4179.0: Tuesday, October 23, 2001 - 2:35 PM

Abstract #28578

Characterization and Risk Factors for Diabetes Mellitus (DM) in American Indian Children and Adolescents: A Case-Control Study

Boureima Hama Sambo, MD, MPH, University of Oklahoma Health Sciences Center, Native American Prevention Research Center, 1800 N.E. 15th, Room # 532, Oklahoma City, OK 73104, (405) 271-2330, boureima-sambo@ouhsc.edu, June E. Eichner, PhD, University of Oklahoma Health Sciences Center, Native American Prevention Research Center (NAPRC), 1800 N.E. 15th, Room # 532, Oklahoma City, OK 73104, Lorraine Halinka Malcoe, PhD, MPH, University of New Mexico Health Sciences Center, 2400 Tucker NE, FPC 149, Albuquerque, NM 87131-5267, Elisa T. Lee, PhD, Center for American Indian Health Research, University of Oklahoma Health Sciences Center, College of Public Health, P.O. Box 26901, Oklahoma City, OK 73190, Bernadine Tolbert, MD, PhD, OCA-IHS, Oklahoma City Area Indian Health Service (OCA-IHS), Oklahoma City, OK 73104, and Charles Hays, University of Oklahoma.

Type 2 DM has increased dramatically in children and adolescents, and this increase has been even more marked among American Indian children where DM is highly prevalent in the adult population. There is limited clinical knowledge about children with Type 2 DM. To remedy this, a case-control study of DM in American Indian children and adolescents was undertaken with the help of several tribes in Oklahoma.

One hundred and fifty cases of DM were identified through the tribal clinical network and the Oklahoma City Area Indian Health Service (OCA-IHS). Controls were randomly selected from the same IHS and tribal facilities and were frequency matched by age to cases. Medical records of cases and controls were abstracted.

No gender difference was found among cases with DM. Sixty three percent of DM at presentation were Type 2, 22 % Type 1, and 15% Type 3 (atypical form of DM). Mean weight at onset of DM was significantly higher for Type 2 (177 lbs) than Type 3 (115 lbs) and Type 1 (49 lbs) [P=.01]. Fasting blood glucose at diagnosis was higher in Type 3 DM, mean (X)=647 mg/dl than Type 2 and Type 1 respectively X=466 mg/dl and X=398 mg/dl. Excessive weight gain during pregnancy combined with higher birth weight were found to be strongly associated with early onset of Type 2 DM.

More and better surveillance is needed to help characterize the diabetes epidemic in American Indian children and adolescents. Clinical and community-based interventions are desperately needed.

Learning Objectives: 1) Describe the problem of diabetes mellitus (DM)in American Indian children and adolescents; 2) Identify risk factors for Type 2 DM in American Indian youth; 3) List differences in the kinds of DM in this population.

Keywords: Children and Adolescents, Diabetes

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA