Diabetes in Navajo youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study.
OBJECTIVE
To estimate the prevalence and incidence of diabetes, clinical characteristics, and risk factors for chronic complications among Navajo youth, using data collected by the SEARCH for Diabetes in Youth Study (SEARCH study).


METHODS
The SEARCH study identified all prevalent cases of diabetes in 2001 and all incident cases in 2002-2005 among Navajo youth. We estimated denominators with the user population for eligible health care facilities. Youth with diabetes also attended a research visit that included questionnaires, physical examination, blood and urine collection, and extended medical record abstraction.


RESULTS
Diabetes is infrequent among Navajo youth aged <10 years. However, both prevalence and incidence of diabetes are high in older youth. Among adolescents aged 15-19 years, 1 in 359 Navajo youth had diabetes in 2001 and 1 in 2,542 developed diabetes annually. The vast majority of diabetes among Navajo youth with diabetes is type 2, although type 1 diabetes is also present, especially among younger children. Navajo youth with either diabetes type were likely to have poor glycemic control, high prevalence of unhealthy behaviors, and evidence of severely depressed mood. Youth with type 2 diabetes had more metabolic factors associated with obesity and insulin resistance (abdominal fat deposition, dyslipidemia, and higher albumin-to-creatinine ratio) than youth with type 1 diabetes.


CONCLUSIONS
Our data provide evidence that diabetes is an important health problem for Navajo youth. Targeted efforts aimed at primary prevention of diabetes in Navajo youth and efforts to prevent or delay the development of chronic complications among those with diabetes are warranted.
Dabelea
Dana
D
Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Denver, Colorado, USA. dana.dabelea@ucdenver.edu
DeGroat
Joquetta
J
Sorrelman
Carmelita
C
Glass
Martia
M
Percy
Christopher A
CA
Avery
Charlene
C
Hu
Diana
D
D'Agostino
Ralph B
RB
Beyer
Jennifer
J
Imperatore
Giuseppina
G
Testaverde
Lisa
L
Klingensmith
Georgeanna
G
Hamman
Richard F
RF
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000208:ethnology* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology* / Q000473:pathology; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000208:ethnology*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D014481:United States; D055815:Young Adult