Diabetes Care, Vol 16, Issue 1 266-270, Copyright © 1993 by American Diabetes Association
Diabetes in a northern Minnesota Chippewa Tribe. Prevalence and incidence of diabetes and incidence of major complications, 1986-1988
SJ Rith-Najarian, SE Valway and DM Gohdes
Bemidji Area Office Indian Health Service, Diabetes Program, Minnesota 56601.
OBJECTIVE--To determine the prevalence and incidence of diabetes, and the
incidence of major diabetic complications, in a Chippewa Indian population.
RESEARCH DESIGN AND METHODS--The format was a longitudinal population study
that used active community and health center-based surveillance. The
setting was a North American Indian reservation community of 4075
residents, served by an IHS clinic from 1986 to 1988. Patients were
American Indians of Chippewa descent living on or near the Red Lake
Reservation. RESULTS--Midway through the study, 346 people had been
diagnosed with diabetes, which yielded an age- and sex-adjusted point
prevalence of 148/1000 population. The adjusted rate for individuals >
or = 25 yr of age was 252/1000 population, 3.82 times the U.S. rate (CI
2.95-4.93). Some 97 new cases of diabetes were identified for an age- and
sex-adjusted average annual incidence of 17/1000 population. The incidence
of hospitalization for LEA was 26/1000 diabetic person-yr, 4.3 times the
1978 U.S. rate (95% CI 2.8-6.8). Twelve individuals developed proliferative
retinopathy, for an incidence of 12/1000 diabetic person-yr. Newly
diagnosed ESRD incidence was 6/1000 diabetic person-yr. Twenty-three acute
myocardial infarctions were observed, yielding an incidence of 22/1000
diabetic person-yr. CONCLUSIONS--Diabetes and its complications are
prevalent in this Chippewa population, and further surveillance is needed
to evaluate the effectiveness of prevention efforts.