Diabetes in Navajo Youth
Prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study
Dana Dabelea , MD, PHD 1 ,
Joquetta DeGroat 2 ,
Carmelita Sorrelman , RN, MPH 2 ,
Martia Glass , MD 3 ,
Christopher A. Percy , MD 2 ,
Charlene Avery , MD 4 ,
Diana Hu , MD 5 ,
Ralph B. D'Agostino, Jr. , PHD 6 ,
Jennifer Beyer , MS 6 ,
Giuseppina Imperatore , MD 7 ,
Lisa Testaverde , MS 1 ,
Georgeanna Klingensmith , MD 8 ,
Richard F. Hamman , MD, DRPH 1 and
for the SEARCH for Diabetes in Youth Study Group
1 Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Denver, Colorado
2 Department of Health Promotion Disease Prevention, Northern Navajo Medical Center, Navajo Area Indian Health Service, Shiprock,
New Mexico
3 Area Diabetes Program, Navajo Area Indian Health Service, Window Rock, Arizona
4 Diabetes Program, Gallup Indian Medical Center, Navajo Area Indian Health Service, Gallup, New Mexico
5 Pediatrics Department, Tuba City Regional Health Care Center, Tuba City, Arizona
6 Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Wake Forest, North Carolina
7 Centers for Disease Control and Prevention, Atlanta, Georgia
8 Barbara Davis Center for Childhood Diabetes, University of Colorado, Denver, Colorado
Corresponding author: Dana Dabelea, dana.dabelea{at}ucdenver.edu
Abstract
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).
RESEARCH DESIGN AND 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.
Footnotes
The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views
of the Centers for Disease Control and Prevention.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work
is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
DIABETES CARE...

Diabetes in Navajo Youth

10.2337/dc09-S206