Diabetes mellitus in Native Americans: The problem and its implications

Since World War II, diabetes has become one of the most common serious diseases among Native Americans. Rates of diabetes and its complications, which include premature death, renal failure, and limb amputation, are substantially higher among Native Americans than among the US general population, and the frequency of diabetes among Native Americans is increasing. Several potentially modifiable factors, including obesity, dietary composition, and physical inactivity, are thought to be contributing to these high rates. The potential benefit from prevention of diabetes is considerable, and a population-based approach may be the most effective way of achieving sustainable lifestyle changes among Native Americans. Estimation of the social and economic costs of diabetes and assessment of the marginal costs and benefits of various diabetes control measures can support resource allocation decisions aimed at improving the health of Native American people.