Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Denver, Denver, Colorado, USA.
Diabetes Care. 2010 Jul;33(7):1463-70. doi: 10.2337/dc09-1652. Epub 2010 Mar 31.
American Indians and Alaska Natives are 2.3 times more likely to have diabetes than are individuals in the U.S. general population. The objective of this study was to compare morbidity among American Indian and U.S. adults with diabetes.
We extracted demographic and health service utilization data for an adult American Indian population aged 18-64 years (n = 30,121) served by the Phoenix Service Unit from the Indian Health Service clinical reporting system. Similar data for a U.S. population (n = 1,500,002) with commercial health insurance, matched by age and sex to the American Indian population, were drawn from the MartketScan Research Database. We used Diagnostic Cost Groups to identify medical conditions for which each individual was treated and to assign a risk score to quantify his or her morbidity burden. We compared the prevalence of comorbidities and morbidity burden of American Indian and U.S. adults with diabetes.
American Indians with diabetes had significantly higher rates of hypertension, cerebrovascular disease, renal failure, lower-extremity amputations, and liver disease than commercially insured U.S. adults with diabetes (P < 0.05). The American Indian prevalence rates were 61.2, 6.9, 3.9, 1.8, and 7.1%, respectively. The morbidity burden among the American Indian with diabetes exceeded that of the insured U.S. adults with diabetes by 50%.
The morbidity burden associated with diabetes among American Indians seen at the Phoenix Service Unit far exceeded that of commercially insured U.S. adults. These findings point to the urgency of enhancing diabetes prevention and treatment services for American Indians/Alaska Natives to reduce diabetes-related disparities.
美国印第安人和阿拉斯加原住民患糖尿病的几率比美国普通人群高 2.3 倍。本研究的目的是比较美国印第安人和美国成年糖尿病患者的发病率。
我们从印第安卫生服务临床报告系统中提取了凤凰服务单位服务的 18-64 岁美国印第安成年人的人口统计学和卫生服务利用数据（n=30121）。从 MarketScan Research Database 中抽取了与美国印第安人口年龄和性别相匹配的拥有商业健康保险的美国人群（n=1500002）的类似数据。我们使用诊断费用组来识别每个个体接受治疗的医疗状况，并为量化其发病负担分配风险评分。我们比较了美国印第安和美国成年糖尿病患者的合并症患病率和发病负担。
患有糖尿病的美国印第安人患高血压、脑血管疾病、肾衰竭、下肢截肢和肝病的比率明显高于患有糖尿病的商业保险美国成年人（P<0.05）。美国印第安人的患病率分别为 61.2%、6.9%、3.9%、1.8%和 7.1%。患有糖尿病的美国印第安人的发病负担比有商业保险的美国成年人高 50%。
在凤凰服务单位看到的美国印第安人患糖尿病的发病负担远远超过了有商业保险的美国成年人。这些发现表明，迫切需要加强美国印第安人和阿拉斯加原住民的糖尿病预防和治疗服务，以减少与糖尿病相关的差异。
