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An ounce of prevention

The disease that takes our elders and threatens our children is on the rise, according to new estimates by the Centers for Disease Control and Prevention. Nearly 24 million people in the United States suffer from diabetes, according to 2007 data recently released by the CDC. That number, roughly 8 percent of the U.S. population, represents a spike of 3 million diagnosed cases in just the past two years. American Indians have the highest rate among racial and ethnic populations, with 16.5 percent affected by the disease. Alaska Natives rank near the bottom, with only 6 percent.

CDC estimates that another 57 million people are pre-diabetic, which puts them at increased risk for developing the disease.

Despite gains made in the last decade, continued long-term success will be hampered if Congress fails to reauthorize vital legislation that helps Native people combat diabetes. Tribes and Indian health organizations continue to pressure the federal government to uphold its treaty responsibility for health care. They are not, however, waiting for the government to come up with creative solutions to the diabetes epidemic. They are doing that on their own, employing quite a few inspiring ideas.

"Healthier Haskell'' began last fall as an effort to make Haskell Indian Nations University one of the healthiest colleges in the country. The original goal was to ''walk around the world,'' but the challenge soon caught the attention of local community groups that later joined the movement. Walkers logged enough miles to reach the goal by Christmas.

A proud coach Al Gipp credited community participation for the challenge's popularity.

''Letting the students and community be a part of this could mean that Indian people aren't labeled as having diabetes, high blood pressure, high cholesterol,'' he told Indian Country Today. ''We just want them to come and work out and have a good time ... to enjoy the fellowship of coming together and visiting and run and share and laugh.''

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Perhaps the most ominous diabetes statistic involves adolescents. From 1990 to 2001, American Indians and Alaska Natives ages 15 - 19 experienced a 106 percent increase in the prevalence of diabetes. The epidemic we once associated with older relatives is now rapidly affecting our youth. Treatment is very slowly shifting toward prevention, with numerous programs cropping up throughout Indian country. These innovative and holistic approaches work to educate children and young adults about healthy lifestyles and take place where they hang out, perfect for lifestyle interventions. The Red Lake Band of Chippewa's new Boys and Girls Club employs a full-time health and life skills coordinator who leads a diabetes prevention program called T.R.A.I.L., which stands for ''Together Raising Awareness for Indian Life.'' She guides kids through healthy decisions and helps them develop good dietary habits.

Programs like these should become models throughout Indian country, even if they are done modestly in classrooms or family kitchens. What a change we could see in the coming generations if health funding focused more on youth education. It takes time to break bad habits and it will take generations to curb the diabetes epidemic. As parents, grandparents, guardians, educators and leaders, it is our responsibility to guide our children toward healthy lives.

Disparities in Indian health care remain but positive gains have been reported by the federally funded Special Diabetes Program for Indians, set to expire this year. According to the National Indian Health Board, the SDPI in the last decade helped to reduce the severity of diabetes on a national level, improve the quality of diabetes care, increase community-based wellness centers, and implement youth prevention programs in schools.

Reauthorization of SDPI funding within a Medicare bill is currently threatened by a partisan disagreement in Congress. It would be a national shame if this program was allowed to wither away, taking with it a decade of major accomplishments in the long war against diabetes.

We can all take steps to better manage diabetes or to reduce our risk of ever developing it. Thirty minutes of physical activity at least three times a week to manage weight is the standard recommendation. The medical community now recommends not just weight loss, but a reduction in abdominal fat as well. Warnings about fat carried around the middle link it to a greater risk of heart disease, stroke, hypertension, some cancers, and higher mortality rates. It is generally recommended that men whose waists measure more than 40 inches and women with waists larger than 35 inches should modify their lifestyle in order to reduce the health risks associated with dangerous belly fat.

We can support local agricultural projects and community wellness programs. Consult Dale Carson's Native Cooking column for ICT, which features healthy recipes using traditional Native foods and preparation. Take control. Eat healthier, sleep better, and be well.