Prevalence of Diabetes and Its Complications in the Eastern Band of Cherokee Indians

Abstract

Objective— To determine the prevalence of diabetes and selected complications among the Eastern Band of Cherokee Indians in North Carolina. Research Design and Methods— Multiple IHS data systems were used to determine diabetes prevalence and complication rates. The RPMS was used to identify diabetes cases as of April 1989, degree of Indian inheritance, cardiovascular diseases (including hypertension), and retinopathy. Data on laser treatments and LEA were obtained from individual registries. Information on ESRD was obtained by a research assistant. The IHS Ambulatory Patient Care reporting system was used to calculate the number of diabetic patients for the years 1982–1987. The IHS user population was used as the denominator. Rates were age-adjusted to the 1980 U.S. population and diabetic population by the direct method. Results— Using clinical records, the age-adjusted prevalence of diabetes in 1988 was 105.6/1000 people, four times the U.S. rate. Rates of diabetes were highest in the groups with the highest degree of Indian inheritance. LEAs occurred among diabetic patients at three times the rate for the U.S. Between 1985 and 1989, new cases of ESRD occurred at a crude annualized rate of 578/million, approximately six times the rate for U.S. whites. Conclusions— Diabetes presents a major burden to the Eastern Band of Cherokees. The limitation inherent in this study probably result in underestimation of the prevalence of diabetes and its complications in the community. Future studies are needed to assess the impact of medical and preventive programs on diabetes prevalence and complications in this community.