Natives three times more likely
to get diabetes

By Phil Ferolito
Yakima Herald Republic

TOPPENISH, Wash. – Corky Ambrose remembers his blood sugar level being as high as 530 when he was first diagnosed with diabetes about 20 years ago.

Sugar levels that high over extended periods of time can cause eye, kidney and heart damage.

“I felt so thirsty, I was trying to drink water all the time,” the 75-year-old tribal member said while sitting at the Yakama Indian Health Service clinic. “I figured something was going on.”

He said he was given medication that brought his blood sugar level down to about 200 -- still higher than the normal level that should range from about 80 to 140.

He lacked energy and breathed heavily. His activity level nosedived.

Ambrose is just one of more than 1,000 Native Americans on the Yakama reservation suffering from diabetes.

Nationally, Native Americans are nearly three times more likely to be diagnosed with diabetes, according to the National Indian Health Board.

“It is increasing at an alarming rate in Indian Country,” said Dr. Rex Quaempts, a Yakama tribal member and family physician with Indian Health Services.

He blames fast foods, inactivity and too much television.

One in five Yakama tribal members older than age 50 are affected by diabetes. But the tribe has started programs to help patients live healthier lives and better manage their diabetes.

Today, Ambrose said he keeps his blood sugar level below 130. Changing his diet and exercising regularly has made the difference, he said.

“I’ve turned it over 180 degrees,” he said. “I just eat salads and stuff. I don’t eat french fries.”

Participating for the past two years in the Healthy Heart program has been the key to his success, he said.

Operated by the Indian Health Services, the program is in its fourth year and is funded by a five-year, $400,000 federal grant. Health officials hope funding will be renewed for the program at the end of next year.

At the clinic, Ambrose sees a pharmacist monthly who reviews his medication, blood sugar, blood pressure and cholesterol. Healthy eating and exercise are also discussed.

He’s returned to powwow dancing, walks regularly and often goes fishing.

“Since I got on this thing, now I’m more active than I have been for a long time,” he said. “I’m not really breathing hard.”

Visiting a single pharmacist who serves as a case manager helps patients focus on combating diabetes by keeping up with their medication needs. They’re also able to do a better job of charting and tracking sugar and cholesterol levels and blood pressure, said case manager Robin John.

“It’s a lot easier than trying to get in to see a doctor,” she said. “It’s a lot more personable.”

Patient Starr McDaniels said that before, she’d only see a doctor once every six months, usually after something was wrong. But under the Healthy Heart program, she said she’s taken a more active approach to combating diabetes.

“I can call and just talk to Robin, let her know how things are going and if I need my meds refilled, she can just do it,” she said.

Since the program began, there has been a 30 to 50 percent overall improvement in patients’ blood sugar, blood pressure and cholesterol -- all factors that are tied to diabetes, Quaempts said.

“The patients are getting better,” he said. “We are very happy with it.”

The program mainly focuses on patients already diagnosed with diabetes, but oftentimes patients refer their family members, John said.

McDaniels’ younger sister recently lost her sight because of diabetes, and now is in the program. Both her parents and a grandparent also have diabetes.

“It’s a family thing,” she said.

Of the 1,049 active diabetes patients on the reservation, about 270 of them take part in the Healthy Heart program.

Most of the rest are involved in the Yakama Nation’s Diabetes Program, where they are educated on preventive measures to prevent the long-term and more serious effects of diabetes, said Melia Delp, a registered nurse with the program.

Diabetes is strongly linked to obesity, and getting patients active is key to combating diabetes, she said.

“That’s probably the single best thing a person can do to reduce their risk or manage their diabetes,” she said.

Line dancing, swimming and aerobics are some of the activities held. There are also track meets and powwows.

“It’s a lifestyle choice,” Quaempts added.