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Younger RST tribal members targeted for diabetes prevention efforts

ROSEBUD, S.D. - More and more Indian youth are at risk for diabetes because of diet, heredity and lack of exercise, says Rita Broken Leg, director of the Rosebud Sioux Tribe's Diabetes Prevention Program.

At a recent open house, Broken Leg and her staff introduced their work in assessing diabetes risk and teaching people in the community about prevention, the focus of their work with tribal students for the last couple of years. By early intervention, they are trying to lower the risk for the onset of diabetes.

In two years of screening tribal students, at least one-third were at risk for developing diabetes, said Broken Leg. She said they looked at risk factors including height, weight and other physical indicators including Acanthosis Nigricans, a dark skin discoloration associated with people who have a greater chance of the onset of the disease.

Of the 1,309 students screened earlier this year at seven schools on the Rosebud Sioux Reservation, nearly one-third of the students showed signs of high risk for diabetes. Many of them were referred to the Indian Health Service's Comprehensive Health Care Center in Rosebud, she said.

Type II diabetes, also known as adult-onset diabetes, is a crisis for American Indians. In a growing number of Indian communities, more than half the population age 50 or older has diabetes. More than 20 percent of American Indian elders have diabetes, Indian Health Service figures indicated just four years ago.

Type II diabetes among Indians is well over four times the national average. Responding to desperate advocacy by IHS and leaders of many of the 558 tribes in the United States, Congress acknowledged the severity of the disease among American Indians by funding grants for prevention programs.

In 1997, federal legislators included $150 million in funding in a five-year period to help tribal communities cope with impact of the disease. As a result, 318 tribal diabetes programs were created and many tribes launched effective grassroots programs for prevention and screening efforts.

Complications of the disease have lead to ongoing emergencies including infant mortality, eye disease, renal and cardiac failure and amputations in Indian health care facilities across the nation.

Broken Leg said a less active lifestyle paired with the introduction of fatty snack foods, candy and soft drinks are taking a toll on younger tribal members.

Broken Leg's staff routinely travels to the schools and community events to deliver its prevention message to tribal members. The team shows them how to do simple exercises, make changes in their diets and reminds them to watch their weight carefully to lower risks.

Type II diabetes, Broken Leg said, was a disease that was normally detected in people in their 40s. However, a disturbing trend has emerged as tribal youth have begun to live a sedentary lifestyle fueled by fast food and a seemingly endless thirst for soft drinks. The constant intake of fat and sugar adds to the likelihood of developing obesity.

"They are getting younger and younger," said Connie Black Bear, the prevention centers administrative officer and fitness coordinator.

A healthy diet avoiding fatty foods and soft drinks goes a long way toward arresting the risk factors. Adding exercise is important for younger tribal members who are finding themselves in front of computer screens and television sets.

Broken Leg noted that the average person can gain as many as five pounds if he or she drinks an eight-ounce can filled with a soft drink each day for a year.

"That's at least 35 pounds of sugar and up to 50 pounds of sugar," she said.

There are more than 1,000 diagnosed diabetics on the Rosebud Sioux reservation, she said.

Obesity now ranks near the top of national levels as a health risk for tribal members. It triggers Type II diabetes. Experts suggest that genetic factors also play an important role.

To combat the disease, Broken Leg said, tribal members should watch diet and their children's weight, but the director doesn't advocate placing children on diets. Instead, her approach is to suggest that parents modify the diets of their children with healthier foods.

The program was funded by two grants, including the original grant of $205,000 and a supplemental grant for $506,000. Early in the program, Broken Leg said, few parents responded by signing consent forms allowing screening of their children.

This year, the forms were worded differently, requesting that parents return them if they didn't wish to have their children screened.

Although most tribal members who visited the center during its two-day open house were interested in the prevention program, some arrived to look at the construction of the facility as a prospect for housing.

Lucy and Earl Swift Hawk were interested in the center because they were considering a similar building for home construction.

Earl Swift Hawk, a tribal elder from Spring Creek, watched intently as representatives from Domes Midwest Inc. of Paige, Neb. showed a video detailing the features of the structure.

The company, headed by Doug Rokhor, has built two of the fiberglass domes on the Rosebud Sioux reservation, a home site north of Gregory, two in north central Nebraska and another in Lewiston, Mont. A Yankton Sioux tribal member is awaiting the completion of her home east of Wagner.

Meanwhile, Rokhor said several tribal housing authority officials and planners looked at the building as a prospect for construction of homes and other buildings. Rokhor went to Hawaii a couple of months ago to market the structures at a Native American conference.