Prevalence of diabetes among Native Americans and Alaska Natives, 1990-1997: an increasing burden.

OBJECTIVE: To determine trends in diabetes prevalence among Native Americans and Alaska Natives. RESEARCH DESIGN AND METHODS: From 1990 to 1997, Native Americans and Alaska Natives with diabetes were identified from the Indian Health Service (IHS) national outpatient database, and prevalence was calculated using these cases and estimates of the Native American and Alaskan population served by IHS and tribal health facilities. Prevalence was age-adjusted by the direct method based on the 1980 U.S. population. RESULTS: Between 1990 and 1997, the number of Native Americans and Alaska Natives of all ages with diagnosed diabetes increased from 43,262 to 64,474 individuals. Prevalence of diagnosed diabetes increased by 29%. By 1997, prevalence among Native Americans and Alaska Natives was 5.4%, and the age-adjusted prevalence was 8.0%. During the entire 1990-1997 period, prevalence among women was higher than that among men, but the rate of increase was higher among men than women (37 vs. 25%). In 1997, age-adjusted prevalence of diabetes varied by region and ranged from 3% in the Alaska region to 17% in the Atlantic region. The increase in prevalence between 1990 and 1997 ranged from 16% in the Northern Plains region to 76% in the Alaska region. CONCLUSIONS: Diabetes is common among Native Americans and Alaska Natives, and it increased substantially during the 8-year period examined. Effective interventions for primary, secondary, and tertiary, prevention are needed to address the substantial and rapidly growing burden of diabetes among Native Americans and Alaska Natives.