title: Incidence of diabetes in American Indians of three geographic areas: the Strong Heart Study.
abstract: OBJECTIVE
  To estimate incidence rates of diabetes and associated risk factors among participants of the Strong Heart Study.
  
  
  METHODS
  Of the 4,549 Strong Heart Study participants examined at baseline, 3,638 returned for a similar examination after an average of 4 years. The 1985 World Health Organization criteria for diabetes were used to identify new diabetes cases. Rates of diabetes among participants who did not have diabetes at baseline examination were determined. The relationships between the incidence rates of diabetes and a number of risk factors measured at baseline examination were studied.
  
  
  RESULTS
  Significant variables associated with the development of diabetes included triglycerides, obesity, fasting plasma glucose, insulin, and degree of American Indian blood among participants with NGT at baseline. For those with IGT at baseline, significant predictors included fasting plasma glucose, 2-h glucose, BMI, degree of American Indian blood, and albuminuria.
  
  
  CONCLUSIONS
  The high incidence rates found in this study were alarming. To slow down the rapid increase of this disease in the American Indian population, preventive programs must be designed and implemented. Patients with IGT should be treated with diabetes medication or put on a rigid weight-reduction program to reduce the risk of progression to diabetes.
authors.affiliation: Center for American Indian Health Research, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73190, USA. elisalee@ouhsc.edu
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Welty
authors.forename: Linda D
authors.initials: LD
authors.lastname: Cowan
authors.forename: Wenyu
authors.initials: W
authors.lastname: Wang
authors.forename: Dorothy A
authors.initials: DA
authors.lastname: Rhoades
authors.forename: Richard
authors.initials: R
authors.lastname: Devereux
authors.forename: Oscar
authors.initials: O
authors.lastname: Go
authors.forename: Richard
authors.initials: R
authors.lastname: Fabsitz
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
mesh_terms: D000368:Aged; D000419:Albuminuria; D001130:Arizona / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology; D018149:Glucose Intolerance / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D007328:Insulin / Q000097:blood / Q000627:therapeutic use; D008875:Middle Aged; D009658:North Dakota / Q000453:epidemiology; D009765:Obesity; D009825:Oklahoma / Q000453:epidemiology; D012307:Risk Factors; D012727:Sex Characteristics; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D014280:Triglycerides