Date of Award

2-2019

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Jeanie McHugo

Keywords

diabetes, prediabetes, American Indian, Native American, diabetes treatment, obesity, glucose, genetic predisposition, pharmacotherapy, ethnicity, insulin, and lifestyle modifications

Abstract

Diabetes is a debilitating disease process caused by the body’s inability to control blood glucose levels. With over 30 million diabetics in the United States, and another 85 million prediabetics, the effects of this disease are wide-spread and far-reaching. Native American/Alaska Native populations have a nearly two-fold increase in incidence of diabetes when compared to non-native populations. Risk factors for diabetes in all populations include modifiable risks such as obesity, diet, physical inactivity as well as non-modifiable factors such as age, family history, and ethnicity. Studies have shown that early identification of symptoms, coupled with proper and intentional treatment can delay the onset of diabetes. The purpose of this project is to determine the efficacy of currently recognized best-practice therapies in Native American patients and to identify barriers to successful implementation of such practices in the Native American population. A thorough review of the available literature shows that research of this topic specific to the Native American population is lacking. However, evidence suggests that the broad, general population recommendations made by the American Diabetes Association in their Standards of Medical Care in Diabetes (2018) will be equally effective in the Native American population when applied objectively. It is also recognized that Native Americans face additional barriers in the effort to identify and treat diabetes. These include geographic, economic, and social factors that inhibit treatment efficacy and ultimately lead to increased morbidity in this population.

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