Native Americans, Alaskans More Likely to Have Higher HbA1c Levels

OAKLAND, CA – American Indians and Alaska Natives (AI/AN) are more than twice as likely to have diabetes as non-Hispanic Caucasians, and the prevalence of diabetes in the AI/AN populations has increased by more than 68% since 1994.

A study group led by researchers from Kaiser Permanente Northern California sought to compare cardiovascular disease risk factor testing rates and intermediate outcomes of care between AI/AN patients with diabetes and non-Hispanic Caucasians enrolled in nine commercial integrated delivery systems in the United States. The results of the study were published recently in the journal BMJ Open Diabetes Research & Care.1

For the study, researchers compared annual testing rates and risk factor control levels for glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP). They also looked at the number of unique diabetes drug classes, insulin use and oral diabetes drug medication adherence between insured AI/AN and non-Hispanic white adults with diabetes older than 18 in 2011.

With 5,831 AI/AN patients — 1.8% of the cohort — meeting inclusion criteria, results indicated that AI/AN patients had similar rates of annual HbA1c, LDL-C and SBP testing, as well as LDL-C and SBP control, compared with non-Hispanic Caucasians. AI/AN patients were significantly more likely to have HbA1c greater than 9%, however, and significantly less likely to adhere to their oral diabetes medications compared to the other group.

“AI/AN patients in commercial integrated delivery systems have similar blood pressure and cholesterol testing and control, but significantly lower rates of HbA1c control and diabetes medication adherence, compared with non-Hispanic Caucasians,” the authors conclude. “As more AI/ANs move to urban and suburban settings, clinicians and health plans should focus on addressing disparities in diabetes care and outcomes in this population.”

  1. 1 Schmittdiel JA, Steiner JF, Adams AS, Dyer W, et al. Diabetes care and outcomes for American Indians and Alaska natives in commercial integrated delivery systems: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) Study. BMJ Open Diabetes Res Care. 2014 Nov 17;2(1):e000043. doi: 10.1136/bmjdrc-2014-000043. eCollection 2014.PubMed PMID: 25452877; PubMed Central PMCID: PMC4246918.

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  1. toni chiara says:

    Lack of good nutrition is a major problem on most of the reservations, rancheros, alaskan villages. Provision of better diet / nutrition NOT just discrepency of health care – which TRULY does exist may help with the rise in diabetes among Native Americans and Alaskan native. For the American Indians / Native American – the government placed them on lands that were the poorest for farming – how about develop hydroponic or other avenues of farming on the reservation / ranchero lands that are so infurtile! this may help the employment situation on many of the reservations and rancheros so then the individuals will be able to afford better nutrition and health care

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