Posted by Ellen on November 01, 1999 at 12:36:15:
In Reply to: Re: Good Ol' NIH! :-( posted by Kelly on November 01, 1999 at 11:09:53:
I can only imagine the level of frustration in the Pima Indians as I too am frustrated seeing asinine study after asinine study being done with no direction toward curing diabetes.
The following is only a small sample of the studies done on this population. Researchers question or blame the weight etc.. And this first one questions if the babies' LOW birth weight is a problem!!! How many millions have been spent and to what end? G-d and Phillip Gorden must be the only ones who know.
------------------------------------
: Diabetes Care 1999 Jun;22(6):944-50Related Articles
Birth weight, type 2 diabetes, and insulin resistance in Pima Indian
children and young adults.
Dabelea D, Pettitt DJ, Hanson RL, Imperatore G, Bennett PH, Knowler WC
National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Phoenix, Arizona 85014, USA.
OBJECTIVE: To investigate the mechanisms underlying the association
between birth weight and type 2 diabetes in a population-based study of
3,061 Pima Indians aged 5-29 years. RESEARCH DESIGN AND METHODS: Glucose
and insulin concentrations were measured during a 75-g oral glucose
tolerance test, and insulin resistance was estimated according to the
homeostatic model (homeostasis model assessment-insulin resistance
[HOMA-IR]). Relationships between birth weight, height, weight, fasting
and postload concentrations of glucose and insulin, and HOMA-IR were
examined with multiple regression analyses. RESULTS: Birth weight was
positively related to current weight and height (P < 0.0001, controlled
for age and sex, in each age-group). The 2-h glucose concentrations
showed a U-shaped relationship with birth weight in subjects > 10 years
of age, and this relation was independent of current body size. In 2,272
nondiabetic subjects, after adjustment for weight and height, fasting
and 2-h insulin concentrations and HOMA-IR were negatively correlated
with birth weight. CONCLUSIONS: Low-birth-weight Pimas are thinner at
ages 5-29 years, yet they are more insulin resistant relative to their
body size than those of normal birth weight. By contrast, those with
high birth weight are more obese but less insulin resistant relative to
their body size. The insulin resistance of low-birth-weight Pima Indians
may explain their increased risk for type 2 diabetes.
PMID: 10372247, UI: 99300835
-------------------------------------------------
: Clin Chim Acta 1999 Aug;286(1-2):81-95Related Articles
The public health epidemiology of type 2 diabetes in children and
adolescents: a case study of American Indian adolescents in the
Southwestern United States.
Fagot-Campagna A, Burrows NR, Williamson DF
Division of Diabetes Translation, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and
Prevention, Atlanta, GA 30341, USA. adf8@cdc.gov
Type 2 diabetes among children and adolescents is a newly recognized
disease in the United States. Because obesity and physical inactivity
are increasing in children and adolescents, the prevalence of pediatric
type 2 diabetes may increase and eventually become an important cause of
adult morbidity and mortality. Data on type 2 diabetes in adolescents
aged 15-19 years were compared between two sources: systematic
population screening of the Gila River Indian Community by the National
Institutes of Health (NIH), and reported cases by the Indian Health
Service (IHS) from clinics in the Southwestern US. The current NIH
estimate of prevalence of type 2 diabetes was much higher than the IHS
estimate (5.1% vs. 0.46%). Both data sources, however, suggest a secular
increase in prevalence between 1986 and 1996-97. These data are used to
discuss the principles, applications, and challenges for accurate
epidemiologic assessment of type 2 diabetes in children and adolescents.
Publication Types:•Review •Review, tutorial
PMID: 10511286, UI: 99439304
----------------------------------------
Nutr Rev 1999 May;57(5 Pt 2):S51-4Related Articles
Type 2 diabetes among the Pima Indians of Arizona: an epidemic
attributable to environmental change?
Bennett PH
National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Phoenix, Arizona 85014, USA.
Publication Types:•Historical article •Review •Review, tutorial
PMID: 10391026, UI: 99319499
--------------------------------------------
Diabetologia 1998 Aug;41(8):904-10Related Articles, LinkOut
Increasing prevalence of Type II diabetes in American Indian children.
Dabelea D, Hanson RL, Bennett PH, Roumain J, Knowler WC, Pettitt DJ
National Institute of Diabetes and Digestive and Kidney Diseases,
National Institutes of Health, Phoenix, Arizona 85014, USA.
Until recently, Type II diabetes was considered rare in children. The
disease is, however, increasing among children in populations with high
rates of Type II diabetes in adults. The prevalence of Type II diabetes
was determined in 5274 Pima Indian children between 1967 and 1996 in
three 10-year time periods, for age groups 5-9, 10-14 and 15-19 years.
Diabetes was diagnosed using World Health Organisation criteria, based
on an oral glucose tolerance test. The prevalence of diabetes increased
over time in children aged 10 years and over: in boys from 0 % in
1967-1976 to 1.4% in 1987-1996 in the 10-14 year old age group, and from
2.43% to 3.78% for age group 15-19 and in girls from 0.72 % in 1967-1976
to 2.88 % in 1987-1996 in the 10-14 year old age group, and from 2.73 %
to 5.31 % for age group 15-19 years. Along with the increase in the
prevalence of Type II diabetes (p < 0.0001), there was an increase in
weight (calculated as percentage of relative weight, p < 0.0001), and in
frequency of exposure to diabetes in utero (p < 0.0001). The increasing
weight and increasing frequency of exposure to diabetes in utero
accounted for most of the increase in diabetes prevalence in Pima Indian
children over the past 30 years. Type II diabetes is now a common
disease in American Indian children aged 10 or more years and has
increased dramatically over time, along with increasing weight. A
vicious cycle related to an increase in the frequency of exposure to
diabetes in utero appears to be an important feature of this epidemic.
