Schraer C D, Adler A I, Mayer A M, Halderson K R, Trimble B A
Alaska Native Medical Center, Anchorage 99501, USA.
Diabetes Care. 1997 Mar;20(3):314-21. doi: 10.2337/diacare.20.3.314.
To determine the prevalence and incidence of diabetes in Alaska Natives and the incidence of cerebrovascular accidents (stroke), myocardial infarction (MI), end-stage renal disease (ESRD), lower-extremity amputations (LEA), and mortality over a 6- to 8-year period.
The data derive from a registry of diagnosed diabetes (World Health Organization [WHO] criteria) of the Alaska Area Native Health Service (AANHS), from medical records, and from the Alaska Bureau of Vital Statistics.
From 1986 to 1993, the prevalence of diabetes in Alaska Natives increased by 22% from 15.7 to 19.2 per 1,000 people. Of these cases, nearly all were diagnosed with type II diabetes. During the same period, 614 new cases were diagnosed. The incidence was 1.5 per 1,000 Alaska Natives per year. The incidence of confirmed MI was 8.0 per 1,000 person-years of diabetes. Aleuts had the highest rate, followed by Indians and Eskimos. The incidence of confirmed stroke was 10.6 per 1,000 person-years of diabetes. Eskimos had a significantly higher rate than Indians (P = 0.002), and women had a higher rate than men. The incidence of LEA was 5.0 per 1,000 person-years of diabetes. The incidence rate dropped significantly after instituting a foot care program. The incidence for ESRD was 3.3 per 1,000 and also showed a decline with time. The all-cause mortality rate of 43.2 per 1,000 person-years of diabetes was nearly equal between men and women. Among Alaska Natives with diabetes, cardiovascular disease (CVD) was the most common cause of death, followed by cancer and diabetes, per se.
We conclude that diabetes is increasing in Alaska Natives, who are experiencing both the microvascular and macrovascular complications of diabetes. The incidence of LEA and ESRD show some evidence of a decrease after intervention efforts.
确定阿拉斯加原住民糖尿病的患病率和发病率，以及在6至8年期间脑血管意外（中风）、心肌梗死（MI）、终末期肾病（ESRD）、下肢截肢（LEA）的发病率和死亡率。
数据来源于阿拉斯加地区原住民健康服务局（AANHS）的确诊糖尿病登记册（世界卫生组织[WHO]标准）、医疗记录以及阿拉斯加生命统计局。
1986年至1993年期间，阿拉斯加原住民糖尿病患病率从每1000人15.7例增至19.2例，增幅为22%。在这些病例中，几乎所有被诊断为II型糖尿病。同期，确诊614例新病例。发病率为每年每1000名阿拉斯加原住民中有1.5例。确诊MI的发病率为每1000人年糖尿病患者中有8.0例。阿留申人发病率最高，其次是印第安人和爱斯基摩人。确诊中风的发病率为每1000人年糖尿病患者中有10.6例。爱斯基摩人的发病率显著高于印第安人（P = 0.002），女性发病率高于男性。LEA的发病率为每1000人年糖尿病患者中有5.0例。实施足部护理计划后发病率显著下降。ESRD的发病率为每1000人中有3.3例，且也随时间下降。糖尿病患者全因死亡率为每1000人年43.2例，男女相近。在患有糖尿病的阿拉斯加原住民中，心血管疾病（CVD）是最常见死因，其次是癌症和糖尿病本身。
我们得出结论，阿拉斯加原住民糖尿病患病率在上升，他们正经历糖尿病的微血管和大血管并发症。LEA和ESRD的发病率在干预措施实施后有下降迹象。
