Diabetes

You can get diabetes if your body does not make or use insulin right. Insulin is what is in your body that changes the sugars in food into energy. With diabetes, glucose builds up in the blood, flows into the urine, and is carried out of the body instead of being used by the cells for energy. Type 1 diabetes happens when your body destroys its own cells that make insulin. Type 2 diabetes occurs when the pancreas doesn't make enough insulin.

Diabetes is a serious and common problem among American Indians and Alaska Natives. Most people have type 2 diabetes. For American Indians/Alaska Natives (AI/AN), both women and men, the number of new cases of type 2 (or adult) diabetes has reached epidemic proportions. Diabetes contributes to several of the leading causes of death in AI/AN, including heart disease, stroke, pneumonia, and influenza. Specific tribes have much higher rates. For example, 50% of Pima Indians in Arizona who are between the ages of 30 and 64 have type 2 diabetes.

Pregnant AI/AN women with type 2 diabetes are at an increased risk of having babies born with birth defects. Diabetes that shows up in pregnancy is called gestational diabetes. This form of diabetes is high among certain AI/AN. Gestational diabetes increases the baby's risk for problems such as macrosomia (large body size) and neonatal hypoglycemia (low blood sugar). Although the blood glucose levels of women with gestational diabetes usually return to normal after childbirth, these women have an increased risk of developing gestational diabetes in future pregnancies. In addition, studies show that many women with gestational diabetes will develop type 2 diabetes later in life.

Serious complications of diabetes are increasing. The most concerning are kidney (or renal) failure, heart disease, amputations, and blindness. Infections, including tuberculosis (TB), are of particular concern to both American Indians and Alaska Natives who have diabetes. Tuberculosis is a disease caused by a bacteria. If TB is in the lungs, it can cause a bad cough, chest pain, fatigue, weight loss, chills, and fever. A study of Sioux Indians showed that their rate of developing tuberculosis is higher if they had diabetes than if they did not.

People with diabetes have a higher chance of having problems with their skin, mouth, kidneys, heart, nerves, eyes, and feet. Although type 1 diabetes cannot be prevented, there are steps you can take to prevent and control type 2 diabetes:

• See your health care providers regularly. Don't forget about the dentist and eye doctor!
• Don't smoke.
• Control your blood sugar and cholesterol levels, your blood pressure, and weight.
• Exercise (30 minutes most days of the week is best).
• Check your feet everyday for blisters, red spots, swelling, or cuts.
• Stay aware of how you feel-if you notice a problem, call your health care provider right away.