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Senate committee focuses on diabetes

WASHINGTON - As the Senate Committee on Indian Affairs heard Feb. 8, diabetes continues to be a tortuous problem for America, and more so for Indians. But signs of success against the epidemic are also starting to show up, especially in the Special Diabetes Program for Indians.

''In spite of our best efforts and successes so far in treating diabetes, the epidemic of diabetes continues to increase,'' stated IHS Director Dr. Charles Grim in written testimony. ''Although diabetes is also increasing in the U.S. population as a whole, the increase in the Indian population is far more dramatic. While the prevalence of diabetes in the U.S. population almost doubled between 1980 and 2004, the prevalence of diabetes among American Indians and Alaska Natives was already higher in the early 1980s than in the U.S. population in 2004. Moreover, the prevalence of diabetes among American Indians and Alaska Natives more than doubled during this time period. Indeed, American Indians and Alaska Natives have the highest age-adjusted rates of diabetes (16.3 percent) among all U.S. racial and ethnic groups. And, in some communities, the prevalence rate is as high as 60 percent among adults.''

Responding to the committee's focus on the Special Diabetes Program for Indians, Grim testified that the nine-year program has brought tribes together in the common purpose of improving ''population-level diabetes-related health ... However, the greatest long-term benefit will most likely be from the diabetes prevention activities now becoming commonplace in American Indian and Alaska Native communities.''

Grim added that the program has also required IHS to prove it can design, manage and measure outcomes of a complex collaborative partnership against chronic disease. ''IHS has shown that it can successfully work with tribal partners to help them progress from whatever their starting position - be it a fully functioning clinical diabetes program, a rudimentary community program or no program at all - along a continuum of diabetes excellence so that all improve in some way. Significant [diabetes care] infrastructure has been established where there was none. Basic programs have become centers of excellence. Innovation has become commonplace in these programs, and the sense of 'tribal ownership' is now entrenched. And positive signs such as a decrease in incidence of diabetes-related end-stage renal disease among American Indians in the Southwest are starting to be seen.''

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