Native Americans with Diabetes

Better diabetes care can decrease kidney failure

Graphic: Team-based and population approaches reduce kidney failure from diabetes in Native Americans: can be a model for other groups

Team-based and population approaches reduce kidney failure from diabetes in Native Americans: can be a model for other groups

Native American adults have more diabetes than any other race or ethnicity.

Whites 8%
Asian Americans 9%
Hispanics 13%
Blacks 13%
Native Americans 16%

SOURCE: National Health Interview Survey and Indian Health Service, 2010-2012.

Kidney failure from diabetes in Native Americans has dropped more than any other race or ethnicity.

Trend graphic comparing kidney failure from diabetes in Native Americans to other groups from 1996 to 2013. In 1996, Native Americans had more kidney failure than blacks, Hispanics, Asians and whites. However, by 2013, Native Americans were third in kidney failure from diabetes despite having the most diabetes.

General population 1996 2013 % change
American Indians/Alaska Natives 57.3 26.5 -54
Asians 23.1 22.2 -4
Blacks 52.2 42.7 -18
Whites 12.1 15.5 +28
Hispanics 40.1 34.2 -15

Per 100,000 people

SOURCE: United States Renal Data System (USRDS), 1996-2013, adults 18 and older.


Improving team-based diabetes care supports kidney disease reductions

Graphic showing the percent of Special Diabetes Program for Indians (SDPI) Sites reporting diabetes services in 1997 and 2013. Bars show the percent for each intervention.

Graphic: Improving team-based diabetes care supports kidney disease reductions

Percent of Special Diabetes Program for Indians (SDPI) Reporting Diabetes Services Intervention

Intervention

Percent

Diabetes clinical teams–1997

30%

Diabetes clinical teams—2013

96%

Diabetes patient registries—1997

34%

Diabetes patient registries—2013

98%

Nutrition services for adults—1997

39%

Nutrition services for adults—2013

93%

Access to registered dietitians–1997

37%

Access to registered dieticians—2013

79%

Access to physical activity specialists

8%

Access to physical activity specialists—2013

74%

Access to culturally tailored diabetes education materials—1997

36%

Access to culturally tailored diabetes education materials

97%

SOURCE: Special Diabetes Program for Indians—2014 Report to Congress. Rockville, Maryland: Indian Health Service

A Model for Diabetes Care

A one-page infographic that depicts the “story” of one particular fictitious patient (Joe). It also includes text boxes with information about what Health Care Systems can do to reach out to entire communities Team-Based Patient Care and Population Management strategies.

Graphic: A Model for Diabetes Care

Public health and population management:

  • Assess communities for poverty, access to healthy food, housing, jobs, transportation, and places to exercise.
    • Work with local government and other organizations to make improvements.
  • Care managers use clinical data to identify people who need to be linked to health care.
  1. Joe is 58 years old with diabetes and kidney disease.
  2. Care manager calls Joe because of missed doctor appointments.
  3. Joe has no sick leave at work or transportation to make it to appointments or pick up his medicine. He also has trouble getting healthy food.
  4. During a home visit, nurse brings Joe his medicine, checks his blood pressure, and draws blood for lab tests.
  5. Nurse connects Joe to community food and transportation resources. She schedules a clinic visit for his next day off.
  6. At the clinic, Joe’s doctor adjusts his medicine. Joe meets with a nutritionist and diabetes educator.
  7. Pharmacist helps make sure Joe gets his medicine on time and is taking it correctly.
  8. Over time, Joe’s blood pressure and blood sugar are controlled and his kidney function remains okay.

Team-based Patient Care

The diabetes care team helps patients avoid kidney failure by:

  • Controlling blood pressure and blood sugar.
  • Using medicines to protect kidneys.
  • Checking kidney lab tests regularly.

SOURCE: CDC Vital Signs, January 2017

Page last reviewed: January 10, 2017