Diabetic complications among American Indians of Washington, Oregon, and Idaho. Prevalence of retinopathy, end-stage renal disease, and amputations.

Abstract:

OBJECTIVE:To estimate the prevalence of severe diabetic complications. RESEARCH DESIGN AND METHODS:We surveyed the data systems of the IHS and local care providers to identify all AI/AN people with any of three diabetic complications: retinopathy needing one or more laser treatments, ESRD needing dialysis, and one or more LEAs. We calculated prevalence rates that were sex-age adjusted to the U.S. population for total sample, each community, gender, and culture area. RESULTS:Of the population-based complete sample with diabetes, 1.7% had retinopathy, 1% ESRD, and 4% LEA. Complication rates among the culture areas were not statistically different. The LEA rate among diabetic men (5.8%) was higher than that among women (2.3%). The odds ratio was 2.2 (95% CI 1.2-4.2). One community had an extraordinarily high LEA rate of 16%. CONCLUSIONS:This study showed that IHS can use its data systems to estimate prevalence of diabetic complications and identify population groups with higher prevalence rates. The data led the IHS clinic with the high LEA rate to start a program to prevent amputations. We suggest quality assurance activities based on the methods of this study.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Freeman WL,Hosey GM

doi

10.2337/diacare.16.1.357

subject

Has Abstract

pub_date

1993-01-01 00:00:00

pages

357-60

issue

1

eissn

0149-5992

issn

1935-5548

journal_volume

16

pub_type

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