Diabetes is one of the most common ailments afflicting Native people. It is estimated that 17 million Americans, or 6.2% of the population of the US population, has diabetes compared to 30% of American Indians who are 25% more likely to develop diabetes than non-Natives. In February 2002, the Choctaw Nation reported that in 2001, 831 new cases of diabetes were diagnosed, bringing the total number of Choctaws with diabetes in the service area to 3800. The number may be much higher, however, because many people with diabetes have not been diagnosed.
Diabetes mellitus occurs when the pancreas stops producing the hormone insulin or does not create enough for the body to function properly. Without insulin, the liver cannot absorb enough insulin to store and the cells cannot absorb enough to use for energy. The result is excessive glucose into the bloodstream and into the urine. There are two types of diabetes mellitus: type I affects five to ten percent of all cases of diabetes and occurs when the pancreas produces little or no insulin. The body must obtain energy from fat because it has no glucose to draw upon. As the fat is utilized and burned, the by-product ketone is produced, which leads to a dangerous condition called ketoacidosis that causes dehydration and high levels of blood sugar.
Type II usually affects those over forty and is usually caused by an imbalanced diet. The insulin-producing cells in the pancreas produce insulin, but not enough for normal bodily functions. Type II affects 90 to 95 per cent of those with diabetes and is often caused by overeating and obesity, although genetics is also a factor. Those who suffer from Type 2 diabetes must take insulin injections. Symptoms of diabetes include frequent thirst, excessive hunger, skin ulcers, pain when walking, an uncontrollable urge to urinate, and fatigue, especially after a meal because the body is awash with sugar that it cannot process. A diabetic will also have numb or tingling feet and hands, cuts that heal slowly, blurry vision from too much sugar in the bloodstream that stretches the lenses, headaches, higher than normal blood pressure, breath that smells strongly because of the liver breaking down fat for fuel, and a leathery band of skin around the neck.
Those who suffer from diabetes have a higher chance of developing atherosclerosis and high blood pressure which can lead to a stroke or heart attack. There also is a chance to develop retinopathy, an eye disease that can lead to blindness, especially those with Type II diabetes. Nerve damage can also result which can cause blindness and extremity amputations, at least. Diabetes does not just attack the elderly. Although an individual may think he or she is eating right and has no family history of diabetes, that person may be surprised to find they are diabetic because of the types and amounts of foods they ingest. And, even if an individual is lean in comparison to most people around them, that person may have a dangerous body composition. Some apparently skinny people may carry too much fat in comparison to their muscle content.
Very thin people can create high glucose levels if they eat incorrectly. Many believe that consuming sports and fruit drinks and a fat-free diet can make them immune; but, even strong athletes with little body fat and high metabolisms often eat a tremendous amount of calories. All that sugar and carbohydrate can be turned into more glucose than their bodies can handle. A test can tell you quickly: a blood sugar level greater than 125 is considered diabetic. Abnormal blood-fat levels can put a person at risk, so it is crucial to have a lipid screening. A person is in potential trouble if their triglyceride level is high and HDL cholesterol level is low.
A major contributing factor to developing diabetes is being over fat. Gaining 11 to 18 pounds doubles the risk of developing Type II diabetes. Just gaining 10 pounds ups one’s risk of heart disease and gaining 20 pounds doubles a woman’s chance of developing breast cancer. Although genetic background accounts for the disposition to being obese, the major culprits are overeating and under-exercising. Many Natives pay little attention to what they put in their mouths and take advantage of the American culture that presents food in extra-large sizes, in cheese-filled crusts, in easy to microwave containers, in lattes with heavy cream and in fast-food shops. McDonalds’ French fries servings have increased, as have the sizes of movie popcorn bags and buckets. Restaurant portions and bottles of soft drinks are often large enough for three people and are relatively cheap, mainly because they are made with trans fats and high-fructose corn syrup. Outside magazine recently cited a study by psychologist Paul Rozin, who found that despite the French propensity for fatty foods, only 7.4% of the French population is obese compared to 22.3 of the American population. He found that regular fries at McDonald’s are 72% larger in the US than in France; a Pizza Hut pizza is 32% larger; an average chocolate bar is 41% larger; an average Coca-Cola is 52% larger; an average hot dog is 52% larger; an average serving of ice cream is 24% larger.
Corn is produced on such a large scale that it can be sold cheaply as sweetener, for high-fat and high-calorie snacks such as corn chips and as feed to create fatter pigs and cattle. Unless one is a hunter who eschews deer blinds, stands and ATVs and walks to stalk game, or are skilled with a blow gun and can track squirrels, rabbits and birds for hours, or are a devout gardener who eats only what is grown in the home garden, we rarely have to use many calories to acquire our meals. Americans have adopted a sedentary lifestyle and watch hours of television and plays videogames every day.
BISHINIK, September 2002, p. 8; For information about how tribes are fighting diabetes, see http://www.nativeheritage.net/; BISHINIK, February 2002, p.1; ibid, September 2003, p.3. Navajos have also been hard hit by this epidemic. According to Susan Montoya Bryan’s June 14, 2004 article, “Army of families, health workers battle diabetes,” at least 18 per cent of Navajos on the reservation have diabetes which is an increase of almost a third in the last five years.
American Diabetes Association:
http://www.diabetesnet.com/diabetes_food_diet/carb_counting.php, (a web page that gives you a formula for calculating how many grams of carbohydrates you may consume depending on how much insulin you use).
Native American Diabetes Project Diabetes Wellness Connection for information on how to control and prevent diabetes: http://www.laplaza.org/health/dwc/nadp/.