Diabetes Care, Vol 16, Issue 1 253-256, Copyright © 1993 by American Diabetes Association
Prevalence of diabetes and its complications in the Eastern Band of Cherokee Indians
MA Farrell, PA Quiggins, JD Eller, PA Owle, KM Miner and ES Walkingstick
Cherokee Indian Hospital, North Carolina.
OBJECTIVE--To determine the prevalence of diabetes and selected
complications among the Eastern Band of Cherokee Indians in North Carolina.
RESEARCH DESIGN AND METHODS--Multiple IHS data systems were used to
determine diabetes prevalence and complication rates. The RPMS was used to
identify diabetes cases as of April 1989, degree of Indian inheritance,
cardiovascular diseases (including hypertension), and retinopathy. Data on
laser treatments and LEA were obtained from individual registries.
Information on ESRD was obtained by a research assistant. The IHS
Ambulatory Patient Care reporting system was used to calculate the number
of diabetic patients for the years 1982-1987. The IHS user population was
used as the denominator. Rates were age-adjusted to the 1980 U.S.
population and diabetic population by the direct method. RESULTS--Using
clinical records, the age-adjusted prevalence of diabetes in 1988 was
105.6/1000 people, four times the U.S. rate. Rates of diabetes were highest
in the groups with the highest degree of Indian inheritance. LEAs occurred
among diabetic patients at three times the rate for the U.S. Between 1985
and 1989, new cases of ESRD occurred at a crude annualized rate of
578/million, approximately six times the rate for U.S. whites.
CONCLUSIONS--Diabetes presents a major burden to the Eastern Band of
Cherokees. The limitation inherent in this study probably result in
underestimation of the prevalence of diabetes and its complications in the
community. Future studies are needed to assess the impact of medical and
preventive programs on diabetes prevalence and complications in this
community.