You can get diabetes if your body does not make or use insulin right. Insulin in your body changes the sugars in food into energy. With diabetes, glucose builds up in the blood, flows into the urine, and is carried out of the body instead of being used by the cells for energy. Type 1 diabetes happens when your body destroys its own cells that make insulin. Type 2 diabetes occurs when the pancreas doesn't make enough insulin.

American Indians and Alaska Natives suffer more from diabetes, compared to all other racial and ethnic groups. American Indians and Alaska Natives with diabetes also have a higher rate of dying, compared to the general population. Most people have type 2 diabetes. For American Indians/Alaska Natives (AI/AN), both women and men, the number of new cases of type 2 (or adult) diabetes has reached epidemic proportions. Diabetes contributes to several of the leading causes of death in AI/AN, including heart disease, stroke, pneumonia, and influenza. Specific tribes have much higher rates. For example, 50% of Pima Indians in Arizona who are between the ages of 30 and 64 have type 2 diabetes.

Pregnant AI/AN women with type 2 diabetes are at an increased risk of having babies born with birth defects. Diabetes that shows up in pregnancy is called gestational diabetes. This form of diabetes is high among certain AI/AN. Gestational diabetes increases the baby's risk for problems such as macrosomia (large body size) and neonatal hypoglycemia (low blood sugar). Although the blood glucose levels of women with gestational diabetes usually return to normal after childbirth, these women have an increased risk of developing gestational diabetes in future pregnancies. In addition, studies show that many women with gestational diabetes will develop type 2 diabetes later in life.

Serious complications of diabetes are increasing. The most concerning are kidney (or renal) failure, heart disease, amputations, and blindness. Infections, including tuberculosis (TB), are of particular concern to both American Indians and Alaska Natives who have diabetes. Tuberculosis is a disease caused by a bacteria. If TB is in the lungs, it can cause a bad cough, chest pain, fatigue, weight loss, chills, and fever. A study of Sioux Indians showed that their rate of developing tuberculosis is higher if they had diabetes than if they did not.

People with diabetes have a higher chance of having problems with their skin, mouth, kidneys, heart, nerves, eyes, and feet. Although type 1 diabetes cannot be prevented, there are steps you can take to prevent and control type 2 diabetes:

* See your health care providers regularly. Don't forget about the dentist and eye doctor!
* Don't smoke.
* Control your blood sugar and cholesterol levels, your blood pressure, and weight.
* Exercise (30 minutes most days of the week is best).
* Check your feet everyday for blisters, red spots, swelling, or cuts.
* Stay aware of how you feel-if you notice a problem, call your health care provider right away.

Publications

1. American Indian and Alaska Native Women's Health - This site provides information to Indian Health Service providers and consumers about American Indian and Alaska Native women's health. It discusses access to care, violence against Native women, cancer, diabetes, HIV/AIDS, substance abuse, cardiovascular disease, and other health issues.

2. An Easy Guide to Breastfeeding for American Indian and Alaska Native Families - The Department of Health and Human Services encourages all women to exclusively breastfeed for 6 months before introducing solid foods and continue to breastfeed for 12 months and thereafter for as long as desired. Choosing to breastfeed honors the traditions of American Indian and Alaska Native families. This guide offers encouragement and advise to support successful breastfeeding by American Indian and Alaskan Native mothers.

3. Diabetes in American Indians and Alaska Natives - Diabetes mellitus is one of the most serious health challenges facing American Indians and Alaska Natives in the United States today. The disease is very common in many tribes, and morbidity and mortality from diabetes can be severe. This publication provides information and statistics on the risks and complications associated with diabetes.

4. Diabetes Risk Test (Copyright © American Diabetes Association) - This tool is an interactive test that can help you determine your risk for diabetes.

5. Health and Heritage: Diabetes - This publication outlines the purpose and goals of the Indian Health Services' National Diabetes Program, dedicated to preventing and raising awareness of the prevalence of Type 2 diabetes among the American Indian/Alaskan Native community.

6. Pima Indians: Pathfinders for Health, The - This booklet describes the role of the Pima Indians in helping to understand diabetes and details NIDDK's efforts to improve clinical care and self-management practices among the Pima Indians.

7. The Pima Indians: Genetic Research - This publication discusses how Pima families from the Gila River Indian Community are making it possible for NIDDK researchers to search for diabetes and obesity genes.

8. The Pima Indians: Kidney Disease - This publication discusses the results of a on-going study being conducted on the Pima Indians. The relationship between kidney failure and diabetes among this group is discussed.

9. The Pima Indians: Obesity and Diabetes - This publication discusses the connection between the slower metabolic rate experienced by the Pima Indians before they became overweight.

10. The Pima Indians: The Vicious Cycle - This publication discusses the relationship between a Pima Indian mother who has diabetes during pregnancy and the very high risk her children have of becoming overweight and developing diabetes as a young adult.

Organizations

1. American Diabetes Association

2. CDC's WISEWOMAN™ - Well Integrated Screening and Evaluation for Women Across the Nation

3. Indian Health Services

4. National Indian Council on Aging

5. National Indian Women's Health Resource Center (NIWHRC)

6. Office of Minority Health, OPHS, OS, HHS