Delegates listen to a report on the progress of diabetes programs at the National Congress of American Indians midyear meeting in Sparks, Nevada. (Photo by Tsanavi Spoonhunter)
This is Trahant Reports.
Dr. Yvette Roubideaux took a quick poll last week from the podium at the National Congress of American Indians mid-year meeting in Sparks, Nevada.
“How many of you think we’ve made great progress with American Indians and Alaska Natives with diabetes? Raise your hand.”
A few hands went up. “How many think we still have more to do?”
Far more hands in the air, followed by, “how many of you think that diabetes is still a significant crisis in our communities?”
Nearly every hand went up.
For the record Roubideaux agreed with all three premises.
But the takeaway is this: Indian Country has made extraordinary progress on the diabetes front … even though there remains a long way to go before the disease is under control.
Indian Country still shows the highest rate of diabetes; Native Americans are twice as likely to get diabetes as other population groups.
But as Roubideaux said last week: The big picture is that we’ve seen amazing outcomes in the prevention and treatment of diabetes over the past 20 years. She credits the Special Diabetes Program for Indians as a key element.
The proportion of people with diabetes who are American Indians and Alaska Natives has not increased since 2011. This Roubideaux called “amazing results.”
She said there is a decline in diabetes-related mortality and the most exciting news is that complications are decreasing, specifically a 54 percent drop in kidney failure, according to the Centers for Disease Control and Prevention.
More than 300 tribes are engaged in diabetes education, exercise programs, or nutrition initiatives.
An issue brief by the U.S. Health and Human Services Office of the Assistant Secretary for Planning and Evaluation translated the data into “cost savings” for taxpayers through Medicare. Permanent kidney failure, also known as end-stage renal disease, is covered by Medicare.
“Under our relatively conservative assumption,” the agency observed, the overall reduction in kidney-related issues estimated an accumulated Medicare savings between 2006 and 2015 of $435.9 million.
At the NCAI conference, Dr. Roubideaux made that point that best practices do lead to better outcomes in diabetes prevention.
Not that many years ago Alaska Natives had the highest rate of juvenile carries disease — an epidemic of tooth decay — yet now because of prevention, education, and community engagement many communities are cavity free. Now imagine that same sort of outcome for diabetes. No doubt we have a long way to go … but it’s possible that the diabetes epidemic can be defeated, too.
I am Mark Trahant.