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Narayanan, Meera L.; Schraer, Cynthia D.; Bulkow, Lisa R.; Koller, Kathryn R.; Asay, Elvin; Mayer, Ann Marie; Raymer, Terry W. (2012)
Publisher: Co-Action Publishing
Journal: International Journal of Circumpolar Health
Languages: English
Types: Article
Subjects: Alaska Native, diabetes, prevalence, incidence, amputations, renal replacement, mortality
Objectives. To examine trends in diabetes prevalence, incidence, complications and mortality between 1985 and 2006 among Alaska Native people. Study design. We used data from the population-based Alaska Native Diabetes Registry, which includes all people who receive care in the Alaska Tribal Health System. Methods. We compared the periods of 1986–1990 and 2002–2006 for diabetes-related amputations, renal replacement and mortality using Poisson regression. Complications and mortality data were examined for trends using Poisson regression. Survival analyses for those diagnosed since 31 December 1985 were performed using the Cox proportional hazard model. Results. Age-adjusted diabetes prevalence increased from 17.3 in 1985 to 47.6/1,000 in 2006. The number of Alaska Native people living in Alaska with diabetes increased from 610 in 1985 to 3,386 in 2006. Diabetes incidence rates have also increased. Comparing age-adjusted rates for the 5-year periods 1986–1990 and 2002–2006, amputations decreased from 5.3 to 2.6/1,000, renal replacement decreased from 3.3 to 1.2/1,000 and mortality decreased from 41.7 to 33.2/1,000. Yearly analyses showed a downward trend for amputations, renal replacement and mortality rates. Survival analyses showed a significantly higher hazard ratio for any amputations, major amputations and renal replacement for the earlier time period compared to the most recent time period. Conclusions. An increase in risk factors, awareness, funding and case-finding may be contributing to the increase in prevalence and incidence of diagnosed diabetes. While diabetes prevalence and incidence are increasing among Alaska Native people, our results suggest that even in remote, rural areas, complications and mortality can be reduced.(Int J Circumpolar Health 2010; 69(3):236–252)Keywords: Alaska Native, diabetes, prevalence, incidence, amputations, renal replacement, mortality
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

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    • ICD-9 codes used for ascertaining diabetes were 250.00-250.93, 357.2, 362.0-362.06, 366.41, 648.0-648.04, 648.80-648.84, 790.20-790.22, 790.29. ICD-9 codes used for ascertaining incidence of amputations were v49.70- v49.77, and operation codes of 84.10-84.19 and 84.3. For renal replacement, the ICD-9 codes used were v56.0-v56.8, v45.1, v42.0 and operation codes of 39.95- 39.953, 54.98-54.983, 55.6-55.692.
    • ICD-9 and ICD-10 codes used for classifying death causes were as follows: circulatory: I00-I99 and 390-459; all heart diseases: I00-I09; I11, I13, I20-I51, 390-398, 402,404, 410- 429; IHD: I20-25; 410-414; 429.2; CVA: I60-69, 430-434, 436-438; diabetes: E10-14 and 250; neoplasms: C00-D48 and 140-239; digestive: K00-K93 and 520-579; respiratory: J00-J99 and 460-519; injuries: S00-Y98 and 800-999; genitourinary: N00-N99 and 580- 629; infectious diseases A00-B99, 001-139.
    • Person- years of diabetes 1986-1990 2002-2006 All Alaska Native 3598.5 13981 Eskimo 1079.5 4836 Indian 1705 6134.5 Aleut 814 3009 Male 1406.5 5965.5 Female 2192 8015.5 Appendix III. Denominators for amputations, renal replacement and renal death rates, including duration of diabetes (for data in Tables V and VII). Duration of diabetes 1996-1998 1999-2001 2002-2006 <55 <5 years 954.5 1371 3235.5 5-9 years 345 518 1546.5 10+ years 301.5 337.5 788 ≥55 <5 years 1099.5 1446.5 2871.5 5-9 years 716.5 1026 2485 10+ years 1052 1234 2971
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