Antidiabetic plants and their active constituents.

PURPOSE: To review the available information on prevalence, complications, and mortality of non-insulin-dependent diabetes mellitus and primary and secondary prevention activities in black persons, Hispanic persons, Native Americans, and Asians and Pacific Islanders in the United States.

DATA SOURCE: MEDLINE search from 1976 to 1994 through the PlusNet search system.

STUDY SELECTION: Use of the key words non-insulin-dependent diabetes mellitus, the names of each specific minority group, socioeconomic status, acculturation, genetics, diet, complications, mortality, treatment, and intervention (lifestyle or medication) produced 290 unduplicated articles. Additional articles cited in the original articles were also included.

DATA EXTRACTION: Risk factors, incidence, prevalence, complications, and mortality of non-insulin-dependent diabetes mellitus.

DATA SYNTHESIS: All minorities, except natives of Alaska, have a prevalence of non-insulin-dependent diabetes mellitus that is two to six times greater than that of white persons. Most studies show an increased prevalence of nephropathy that can be as much as six times higher than that of white persons. Retinopathy has variably higher rates in black persons, Hispanic persons, and Native Americans. Amputations are done more frequently among black persons than among white persons (9.0 per 1000 compared with 6.3 per 1000), and Pima Indians have 3.7 times more amputations than do white persons. Diabetes-related mortality is higher for minorities than for white persons, and the rate is increasing. The relative importance of genetic heritage, diet, exercise, socioeconomic status, culture, language, and access to health care in the prevalence, incidence, and mortality of diabetes is not clear. Studies of interventions in minority populations are in progress.

CONCLUSION: Diabetes should be treated as a public health problem for minority populations.

Non-Insulin-Dependent Diabetes Mellitus in Minorities in the United States

OBJECTIVE— To review the long-term effects of the diabetic pregnancy on the offspring among the Pima Indians of Arizona.

RESEARCH DESIGN AND METHODS— Studies published by the Phoenix Epidemiology and Clinical Research branch of the National Institute of Diabetes and Digestive and Kidney Diseases, since the inception of the longitudinal diabetes studies in 1965 were reviewed. In addition, pertinent studies from other centers, mentioned as references in these publications, were reviewed. As far as possible, all original articles and abstracts on this aspect of the Pima Indian studies were discussed.

RESULTS— The offspring of women who had diabetes during pregnancy, on average, were more obese and had higher glucose concentrations and more diabetes than the offspring of women who developed diabetes after pregnancy or who remained nondiabetic. Although no new analyses were attempted, several of the older publications were updated by repeating the analyses on later, expanded data sets.

CONCLUSIONS— The diabetic pregnancy, in addition to its effects on the newborn, has effects on the subsequent growth and glucose metabolism of the offspring. These effects are in addition to genetically determined traits.

Diabetes and Obesity in the Offspring of Pima Indian Women With Diabetes During Pregnancy

https://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1027&context=anthropologyfacpub

The Roasted and the Boiled: Food Composition and Heat Treatment with Special Emphasis on Pit-Hearth Cooking

The Kahnawake Schools Diabetes Prevention Project: Intervention, Evaluation, and Baseline Results of a Diabetes Primary Prevention Program with a Native Community in Canada☆☆☆

Non-insulin-dependent diabetes mellitus is a major health problem in American Indian communities. Indian Health Service (IHS) collects information about outpatient visits and hospitalizations and analyzes mortality in American Indians and native Alaskans. Between October 1, 1982, and September 30, 1983 (fiscal year 1983), diabetes was the second leading clinical impression for all outpatient visits of patients 15 yr and older. Discharge diagnoses confirm both microvascular and macrovascular complications. Seventy-six percent of all IHS hospitalizations during fiscal year 1983 for lower-extremity amputation also coded diabetes. In 1982, the age-adjusted diabetes death rate per 100,000 was 19.9 for American Indians and native Alaskans, compared with 9.6 for all races in the United States.

D M Gohdes

Papers

Diabetes in American Indians: A growing problem