Diabetes in a northern Minnesota Chippewa Tribe. Prevalence and incidence of diabetes and incidence of major complications, 1986-1988.

ABSTRACT

OBJECTIVE: To determine the prevalence and incidence of diabetes, and the incidence of major diabetic complications, in a Chippewa Indian population. RESEARCH DESIGN AND METHODS: The format was a longitudinal population study that used active community and health center-based surveillance. The setting was a North American Indian reservation community of 4075 residents, served by an IHS clinic from 1986 to 1988. Patients were American Indians of Chippewa descent living on or near the Red Lake Reservation. RESULTS: Midway through the study, 346 people had been diagnosed with diabetes, which yielded an age- and sex-adjusted point prevalence of 148/1000 population. The adjusted rate for individuals > or = 25 yr of age was 252/1000 population, 3.82 times the U.S. rate (CI 2.95-4.93). Some 97 new cases of diabetes were identified for an age- and sex-adjusted average annual incidence of 17/1000 population. The incidence of hospitalization for LEA was 26/1000 diabetic person-yr, 4.3 times the 1978 U.S. rate (95% CI 2.8-6.8). Twelve individuals developed proliferative retinopathy, for an incidence of 12/1000 diabetic person-yr. Newly diagnosed ESRD incidence was 6/1000 diabetic person-yr. Twenty-three acute myocardial infarctions were observed, yielding an incidence of 22/1000 diabetic person-yr. CONCLUSIONS: Diabetes and its complications are prevalent in this Chippewa population, and further surveillance is needed to evaluate the effectiveness of prevention efforts.