JULIEN NAYLOR and CINDY SCHRAER
Alaska Area Diabetes Program, Alaska Native Medical Center
Objective: To determine the prevalence of risk factors for cardiovascular disease among Alaska Natives with type 2 diabetes and look for differences between ethnic groups: Eskimo, Indian and Aleuts.
Study Design and Methods: A centralized register is maintained that tracks the prevalence of diabetes in the Alaska Native population. This database interfaces with a randomized audit of charts statewide that collects clinical information on patients with type 2 diabetes (2001 Indian Health Service Diabetes Care and Outcomes Audit) in Alaska. Selected measures of cardiovascular risk were identified in the 2001 audit to include hypertension, BMI, dyslipidemia, glycemic control, microalbuminuria and smoking.
Results: Preliminary data on 580 Alaska Natives with type 2 diabetes show 62% had SBP > 130. Over 75% were obese (BMI >30). Over 47% had LDL > 100 and, overall, 33% had proteinuria (gross protein or microalbuminuria). Only 20% had HgbA1c > 9 and 42% had HgbA1c < 7%. Only 36% were current smokers. There were very few statistical significant differences between age and ethnic groups.
Conclusions: Most patients appear to be in good glycemic control. However, obesity and blood pressure control appear to be the biggest challenge among Alaska Natives with diabetes.
Special Equipment: LDC Projector
Outcomes and Transferability:
The Strong Heart Study has shown that there is a rising mortality rate from cardiovascular disease in American Indians communities as the rate of diabetes increases. Diabetes was a relatively uncommon condition in Alaska Natives fifteen years ago, but the increasing prevalence of diabetes in Alaska Natives is the highest in the American Indian communities. Recognizing the risk factors for cardiovascular disease among Alaska Native with diabetes is essential if this risk is to be reduced through clinical interventions.
Relation to Conference Theme:
It is expected that as the rates of diabetes increase in our Alaska indigenous communities, so will the rate of cardiovascular disease. Further research is needed to see whether the Northern Indigenous people of North America with diabetes have increased rates of modifiable CVD risks such as hyperglycemia, hypertension, dyslipidemia and proteinuria.