title: Diabetes and its complications among selected tribes in North Dakota, South Dakota, and Nebraska.
abstract: OBJECTIVE
  To determine the prevalence and incidence rates of diabetes and two specific complications for selected American-Indian tribes in North Dakota, South Dakota, and Nebraska.
  
  
  METHODS
  A descriptive epidemiological study was conducted using ambulatory care data during 1987 for prevalence and diabetes registries and complication case reporting during 1988 from IHS facilities on reservations in these states.
  
  
  RESULTS
  The Winnebago and Omaha tribes had the highest age-adjusted diabetes rates, with prevalence 8.8 times and incidence 7.7 times the respective U.S. rates. The diabetes prevalence rate of combined data for the Sioux was 3.7 times the U.S. rate. Among Sioux Indians, the age-adjusted incidence rate for ESRD was 4.8 times the American-Indian/Alaska-Native rate and 13.4 times the rate for U.S. whites. The proportion of new diabetes-related ESRD (86%) was almost 3 times greater than the general U.S. population rate (30%). Also, among the Sioux, the age-adjusted incidence rate for LEA (86.7/10,000 diabetic population) was 1.5 times higher than the U.S. rate; the proportion of diabetes-related LEA (84%) was 1.8 times higher than the general U.S. population rate (45%).
  
  
  CONCLUSIONS
  The age-adjusted rates of diabetes and certain complications among these Northern Plains tribes are greater than the U.S. rates. Improved health services to detect and monitor diabetes and its complications and community-based prevention activities directed at the epidemic of diabetes among the various Indian tribes are urgently needed.
authors.affiliation: Department of Epidemiology, Aberdeen Area Indian Health Service, Public Health Service Indian Hospital, Rapid City, South Dakota 57702.
authors.forename: R M
authors.initials: RM
authors.lastname: Stahn
authors.forename: D
authors.initials: D
authors.lastname: Gohdes
authors.forename: S E
authors.initials: SE
authors.lastname: Valway
mesh_terms: D000367:Age Factors; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology*; D005006:Ethnicity; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D009329:Nebraska / Q000453:epidemiology; D009658:North Dakota / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013023:South Dakota / Q000453:epidemiology; D014481:United States / Q000453:epidemiology