The Journal of Nutrition Vol. 127 No. 10 October 1997, pp. 2106S-2113S
Copyright ©1997 by the American Society for Nutritional Sciences

Diabetes Mellitus among Navajo Indians: Findings from the Navajo Health and Nutrition Survey

Julie C. Will^*, , Karen F. Strauss, James M. Mendlein^*, Carol Ballew^*, Linda L. White^**, and Douglas G. Peter

^* Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724;  Nutrition and Dietetics Section, Indian Health Service, Rockville, MD 20857; ^** Kayenta Service Unit, Navajo Area Indian Health Service, Kayenta, AZ 86033; and  Navajo Area Indian Health Service, Window Rock, AZ 86515

Noninsulin-dependent diabetes mellitus is a major health problem among most American Indian tribes. This is the first population-based reservation-wide study of the Navajo that has used oral glucose tolerance testing to determine diabetes status. Employing WHO criteria, we found an age-standardized prevalence of diabetes mellitus (DM) of 22.9% among persons aged 20 y and older. This prevalence is 40% higher than any previous age-standardized estimate for the Navajo and four times higher than the age-standardized U.S. estimate. More than 40% of Navajo aged 45 y and older had DM. About one third of those with DM were unaware of it, with men more likely to be unaware than women. Among persons with a medical history of DM, almost 40% had fasting plasma glucose values 200 mg/dL. Persons with DM were heavier, more sedentary and more likely to have a family history of DM than were persons without DM. Persons with DM had more hypertension, lower HDL levels and higher triglyceride levels than their counterparts without DM. Insulin usage was infrequent among persons with a history of DM, and about one third of women with such a history used no medical therapy to control their diabetes. Although important measures to combat diabetes have already been undertaken by the Navajo, additional efforts are required to slow the progression of this disease and prevent its sequelae.