The number of American Indians with diabetes continues to rise despite aggressive prevention programs, but still there is cause for optimism, health officials said Tuesday.
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Studies show without doubt that lifestyle changes -- diet, exercise and weight loss -- significantly reduce diabetes risk in all populations, speakers said at a national conference on preventing diabetes in Indians.
Experts project that a quarter of all non-Hispanic whites and 50 percent of all people of color born in 2000 will develop diabetes in their lifetimes, said Dr. Richard Hamman of the University of Colorado's Department of Preventive Medicine.
American Indians lead all racial and ethnic groups in incidence of diabetes and are more than twice as likely as non-Hispanic whites to get the disease.
"Clearly, Houston, we have a problem," Hamman told more than 500 people who came from across the country to network and share best practices.
The conference is sponsored by the Indian Health Service and the Oklahoma Native American EXPORT Center.
Hamman reviewed medical studies of the effectiveness of various diabetes prevention programs. There is preliminary evidence that certain medications may work and conclusive evidence that weight loss, a low-fat diet and exercise do, he said.
Meeting all three goals reduces the incidence of diabetes by almost 90 percent, and the effect occurs in every racial, ethnic and age group, Hamman said.
One study suggested for every kilogram (2.2 pounds) of weight loss, there is a 16 percent reduction in diabetes risk, Hamman said.
"So someone doesn't have to go out and become this tiny little person. Just a little weight loss significantly reduced the incidence," he said.
When diabetes strikes, early diagnosis and treatment delay the worst complications, and the Indian health system is a world leader in doing both while spending less than private health care providers, said Assistant Surgeon General Charles W. Grim, director of the Indian Health Service.
"One never hopes to get a disease. ... But if you get diabetes, you should hope you're an American Indian or Alaska native because that system knows how to treat it perhaps better than anyone in the world," Grim said.
Tests of Indian patients with diabetes show they are controlling the high blood-sugar levels that ravage the body, said Dr. Kelly Moore, clinical consultant for the Indian Health Service's National Diabetes Prevention Program in Albuquerque, N.M.
"This is great news," Moore said. "There are a number of positive things happening in Native American and Alaskan Native communities despite the disparate burden we bear," she said.
More than 75 tribes from across the country came to the conference.
"I wanted to get an idea of what other communities are doing in terms of prevention," said Jolene Luna, who came from Zuni, N.M., where she works with a small Navajo community.
Ron Tso, head of an Indian Health Service facility in Chinle, Ariz., said the movement now is toward empowering communities and individuals to take control of their health.
"I think what you're finding is more of a spirit of optimism," Tso said.
The conference continues through Thursday at the Cox Convention Center.
Low-fat recipes approved by the Indian Health Service Division of Diabetes Treatment and Prevention.
Diabetes Prevention Program To prevent diabetes, the Indian Health Service recommends:
A 7 percent weight loss.
A diet with fewer than 25 percent of calories from fat.
Consumption of 1,200 to 2,000 calories a day.
150 minutes of exercise per week.
Source: Indian Health Service
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