PMID: 9726592, UI: 98393193
-----------------------------------------------
: MMWR Morb Mortal Wkly Rep 1998 Oct 30;47(42):901-4Related Articles
Prevalence of diagnosed diabetes among American Indians/Alaskan
Natives--United States, 1996.
Since the early 1960s, diabetes has disproportionately affected American
Indians/Alaskan Natives (Als/ANs) compared with other populations.
Diabetes is a major cause of morbidity (such as blindness, kidney
failure, lower-extremity amputation, and cardiovascular disease) and
premature mortality in this population. To update information about the
prevalence of diabetes among Als/ANs, data were analyzed from the Indian
Health Service (IHS) national outpatient database for 1996 and were
compared with the prevalence of diabetes among non-Hispanic whites in
the United States. This report presents the findings of this analysis,
which indicate that the prevalence of diabetes among Als/ANs remains
high and is approximately three times the prevalence among non-Hispanic
whites.
PMID: 9810015, UI: 99025887
----------------------------------
: Diabetes Metab 1997 Nov;23 Suppl 4:6-9Related Articles
[Non-insulin-dependent diabetes in populations at risk: the Pima
Indians].
[Article in French]
Charles MA, Eschwege E, Bennett PH
INSERM U 21, Villejuif, France.
Pima Indians have the highest prevalence of non-insulin-dependent
diabetes mellitus reported in the world, reaching 70% in the 55-64 year
age-group. Although obesity is also quite prevalent in this population,
it cannot in itself be held responsible for the high frequency of the
disease. Profound changes in the way of life of the Pima Indians during
the past century have been associated with the emergence of diabetes. A
genetic susceptibility in this population probably explains why diabetes
became an "epidemic". Compared to Caucasians with similar degrees of
obesity and glucose tolerance, Pima Indians are insulin-resistant. This
characteristic, which is a strong predictor of diabetes, seems to be
genetically determined in this population, and an active search for the
gene(s) involved has started. Surprisingly, for an insulin-resistant
population, cardiovascular mortality is low in Pima Indians. An
understanding of the similarities and differences between diabetic
Caucasians and Pima Indians is one means of advancing our knowledge of
non-insulin-dependent diabetes mellitus and insulin resistance.
Publication Types:•Review •Review, tutorial
PMID: 9463026, UI: 98083450
---------------------------------------------------
Diabetes Metab Res Rev 1999 May-Jun;15(3):175-80Related Articles
Molecular scanning of the beta-3-adrenergic receptor gene in Pima
Indians and Caucasians.
Silver K, Walston J, Yang Y, Pratley R, Ravussin E, Raben N, Shuldiner
AR
Division of Endocrinology and Metabolism, Johns Hopkins University
School of Medicine, Baltimore, MD 21201, USA. ksilver@umppa1.ab.umd.edu
BACKGROUND: The beta-3-adrenergic receptor (beta3AR) stimulates
lipolysis and thermogenesis in adipocytes. The Trp64Arg beta3AR variant
is associated in some, but not all, studies with an earlier onset of
Type 2 diabetes mellitus and features of the insulin resistance
syndrome. Functional studies as to the role of the Trp64Arg variant have
been inconclusive. Earlier studies screened the beta3AR gene in only ten
obese, diabetic Pima Indians. Potentially another yet to be identified
polymorphism in the beta3AR gene in linkage disequilibrium with the
Trp64Arg polymorphism could explain the findings in the association and
functional studies. METHODS: We scanned the beta3AR gene in 20 diabetic
Pima subjects and 20 Caucasian subjects using single stranded
conformational polymorphism (SSCP) analysis. Variants were sequenced
using dideoxy sequence analysis and further characterized using allele
specific oligonucleotide hybridization (ASO) and RNA template
specific-polymerase chain reaction (RS-PCR) assays. RESULTS: We found a
guanine to thymidine substitution in the first intron, 14 bases from the
splice donor site in both groups. In virtually all subjects, only two
haplotypes were detected, Trp64/g1856 and Arg64/t1856, indicating that
the g1856t polymorphism is in linkage disequilibrium with the Trp64Arg
polymorphism. The g1856t substitution introduces a new consensus splice
donor site which, if used, would encode a truncated protein. RNA levels
of the two beta3AR alleles were approximately equal in omental adipose
tissue of heterozygotes. No aberrantly spliced beta3AR mRNA was
detected, indicating that the new consensus splice donor site is not
used in vivo. CONCLUSION: The g1856t polymorphism is in linkage
disequilibrium with the Trp64Arg variant, but does not appear to have a
functional role. Copyright 1999 John Wiley & Sons, Ltd.
Publication Types:•Clinical trial
PMID: 10441039, UI: 99370329
-------------------------------------------