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Prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study
OBJECTIVE - To estimate the prevalence and incidence of diabetes, clinical characteristics, and risk factors for chronic complications among Navajo youth, using data collected by the SEARCH for Diabetes in Youth Study (SEARCH study).
RESEARCH DESIGN AND METHODS - The SEARCH study identified all prevalent cases of diabetes in 2001 and all incident cases in 2002-2005 among Navajo youth. We estimated denominators with the user population for eligible health care facilities. Youth with diabetes also attended a research visit that included questionnaires, physical examination, blood and urine collection, and extended medical record abstraction.
RESULTS - Diabetes is infrequent among Navajo youth aged <10 years. However, both prevalence and incidence of diabetes are high in older youth. Among adolescents aged 15-19 years, 1 in 359 Navajo youth had diabetes in 2001 and 1 in 2,542 developed diabetes annually. The vast majority of diabetes among Navajo youth with diabetes is type 2, although type 1 diabetes is also present, especially among younger children. Navajo youth with either diabetes type were likely to have poor glycemic control, high prevalence of unhealthy behaviors, and evidence of severely depressed mood. Youth with type 2 diabetes had more metabolic factors associated with obesity and insulin resistance (abdominal fat deposition, dyslipidemia, and higher albumin-to-creatinine ratio) than youth with type 1 diabetes.
CONCLUSIONS - Our data provide evidence that diabetes is an important health problem for Navajo youth. Targeted efforts aimed at primary prevention of diabetes in Navajo youth and efforts to prevent or delay the development of chronic complications among those with diabetes are warranted.
Diabetes Care 32 (Suppl. 2):S141-S147, 2009
Data on the burden of diabetes in U.S. Native American youth are limited, with the exception of the Pima In- dians of Arizona (1,2). In adults, Pima In- dians have the highest occurrence of type 2 diabetes in the world, and very high rates have been reported in many other U.S. Indian tribes (3). Although type 2 dia- betes has traditionally been viewed as a dis- order of adults, an alarming two- to threefold increase in the prevalence of type 2 diabetes has been documented over the last 30 years among Pima Indian youth, in parallel with...