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Diabetes among Alaska Natives: A review

https://arctichealth.org/en/permalink/ahliterature3105
Source
Int J Circumpolar Health. 2003 Dec;62(4):363-387
Publication Type
Article
Date
Dec-2003
  1 document  
Author
Naylor, JL
Schraer, CD
Mayer, AM
Lanier, AP
Treat, CA
Murphy, NJ
Author Affiliation
Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA. jnaylor@anmc.org
Source
Int J Circumpolar Health. 2003 Dec;62(4):363-387
Date
Dec-2003
Language
English
Geographic Location
U.S.
Publication Type
Article
File Size
118944
Keywords
Alaska Natives
Alaskan Indian
Aleut
Complications
Diabetes
Gestational diabetes
Abstract
This review summarizes the published information on diabetes mellitus and gestational diabetes among Alaska Natives. The most recently published age-adjusted prevalence was 28.3/1000 in 1998. There is evidence of a steadily increasing prevalence, documented both by cross sectional screening studies and patient registry methods. The overall incidence rates in 1986-1998 of lower extremity amputation (6.1/1000) and renal replacement therapy (2.1/1000) appear to be lower than those in other Native American populations in the United States. Incidence of stroke and MI in 1986-1998 varied widely by ethnic group and gender with Eskimo women having the highest rate of stroke (19.6/1000), and Aleut men the highest rate of MI (14/1000). The overall mortality among diabetic Alaska Native people in 1986-1993 (43.2/1000) was somewhat lower than that in other US diabetic populations, with heart disease being the most common cause of death. A high rate of gestational diabetes (6.7%) was reported in one region in 1987-88, but this appeared to decline following nutritional education intervention. In screening studies, the prevalence of abnormal glucose tolerance has been found to be positively associated with body mass index and negatively associated with daily seal oil or salmon consumption and higher levels of physical activity. Observations on the prevalence and relationships among other factors in the insulin resistance syndrome are summarized. Suggestions for prevention of diabetes and further studies are presented.
PubMed ID
14964764 View in PubMed
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Reduction of amputation rates among Alaska Natives with diabetes following the development of a high-risk foot program

https://arctichealth.org/en/permalink/ahliterature3085
Source
Pages 114-119 in J. Lepp�¤luoto, ed. Circumpolar Health 2003. Proceedings of the 12th International Congress on Circumpolar Health, Nuuk, Greenland, September 10-14, 2003. International Journal of Circumpolar Health. 2004;63(Suppl.2)
Publication Type
Article
Date
2004
isolated populations is possible by de- veloping a progran1to1naximize the skill levels of available personnel and to coordinate referral ser- vices for patients \'.'ith high-risk foot conditions. REFERENCES I. Schraer CD, Lanier AR Boyko EJ, Gohdes D, Murphy NJ: Prevalence of diabetes mellitus in
  1 document  
Author
Schraer, CD
Weaver, D
Naylor, JL
Provost, E
Mayer, AM
Author Affiliation
Alaska Native Tribal Health Consortium, Diabetes Program, Anchorage 99508, USA. cdschraer@anmc.org
Source
Pages 114-119 in J. Lepp�¤luoto, ed. Circumpolar Health 2003. Proceedings of the 12th International Congress on Circumpolar Health, Nuuk, Greenland, September 10-14, 2003. International Journal of Circumpolar Health. 2004;63(Suppl.2)
Date
2004
Language
English
Geographic Location
U.S.
Publication Type
Article
Digital File Format
Text - PDF
Physical Holding
Alaska Medical Library
Keywords
Alaska - epidemiology
Alaska Natives
Amputation - utilization
Diabetes
Diabetic foot - epidemiology - surgery
Foot care
Humans
Indians, North American - statistics & numerical data
Prevalence
Abstract
OBJECTIVE: The prevalence of diabetes is increasing rapidly among Alaska's Indian, Eskimo and Aleut populations. Approximately half the Native people with diabetes have no road access to hospitals or physicians, presenting a challenge in the attempt to prevent lower extremity amputation as a complication. In late 1998 funding became available for diabetes prevention and treatment among Native Americans. The tribal health corporations in Alaska decided to use a portion of this funding to implement a high-risk foot program to decrease the amputation rate. PROGRAM DESIGN: The program initially involved a surgical podiatrist who provided training to local staff and performed preventive and reconstructive surgery on several patients with impending amputations. The program then provided training for a physical therapist to become a certified pedorthist. This individual established the long-term maintenance phase of the program by conducting diabetic foot clinics routinely at the Alaska Native Medical Center, a referral center in Anchorage. He also travels to other regions of the state to provide training for village and hospital-based health care providers and to conduct field clinics. A system was established in a common database management program to track the patients' foot conditions. Patient education is emphasized. RESULTS: The overall amputation incidence among all Alaska Native patients with diabetes decreased from 7.6/1,000 in the pre-program period (1996 to 1998) to 2.7/1,000 in the post-program period (1999-2001) (p
PubMed ID
15736633 View in PubMed
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