Living well with diabetes in Alaska

• Published in: International Journal of Circumpolar Health
• Main Authors: Meera L. Narayanan, Peter Holck, Ai-Ling Lin, Cynthia D. Schraer
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2024
• Subjects: Alaska Native; diabetes; long-term; complications; outcomes; Arctic medicine. Tropical medicine; RC955-962; Circumpolar Health; International Journal of Circumpolar Health; Alaska
• Online Access: https://doi.org/10.1080/22423982.2024.2341988; https://doaj.org/article/2e966ebb181243b2b913d89f7ee2c351

ABSTRACTMany people with diabetes mellitus experience minimal or no complications. Our objective was to determine the proportion of Alaska Native people who experienced four major complications or mortality and to identify factors that may be associated with these outcomes. We used records in a diabetes registry and clinical and demographic variables in our analyses. We used logistic regression and Cox Proportional Hazards models to evaluate associations of these parameters with death and complications that occurred prior to 2013. The study included 591 Alaska Native people with non-type 1 diabetes mellitus, diagnosed between 1986 and 1992. Over 60% of people in this study remained free of four major diabetes-related complications for the remainder of life or throughout the approximately 20-year study period. Lower BMI, higher age at diagnosis of diabetes, and use of at least one diabetes medication were associated with death and a composite of four complications. A majority of Alaska Native people with DM had none of four major complications over a 20-year period. Lower BMI and use of diabetes medications were associated with higher hazard for some deleterious outcomes. This suggests that goals in care of elders should be carefully individualised. In addition, we discuss several programme factors that we believe contributed to favourable outcomes.