Diabetic Complications Among American Indians of Washington, Oregon, and Idaho: Prevalence of retinopathy, end-stage renal disease, and amputations
- William L Freeman, MD, MPH and
- Gwendolyn M Hosey, RN, MS, ANP, CDE
- Research Program, Indian Health Service Office of Health Program Research and Development Tucson, Arizona Portland Area Diabetes Program, Lummi Indian Health Center Bellingham, Washington
- Address correspondence and reprint requests to Gwendolyn M. Hosey, RN, MS, ANP, CDE, Portland Area Diabetes Program, Indian Health Service, Lummi Indian Health Center, 2592 Kwina Road, Bellingham, WA 98226-9297.
Abstract
OBJECTIVE— To estimate the prevalence of severe diabetic complications.
RESEARCH DESIGN AND METHODS— We surveyed the data systems of the IHS and local care providers to identify all AI/AN people with any of three diabetic complications: retinopathy needing one or more laser treatments, ESRD needing dialysis, and one or more LEAs. We calculated prevalence rates that were sex-age adjusted to the U.S. population for total sample, each community, gender, and culture area.
RESULTS–Of the population-based complete sample with diabetes, 1.7% had retinopathy, 1% ESRD, and 4% LEA. Complication rates among the culture areas were not statistically different. The LEA rate among diabetic men (5.8%) was higher than that among women (2.3%). The odds ratio was 2.2 (95% CI 1.2-4.2). One community had an extraordinarily high LEA rate of 16%.
CONCLUSIONS— This study showed that IHS can use its data systems to estimate prevalence of diabetic complications and identify population groups with higher prevalence rates. The data led the IHS clinic with the high LEA rate to start a program to prevent amputations. We suggest quality assurance activities based on the methods of this study.
- Copyright © 1993 by the American Diabetes Association
