmericanNon-Hispanic Whites Native American/Non- Hispanic White Ratios 157.12.1 (The Office of Minority Health, 2010)

4. Percentages of persons 18 years of age and over with diabetes (1999-2003) (The Office of Minority Health, 2010)

5. Diabetes Death Rates per 100,000 (2006) Native AmericanNon-Hispanic Whites Native American/Non- Hispanic White Ratios 39.620.41.9 (The Office of Minority Health, 2010)

6. Diabetes Death Rates per 100,000 (2006) (The Office of Minority Health, 2010)

7. DM Death Rates 45 – 54 Years (2003)

8. DM Death Rates 55 – 64 Years (2003)

9. DM Death Rates Over 65 Years (2003)

10. Percentage of persons 18 years of age and over with diabetes who had a foot examination (2006) Native AmericanNon-Hispanic Whites Native American/Non- Hispanic White Ratios 74671.1 (Trends in Indian Health 2002 – 2003 Edition, 2010)

11. Causes of Type 2 Diabetes in NA  Population-based studies have consistently found that high alcohol intake increases one’s risk of developing Type 2 diabetes (Carlsson et al., 2000; Holbrook, Barrett-Connor, & Wingard, 1990; Howard, Arnsten, & Gourevitch, 2004; Kao, Puddey, Boland, Watson, & Brancati, 2001).  In their meta-analysis of the effect of alcohol consumption on diabetes, Howard et al. found that individuals who consume 3 or more alcoholic drinks each day have a 43% greater risk of diabetes.  NA specific interventions based on cultural moderators are similar to those developed for Hawaiian populations, and may include the promotion of familial relational bonds and community support, and the use of spiritual and traditional healers. (Tann, Yabiku, Okamoto, Yanow, 2007)

12. Causes of Type 2 Diabetes in NA  The emergence of type 2 diabetes mellitus in young people is believed to be associated with changes in physical activity and nutrition that are ubiquitous in modern society.  Not all populations are equally affected. NA children in the United States and Canada have a higher rate of this disease than do children of other ethnicities.

13. Native American Diabetes Project: Designing Culturally relevant educationally material  A diabetes culturally sensitive educational program designed for NA incorporated traditional tribal ways and habits.  The symbol of the eagle was utilized as it symbolizes courage, strength, and wisdom.  An initial story titled “Through the Eyes of the Eagle” was so successful that more stories were included to introduce key concepts.  Prayers were written to conclude each educational session. (Carter et al., 1997)

15. References  Carter, J.S. et al. (1997). Native American diabetes project: Designing culturally relevant education materials. Diabetes Educator, 23(2), 133 – 139.  Gahagan, S., & Silverstein, J. (2003). Prevention and treatment of type 2 diabetes mellitus in children, with special emphasis on American Indian and Alaska Native children. American Academy of Pediatrics Committee on Native American Child Health. Pediatrics, 112(4), e328.  Indian Health Service. (2010). Trends in Indian Health 2002 – 2003 Edition. Retrieved from http://www.ihs.gov/NonMedicalPrograms/IHS_Stats/index.cfm?module =hqPubTrends03#cover http://www.ihs.gov/NonMedicalPrograms/IHS_Stats/index.cfm?module =hqPubTrends03#cover  Tann, S., Yabiku, S., Okamoto, S., & Yanow, J. (2007). triADD: the risk for alcohol abuse, depression, and diabetes multimorbidity in the American Indian and Alaska Native populations. American Indian And Alaska Native Mental Health Research (Online), 14(1), 1-23.  The Office of Minority Health. (2010). Diabetes and American Indian. Retrieved from http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=5&I D=3024 http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=5&I D=3024