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Diabetes Care 26:55-60, 2003
© 2003 by the American Diabetes Association, Inc.

Epidemiology/Health Services/Psychosocial Research
Original Article

Prevalence of Diabetes Is Higher Among Female than Male Zuni Indians

Marina Scavini, MD1,2, Christine A. Stidley, PHD1,3, Vallabh O. Shah, PHD4, Andrew S. Narva, MD5, Francesca Tentori, MD4,6, David S. Kessler, MD7, Arlene Bobelu, BS1, Carleton P. Albert, BS4, Jeanette Bobelu, BSN4, Eunice Jamon, LPN4, Kathy Natachu4, Donica Neha, BSN4, Mildred Waikaniwa4, Thomas K. Welty, MD4, Jean W. MacCluer, PHD8 and Philip G. Zager, MD4

1 Dialysis Clinic, Inc., Albuquerque, New Mexico
2 H. San Raffaele Scientific Institute, Milan, Italy
3 Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico
4 Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
5 Kidney Disease Program, Indian Health Service, Albuquerque, New Mexico
6 Universita’ degli Studi di Milano, Scuola di Specializzazione in Nefrologia, Milan, Italy
7 Zuni Indian Hospital, Zuni Pueblo, New Mexico
8 Southwest Foundation for Biomedical Research, San Antonio, Texas

OBJECTIVE—Test the hypothesis that diabetes and related risk factors are more common among female than male Zuni Indians.

RESEARCH DESIGN AND METHODS—We conducted a population-based, cross-sectional survey of the Zuni Indians aged >=5 years. We used households within neighborhood clusters as the sampling frame. We administered a questionnaire, collected blood and urine, and measured height and weight. Self-reported diabetes was used to assess previously diagnosed diabetes. Participants without a prior history of diabetes were classified as having newly diagnosed diabetes if they had HbA1c >7.0% or random glucose >=11.1 mmol/l during the survey.

RESULTS—The prevalence of previously diagnosed diabetes among Zuni Indians aged >=5 years (n = 1,503) was higher among female Zuni Indians (16.7% [95% CI 14.1–19.3]) than male Zuni Indians (9.7% [7.4–12.1]) (P < 0.001). The prevalence of newly diagnosed diabetes was similar among female Zuni Indians (2.4% [1.4–3.4]) and male Zuni Indians (2.4% [1.2–3.6]). The prevalence of previously and newly diagnosed diabetes was higher among female Zuni Indians (19.1% [16.4–21.9]) than male Zuni Indians (12.2% [9.5–14.8]) (P < 0.001). The prevalence of obesity was higher among female Zuni Indians (34.3% [30.9–37.7]) than male Zuni Indians (21.5% [18.4–24.7]) (P < 0.001). Obesity was associated with diabetes among female and male Zuni Indians. Physical inactivity was more common among female Zuni Indians (44.2% [40.7–47.8]) than male Zuni Indians (35.1% [31.5–38.7]) (P < 0.001). However, physical inactivity was not associated with diabetes among either female or male Zuni Indians. Gestational diabetes was a risk factor among female Zuni Indians.

CONCLUSIONS—Among the Zuni Indians, the prevalence of diabetes was 57% higher among female than male members of the population. Culture, tradition, and lifestyle differences may contribute to the higher prevalence of diabetes and obesity among female Zuni Indians.

Abbreviations: GDM, gestational diabetes mellitus • IQR, interquartile range • OR, odds ratio • PBCSS, population-based cross-sectional survey • SHS, Strong Heart Study • ZTC, Zuni Tribal Census


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