Extending the public health impact of screening for diabetes in high-risk populations: opportunities in American Indian communities.
OBJECTIVE
To assess trends in diabetes screening among American Indian adults and identify opportunities to extend blood glucose screening to those at risk for undiagnosed diabetes and prediabetes.


METHODS
In 1999, 2001, and 2003, approximately 1,000 American Indian adults aged 18 years and older living on or near the seven reservations in Montana were interviewed through telephone surveys.


RESULTS
Of respondents without diagnosed diabetes, the proportion who recalled blood glucose screening for diabetes within the past 3 years increased from 68 percent in 1999 to 78 percent in 2003. Between 1999 and 2003, screening increased among men (64%-75%), women (71%-80%), those aged 18-44 years (64%-72%), and those aged 45 years and older (76%-84%). Factors independently associated with screening included age more than 45 years, family history of diabetes, and a history of high cholesterol. Current smokers were less likely to report screening compared to nonsmokers. Gender, obesity, and a history of high blood pressure were not associated with screening.


CONCLUSIONS
Although self-reported diabetes screening increased over a 5-year period among Indians in Montana, additional groups who could benefit from screening include younger and obese individuals, and those with hypertension.
Harwell
Todd S
TS
Chronic Disease Preventive and Health Promotion Bureau, Montana Department of Public Health and Human Services, Helena, Montana 59620, USA. tharwell@mt.gov
Oser
Carrie S
CS
Strasheim
Carol
C
Dennis
Terry D
TD
Moore
Kelly R
KR
Johnson
Elizabeth A
EA
Helgerson
Steven D
SD
Gohdes
Dorothy
D
D000293:Adolescent; D000328:Adult; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007198:Indians, North American; D008297:Male; D008403:Mass Screening; D009009:Montana; D011634:Public Health