Type 2 Diabetes in the

American Indian / Alaskan

Native Population
Amy Abraham, Gill Casteen, Lauren Hilt,
Jacob McNeer, & Arunmani Phravorachith

*click video in bottom corner for audio

The Problem
The American Indian/Alaskan Native (AI/AN)
population has the highest prevalence of diabetes
mellitus (type 2 diabetes) in US.
● 71%
rates prevalence increase
continuing to for
increase
children and young adults
● mortality rate 3x higher than
average and lifespan 5.2
years shorter
Why is Type 2 Diabetes a Problem?
● Chronic disease from
insulin resistance
● Many severe long term
complications
● Shortens life span by 15
years
● 7th leading cause of death
in US
What are the causes?
● Prevalence and incidence data shows that Diabetes
is more likely affect some groups of people more
than others
○ Ethnicity, age, sex, and location
● Causes: Genetic disposition, unhealthy diet
sedentary lifestyle
Looking to the Future
● Statistics show that health disparities
between AI/AN and other populations will
not improve unless significant intervention
occurs
● New goals
Current Diabetes Interventions for AI/AN
● The Trimdown Program
● Lifestyle Balance Program
● The Seneca Health Trail Blazers
● Red Lake Band of Chippewa Indians- Weight
Management Program
● Fresno Native American Health Centers-Greatest
Loser Program
Limitation of Current Interventions

● Medical Mistrust in AI/AN Communities

○ Health Literacy
● Lasting Change in Lifestyle
○ Intrinsic Motivation
● Access to Interventions
○ Transportation
○ Time
What does tomorrow hold?
● In 2009, a report showed that AI/AN populations
receive 30% worse care than whites and have 62%
worse access.
● To change the high rate of diabetes, AI/AN
communities have created school programs that
focus on:
○ Increasing physical activity
○ Improving dietary habits
Indian Health Service (IHS)
● Focuses on addressing the consequences of
diabetes among the American Indian and Alaska
Native populations
● Special Diabetes program established in 1997 that
provides treatment for those living with diabetes
and preventative measures for the IHS, Tribal and
Urban Indian health programs
Our Approach
● School Based Intervention Program
○ Education on Nutrition and Exercise
● Importance of Motivation
○ Must address barriers
It cannot be assumed that what works for
one person will work for everyone else.
Our Approach
● Cultural Implementation
○ Native American Traditions
The success of this program relies on the
ability of schools to have lasting impact on
children and their families.
Acknowledgements
Shout out to…

● Lauren Hilt for always being proactive and going above and beyond with
her task for the week.
● Jacob McNeer for finding key resources for the research project and
helping develop the program we created.
● Arunmani Phravorachith for always doing her fair share and researching
how the problem will look in the future.
● Gill Casteen for taking the lead with assignment #3 and making sure the
group always stayed on task each week.
● Amy Abraham for always setting a high standard for the group with her
exceptional efforts and work each week.
References
Broussard, B.A., Sugarman, J.R., Bachman-Carter, K., Booth, K., Stephenson, L…& Gohdes, D. (1995). Toward comprehensive obesity
prevention programs in Native American communities. Obesity Research, 3: 289-297. doi:10.1002/j.1550-8528.1995.tb00476.x

Centers for Disease Control and Prevention. National diabetes statistics report, 2017. Diabetes.org.
http://www.diabetes.org/assets/pdfs/basics/cdc-statistics-report-2017.pdf.

Diabetes in American Indians and Alaska Natives. (2016, November 02). Retrieved from
https://diabeticgourmet.com/articles/diabetes-in-american-indians-and-alaska-natives/#24

Edwards K, Patchell B. State of the science: a cultural view of Native Americans and diabetes prevention. J Cult Divers. 2009;16(1):32–
5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905172/

Gittelsohn, J., Rowan, M. Preventing diabetes and obesity in American Indian communities: the potential of environmental
interventions. The American Journal of Clinical Nutrition. 2011. Retrieved from
https://academic.oup.com/ajcn/article/93/5/1179S/4597897

Indian Health Service. (n.d.) Special diabetes program for Indians. Retrieved from https://www.ihs.gov/sdpi/about/

Poudel, A., Zhou, J. Y., Story, D., & Li, L. (2018). Diabetes and Associated Cardiovascular Complications in American Indians/Alaskan
Natives: A Review of Risks and Prevention Strategies. Journal of diabetes research, 2018, 2742565. doi:10.1155/2018/2742565