DIABETES MELLITUS IN ALASKA NATIVES

我们建议计划一项关于糖尿病的研究项目， 阿拉斯加州安奈特岛的梅特拉卡特拉印第安人社区。约1525人 臣民居住在这个社区，其中约1100人是尖沙咀人 印第安人。我们对临床糖尿病的初步研究 整个阿拉斯加州的流行率显示，最高的 流行率发生在安奈特岛的阿拉斯加土著居民中。 然而，二三十年前，糖尿病在阿拉斯加很少发生。 原住民。在这段时间里，生活方式发生了很大的变化， 商店购买的食品和劳动力的供应越来越普遍 储蓄机。该研究项目的初步目标将包括 测量糖尿病患病率，确定危险因素 以及设计一种行为干预来治疗糖尿病 减少这种代谢紊乱的患病率。具体的 实现这些目标所遵循的目标和程序将取决于 什么被认为是可行的和土著社区感兴趣的，以及 调查人员在规划过程中。目前， 以下是本研究项目的设想。口头的 安妮特岛所有阿拉斯加原住民的葡萄糖耐量试验 年龄在20岁及以上的将进行。由于年龄太小， 人口结构方面，大约一半的安奈特岛居民将是 包括在本次调查中。将使用世界卫生组织的标准 将诊断为糖耐量正常、糖耐量受损 耐受性和糖尿病。我们预计所有被发现的糖尿病患者 NIDDM，因为IDDM在阿拉斯加原住民中很罕见。空腹胰岛素和 将测量C-肽水平以评估胰岛素的流行率 糖耐量正常的受试者的抵抗力。仪器以达到 评估膳食摄入量和体力活动将在这一帮助下进行 合作者。这些生活方式变量将在受试者中进行比较 以评估它们对糖耐量正常和异常的影响 糖尿病患病率。

We propose to plan a research project on diabetes mellitus among the Metlakatla Indian Community of Annette Island, Alaska. About 1,525 subjects reside in this community, of whom about 1,100 are Tsimshian Indians. A preliminary study performed by us of clinical diabetes mellitus prevalence across the entire state of Alaska revealed that the highest prevalence occurred among Alaska Native residents of Annette Island. Twenty to thirty years ago, however, diabetes rarely occurred among Alaska Natives. Over this time period, lifestyle has changed considerably with the increasingly widespread availability of store bought food and labor saving machines. Preliminary goals of the research project will include measurement of diabetes mellitus prevalence, ascertainment of risk factors for diabetes mellitus, and the design of a behavioral intervention to decrease the prevalence of this metabolic disorder. The specific objectives and procedures to be followed to achieve them will depend on what is deemed feasible and of interest to the Native community and investigators during the planning process. At the current time, the following tentative plan for the research project is as follows. Oral glucose tolerance testing of all Alaska Native residents of Annette Island age 20 years and older will be conducted. Due to the youthful age structure of the population, about half of Annette Island residents will be included in this survey. World Health Organization criteria will be used to assign the diagnosis of normal glucose tolerance, impaired glucose tolerance, and diabetes mellitus. We expect all diabetes found to be NIDDM, due to the rarity of IDDM among Alaska Natives. Fasting insulin and C-peptide levels will be measured to assess the prevalence of insulin resistance among subjects with normal glucose tolerance. Instruments to assess dietary intake and physical activity will be developed with the help of collaborators. These lifestyle variables will be compared in subjects with normal and abnormal glucose tolerance to assess their effect on diabetes prevalence.