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Offering families healthy choices in the fight against Type 2 diabetes

ROSEBUD, S.D. – Type 2 diabetes is 100 percent preventable. With that in mind, the Rosebud Sioux Tribe Diabetes Prevention Program screens more than 3,000 school children on the reservation each year looking for risk factors of the disease. If a child is found to have more than one risk factor, they and their family are invited to the clinic for a doctor visit and a tour of the well-equipped fitness center.

“We know that we have an obesity problem on the reservation and that diabetes is a great concern,” said Connie Brushbreaker, director of the program. “When the Diabetes Prevention Program began in 1998, our youth became the focus of our program; getting them screened and referred to the clinic was a priority.” More than 700 kids are currently enrolled in the program, and more than 1,900 kids in Rosebud Reservation schools have been identified by the prevention program as having a high risk for developing diabetes.

The tribe received initial funding in 1998 for the program from the U.S. Congress under the Special Diabetes Program for Indians appropriation. The tribe designed its own intervention and prevention program using methods that were culturally specific and effective for their community, focusing primarily on children.

In addition to working with at risk youth, the program promotes healthy lifestyles among people of all ages. Funding has been used to develop a wellness center, hire a staff of fitness specialists and develop a medical evaluation and multi-disciplinary intervention strategy.

Brushbreaker said the kids who use the wellness center are the ones who are ready to change to a healthier lifestyle and whose parents are taking more of an interest in their health and well-being. “We still have a lot of denial out there. Like with any chronic disease, no parent wants to believe that their child could be at risk. We get a lot of opposition from some parents who have the attitude that, ‘If my child isn’t sick right now don’t bother me.’ The point we try to make to the parents of at risk youth is that if they don’t do something now to prevent this from going any further, there will be complications later in life.”


Connie Brushbreaker, director of the Rosebud Sioux Tribe Diabetes Prevention Program.

Risk factors of Type 2 diabetes include being overweight or obese, high blood pressure, a waist measurement wider than the hip measurement and dark patches on the skin known as Acanthosis Nigricans, or AN. Children on the reservation as young as 8 have been identified as having Type 2 diabetes.

A core component of the prevention program is a medical evaluation involving a medical history, physical examination and possibly lab tests. “When we do the clinic visit, we try to include the whole family instead of pointing out the one child. It isn’t healthy for a family to single out one child and have them eat and do things a certain way while their siblings are doing the opposite,” Brushbreaker said.

Staff works with the youth to analyze their food intake, determine their cardio-respiratory fitness level and muscle strength and helps them to devise a plan to reduce their risk using a combination of changes including reducing food intake and increasing physical activity levels. Every three months the team meets with the youth to re-evaluate their health and goals.

Brushbreaker has had several parents who did not take their child’s risk factors seriously and whose children were later diagnosed with Type 2 diabetes when they were 18 or 19 years old. “I have had mothers calling me crying, saying that they should have listened to me. It is sad that their child has been diagnosed at such a young age, but we try to help them at that point focus on what they can do to prevent complications or keep it from getting any worse.”

With more than 1,200 diabetic patients in the local community and more than 40 patients using the dialysis center, the goal of identifying diabetes risk at an early age is to prevent the onset of the disease, potentially saving a life.

“Fitness and health are not instant,” Brushbreaker said. “It takes daily work, whether you start out with five minutes a day of some kind of exercise or making healthier choices, to exercising five days a week for a half hour, which is what is recommended. Type 2 diabetes is 100 percent preventable. It’s all about making healthy choices.”

The American Diabetes Association says 24 million children and adults in the United States live with diabetes, 57 million Americans are at risk for Type 2 diabetes and one out of every three children born today will have diabetes if current trends continue.

According to the Indian Health Service Division of Diabetes Treatment and Prevention, 95 percent of American Indians with diabetes have Type 2 as opposed to Type 1.

Diabetes is a serious disease that can cause our children to eventually develop life-threatening complications such as heart disease, stroke, kidney disease, blindness and amputation. Don’t let your child become another statistic; prevent Type 2 diabetes by making informed healthy choices for yourself and those you love.