Diabetes in Navajo Youth

Prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study

  1. Dana Dabelea, MD, PHD1,
  2. Joquetta DeGroat2,
  3. Carmelita Sorrelman, RN, MPH2,
  4. Martia Glass, MD3,
  5. Christopher A. Percy, MD2,
  6. Charlene Avery, MD4,
  7. Diana Hu, MD5,
  8. Ralph B. D'Agostino, Jr., PHD6,
  9. Jennifer Beyer, MS6,
  10. Giuseppina Imperatore, MD7,
  11. Lisa Testaverde, MS1,
  12. Georgeanna Klingensmith, MD8,
  13. Richard F. Hamman, MD, DRPH1 and
  14. for the SEARCH for Diabetes in Youth Study Group
  1. 1Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Denver, Colorado
  2. 2Department of Health Promotion Disease Prevention, Northern Navajo Medical Center, Navajo Area Indian Health Service, Shiprock, New Mexico
  3. 3Area Diabetes Program, Navajo Area Indian Health Service, Window Rock, Arizona
  4. 4Diabetes Program, Gallup Indian Medical Center, Navajo Area Indian Health Service, Gallup, New Mexico
  5. 5Pediatrics Department, Tuba City Regional Health Care Center, Tuba City, Arizona
  6. 6Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Wake Forest, North Carolina
  7. 7Centers for Disease Control and Prevention, Atlanta, Georgia
  8. 8Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, Colorado
  1. Corresponding author: Dana Dabelea, dana.dabelea{at}


OBJECTIVE—To estimate the prevalence and incidence of diabetes, clinical characteristics, and risk factors for chronic complications among Navajo youth, using data collected by the SEARCH for Diabetes in Youth Study (SEARCH study).

RESEARCH DESIGN AND METHODS—The SEARCH study identified all prevalent cases of diabetes in 2001 and all incident cases in 2002–2005 among Navajo youth. We estimated denominators with the user population for eligible health care facilities. Youth with diabetes also attended a research visit that included questionnaires, physical examination, blood and urine collection, and extended medical record abstraction.

RESULTS—Diabetes is infrequent among Navajo youth aged <10 years. However, both prevalence and incidence of diabetes are high in older youth. Among adolescents aged 15–19 years, 1 in 359 Navajo youth had diabetes in 2001 and 1 in 2,542 developed diabetes annually. The vast majority of diabetes among Navajo youth with diabetes is type 2, although type 1 diabetes is also present, especially among younger children. Navajo youth with either diabetes type were likely to have poor glycemic control, high prevalence of unhealthy behaviors, and evidence of severely depressed mood. Youth with type 2 diabetes had more metabolic factors associated with obesity and insulin resistance (abdominal fat deposition, dyslipidemia, and higher albumin-to-creatinine ratio) than youth with type 1 diabetes.

CONCLUSIONS—Our data provide evidence that diabetes is an important health problem for Navajo youth. Targeted efforts aimed at primary prevention of diabetes in Navajo youth and efforts to prevent or delay the development of chronic complications among those with diabetes are warranted.


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