Diabetes affecting minority populations<br>

For reasons that are not completely known to medical professionals, diabetes tends to affect minority populations more so than non-Hispanic white people.

For that reason among others, the Winslow Indian Health Care Center chose to participate in SEARCH for Diabetes in Youth, a five-year multi-center study funded by the Center for Disease Control and Prevention and National Institutes of Health and supported by the National Institute of Diabetes and Digestive and Kidney Diseases.

The goals are to determine how many people under age 20 have diabetes by type and learn how the types vary by age and race. Doctors also want to improve treatment of diabetes and learn how it affects children’s lives.

Dr. Dana Dabelea, principle investigator for SEARCH in Colorado, said obesity is the strongest environmental risk factor for type 2 diabetes.

“Minorities are generally more obese than non-Hispanic whites,” she said. “They’re more insulin resistant because of their obesity and as well as possibly because of their genetic makeup.

“Type 2 diabetes has a very strong genetic component. We haven’t discovered the genes that cause type 2 diabetes. It occurs in certain groups such as American Indians with a much higher frequency than in other populations with less American Indian mixture.”

Often diabetes goes undiagnosed because many of its symptoms seem harmless. Some symptoms include frequent urination, excessive thirst and hunger, unusual weight loss, increased fatigue, irritability and blurry vision.

There are about 13,000 new cases of type 1diabetes in children every year and about 1.3 million cases overall. Diabetes affects about 18.2 million Americans of which 5.2 million are undiagnosed according to the American Diabetes Association (ADA). Diabetes has no cure but can be treated with proper medicine and exercise and diet.

While it occurs in people of all ages and races, minorities have a higher risk for developing type 2 diabetes than others. The ADA reports that type 2 diabetes is more common in African Americans, Latinos, Native Americans and Asian Americans/Pacific Islanders, as well as the elderly.

Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. In type 1, the body does not produce insulin, which is necessary for the body to be able to use sugar. Sugar is the basic fuel for cells and insulin takes the sugar from the blood into the cells.

Type 2 diabetes is the most common form of diabetes. In type 2, either the body does not produce enough insulin or the cells ignore the insulin. Type 2 diabetes is a relatively new form of diabetes among children. Currently, there are no gold standard definitions of type 1 and type 2 diabetes among youth. The SEARCH study hopes to develop such clinically useful definitions. SEARCH is also studying a hybrid version in which patients display symptoms of both types.

SEARCH hopes to track approximately 9,000 children and youth who have been diagnosed with diabetes through six clinical centers located in California, Colorado, Hawaii, Ohio, South Carolina and Washington. The regional centers provide a broad cross section of ethnicities in America.

SEARCH so far has received approximately 4,000 surveys from 7,000 patients along with about 2,000 in-house visits. Since the project is ongoing, results are preliminary and not available for publication yet.

Lita Scott is a Diabetes Community Health nurse and local coordinator for SEARCH at WIHCC. The center started pediatric diabetes program in 1999 and runs a comprehensive school health program that works with schools to promote healthy life styles.

Some of their patients have moved out of the area, but they have maintained a pediatric population of 11 (two type 1 and nine type 2 cases).

“Initially we thought diabetes was just more among Native Americans, now it’s among (all) minority populations and we’re seeing the trends among youth,” she said. “Maybe five years ago, type 2 is common among young adults but not children.”

Virginia Dayish is using her clout as the Second Lady of the Navajo Nation to educate people on the prevention of diabetes. Dayish, herself diagnosed with Type 2, and her husband, Navajo Nation Vice-President Frank Dayish, support the program at WIHCC.

Virginia Dayish said obesity is becoming more common among Navajo people because they are moving away from their roots in healthy food and an active lifestyle.

“We forgot who we are as we try to keep up with a fast-paced world,” she said. “There’s meaning in the food we have. But we’ve changed our whole eating habits.”

According to the ADA, on average, Hispanic/Latino Americans are 1.5 times more likely to have diabetes than non-Hispanic whites of similar age. Mexican Americans, the largest Hispanic/Latino subgroup, are more than twice as likely to have diabetes than non-Hispanic whites of similar age. American Indians and Alaska Natives are 2.2 times more likely to have diabetes than non-Hispanic whites of similar age.

SEARCH researchers are hoping to receive further funding to keep the study going.

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