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. 2007 Jan;4(1):A06.
Epub 2006 Dec 15.

The epidemic of extreme obesity among American Indian and Alaska Native adults with diabetes

Charlton Wilson  1 , Susan Gilliland, Kelly Moore, Kelly Acton
Affiliations

The epidemic of extreme obesity among American Indian and Alaska Native adults with diabetes

Charlton Wilson et al. Prev Chronic Dis. 2007 Jan.

Abstract

Introduction: The purpose of this study was to describe the prevalence of obesity among American Indian and Alaska Native (AI/AN) adults with diabetes and to examine the temporal trends for class I, II, and III obesity in this high-risk group during a 10-year period.

Methods: We used data on body mass index (BMI) from the annual Diabetes Care and Outcomes Audit to estimate the prevalence of class I, II, and III obesity (class I = 30.0-34.9 kg/m2, class II = 35.0-39.9 kg/m2, and class III > or = 40.0 kg/m2) in each year from 1995 through 2004. We also investigated trends in mean BMI during the 10-year period and the role of treatment in these trends using multivariable linear regression models.

Results: Obesity was highly prevalent in this population in 2004 (class I, 28.9%; class II, 20.4%; class III, 20.3%). From 1995 through 2004, the percentage of obese adults increased from 16.7% to 20.4% in class II and 11.5% to 20.3% in class III (P < .001), and the mean BMI increased from 32.1 kg/m2 to 34.4 kg/m2. The increase in BMI was greater in the younger age groups. Adjusted mean BMI increased significantly over 10 years for each of three treatment categories.

Conclusion: Extreme degrees of obesity are a common and increasing problem among AI/AN adults with diabetes. We did not find an association between the type of diabetes treatment and the trend toward extreme degrees of obesity. The increase in extreme obesity could potentially affect the burden of morbidity and mortality among AI/AN adults with diabetes. Effective and culturally appropriate weight management interventions are needed.

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Figures

Graph
Figure 1
Adjusted mean body mass index (BMI [kg/m2]) by age among American Indian and Alaska Native adults with diabetes, Diabetes Care and Outcomes Audit, Indian Health Service, 1995–2004. Mean was adjusted for age, sex, duration of diabetes, treatment type, and treatment facility.
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