WASHINGTON, DC— Many American Indians and Alaska Natives (AI/ANs) believe that it is inevitable that they will suffer from Type 2 diabetes, activists from Indian Country told a Senate committee.

“My peers many times feel that Type 2 diabetes is inevitable. They tell me that they know they will get it eventually because their parents, grandparents, and other family members have diabetes,” Caitlin Baker, a 16-year-old member of the Muscogee Creek nation, told the Senate Indian Affairs Committee.

Baker recently testified about the impact of diabetes with a panel that included Gary Hall, a 10-time Olympic medalist, and Wes Studi, a member of the Cherokee nation who is an actor and played roles in “Avatar,” “The Last of the Mohicans,” and “Dances with Wolves.”

The rate of diabetes among AI/ANs is believed to be more than twice the rate of the general population in the US. The “real disaster” of the disease is how accepted it is as a part of life in Indian Country, Studi testified. “We need to get the idea out that it is not an acceptable thing, it is just another epidemic that has scourged Indian Country.”

Senate Indian Affairs Chairman Sen Byron Dorgan, D-ND, called the problem of diabetes in Indian Country “extraordinary.” He said that it was important that Congress reauthorize the Special Diabetes Program. The program provides research funding for Type 1 diabetes, and a parallel program, the Special Diabetes Program for Indians (SDPI) provides funding for grants that target diabetes prevention and treatment programs among Indian tribes.

The current authorization provides $150 million per year for each of these programs through September 30, 2011.

Addressing Diabetes

Studi credited SDPI grants in allowing tribal communities to implement a wide range of strategies to address diabetes in a culturally appropriate manner. He called for more resources to “conduct research, provide assistance, and purchase the medications necessary to sustain and expand” the SDPI program.

Melvina McCabe, a Navajo physician who is the president of the Association of American Indian Physicians, told the committee that SDPI has funded programs for AI/ANs that promote weight loss and exercise, which are key components in Type 2 diabetes prevention and cardiovascular risk reduction. She said that since implementing the SDPI program, community walking and running programs increased from 20% to 92% and community exercise programs increased from 16% to 69% among tribes. In addition, weight management programs for children increased from 8% to 72%.

McCabe, however, also acknowledged factors that hinder diabetes care in Indian communities, such as many AI/ANs do not have electricity and running water. “Without electricity, how do we store our insulin appropriately, how do we store healthy foods such as fresh vegetables, fruits, eggs, milk?”

Socio-economic factors also present a challenge. She recounted how she treated a diabetic patient who admitted that he was only taking his medications twice a week so that the medications would last longer. In addition, he said he could not afford healthy foods because they were more expensive. He suffered a stroke and is now in a nursing home.

JudithFradkin,MD,directoroftheDivisionofDiabetes,EndocrinologyandMetabolicDiseasesatNIH’sNationalInstituteofDiabetesand Digestive Kidney Diseases (NIDDK), also testified. She said that NIDDK is involved in funding several diabetes projects through the Special Diabetes Program. One or these projects, The Environmental Determinants of Diabetes in the Young (TEDDY) study, recently completed recruitment of over 8,000 newborns who are at high genetic risk for Type 1 diabetes and is now following them to age 15 to identify possible environmental triggers of the disease.

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