diabetescarelive.info

Diabetic Retinopathy
Diabetic retinopathy is a deterioration of the blood vessels in the eye caused by high blood glucose levels. It can lead to impaired vision and, ultimately, to blindness. One study showed a 49 percent prevalence of diabetic retinopathy in Oklahoma Indians.¹ Pima Indians also have excessive rates of diabetic retinopathy.¹⁴

Cataracts
The incidence of cataract extraction among Pima Indians with diabetes was more than twice the rate of people without diabetes.¹

Diabetic Nephropathy
From 1987 to 1990, American Indians with diabetes experienced end-stage renal disease (the final stage of kidney disease associated with kidney failure and dialysis) six times more frequently than did non-Hispanic whites.¹ Especially high rates of diabetic nephropathy (kidney disease) were seen in Alaska Native, Cherokee, Chippewa, Navajo, Oklahoma, Pima, Sioux, and Zuni tribes.¹ In 1989, end-stage renal disease was a leading cause of death among Pima Indians with diabetes.¹⁴

Among Alaska Natives, women were more likely to develop end-stage renal disease and more likely to die of renal failure than men. The overall incidence of dialysis caused by diabetic renal disease from 1986 until 1993 in Alaska Natives was two per 1,000 person-years of diabetes.²

Lower Extremity Amputation
Rates of lower extremity amputation are high in some American Indians but vary by tribe. Several studies indicate a higher amputation rate among men than among women. Loss of protective sensation as detected by a screening monofilament test identified diabetic individuals at high risk for amputation and foot ulceration.¹⁹

Periodontal Disease
Among Pima Indians, the periodontal disease rate was 2.6 times higher in people with diabetes than in those without it. Poor glycemic control among American Indians has been associated with an increased risk of periodontal disease.¹

Infections
Infections related to diabetes in American Indians are of particular concern. A study in Sioux Indians showed that those with diabetes were 4.4 times more likely to develop tuberculosis than were Sioux Indians without diabetes. Mortality in Pima Indians with infectious diseases is significant, according to a study that found that five out of six people who died from a serious infection (coccidioidomycosis) had diabetes. In 1987, tuberculosis mortality among American Indians was 5.8 times higher than the rate among all races in the United States.¹