Purpose: Design primary prevention program for type II diabetes in Native American youths. Background: Type II diabetes is a disease of high morbidity with great prevalence in Native Americans. In a recent school-based screening of the Omaha Indian Tribe, 39%(n=195) showed risk factors for type II diabetes. Risk factors assessed were Acanthosis nigricans, body mass index (BMI), blood pressure (BP), and random blood glucose (BG). Acanthosis markings were graded by severity: grade 0 through grade 4. Presence of Acanthosis marking is a sign of hyperinsulinemia and a risk factor for onset of type II diabetes. Methods: Subjects were referred to physical therapy and occupational therapy for risk factor reduction, based on Acanthosis, BMI, BP, and BG. A pilot program of education and direct intervention was developed for those with the most severe markings (grade 3 & grade 4; n=16). Education focuses on identification of and strategies to ameliorate diabetes risk factors. Direct interventions include tailored exercise prescription, occupational pattern analysis, and lifestyle re-design. Outcomes were tracked pre- / post-intervention. The assessment tools utilized include: 1) 3-minute step test to assess exercise capacity; 2) survey data regarding health behaviors and knowledge of diabetes; and 3) qualitative, narrative data. Results: Initial investigation has revealed that the severity of the Acanthosis marking can be reduced through exercise, decreased BMI, and change in occupational patterns. Conclusion/Discussion: The working hypothesis is that following 6-8 weeks of intervention not only will Acanthosis be ameliorated, but insulin levels will be reduced and occupational pattern modifications will occur.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Identify the risk factors for diabetes mellitus endemic to Native Americans. 2. Discuss education & primary prevention programming geared for Native American children. 3. Identify cultural sensitivity strategies essential for successful academic-community partnerships in underserved areas.
Keywords: Diabetes, Native Americans
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Omaha Indian Tribe
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: This author has partial employment with the Omaha Tribe; this arrangement is subsidized by Creighton University.