Message of Hope

We Can Prevent Diabetes in Native American Communities

(A Resource of the Diabetes Prevention Program)

What is the future of diabetes prevention in Native American Communities?

Picture Native American man and woman walking. As Native people we have all seen how diabetes affects our lives and our communities. Our focus for the future needs to be on prevention, and we now have proof that we have the power to prevent diabetes. Despite our higher risks for the disease, as Indian Communities we can all work toward preventing diabetes by making modest lifestyle changes. Participants in the Diabetes Prevention Program (DPP) have proven that diabetes can be prevented! The message of hope is clear. We can prevent diabetes in ourselves, in our families and in our communities.

What were the results of the DPP?

The findings of the DPP showed that lifestyle changes, including a healthy diet, adequate exercise and modest weight loss, can dramatically reduce a person’s risk for getting diabetes. The lifestyle changes worked equally well in men and women and in all ethnic groups for preventing diabetes. Although not as effective, the diabetes pill, metformin, also helped to prevent or delay diabetes. But by far, the best way to prevent diabetes is by adopting a healthy lifestyle. Even more encouraging, about twice as many people in the lifestyle group saw their blood sugars return to normal, showing that diet and exercise can reverse prediabetes. With only modest changes in our diets and physical activity along with minimal weight loss, we can reduce our risk for diabetes by 58% in just 3 years! Indian communities have been promoting lifestyle changes to prevent diabetes for decades, but we have not known how much lifestyle change was needed and how dramatically those changes would reduce diabetes. Now, because of the results of the Diabetes Prevention Program, we know that efforts to lose 7% of our weight and exercising 2½ hours a week will dramatically reduce our risk for diabetes.

Picture of Native American woman jogging.

What is the Diabetes Prevention Program?

The Diabetes Prevention Program was a national study that included several American Indian communities. These communities were the Gila River Indian Community, Salt River Pima-Maricopa Indian Community, Urban Indian community of Phoenix, Zuni Indian Pueblo and the Navajo Nation community in Shiprock, NM. People who chose to participate in the DPP were randomly assigned to receive lifestyle changes, a diabetes pill called metformin (also known as Glucophage) or a placebo (inactive pill). The latter two groups also received general advice on healthy eating and exercise. Everyone in the study had impaired glucose tolerance (IGT) or prediabetes and was at high risk for developing diabetes. The goal of the study was to learn which of the treatments would most effectively prevent or delay diabetes.

What kind of lifestyle changes did DPP participants make?

Picture of Native American woman cooking outside.

The DPP’s lifestyle goals were to achieve and maintain a 7% weight loss (14 pounds for someone who weighs 200 pounds) and exercise 2½ hours per week. Walking was the most popular choice for exercise. Participants also cut back on their total caloric intake and the amount of fat they ate. They learned ways to overcome barriers to healthy eating and exercise in order to reach their goals. The classes used are called the Lifestyle Balance Program and are available and can be printed from the web site www.bsc.gwu.edu/dpp/. Each participant had a lifestyle coach or case manager to assist them in achieving and maintaining their lifestyle changes. Though lifestyle change is not easy, the goals set for DPP participants are achievable. The message of HOPE is clear. All of us can work to reduce diabetes by supporting these lifestyle changes in ourselves, in our families and in our communities.

The Diabetes Prevention Program would like to thank:

All DPP participants, the Gila River Indian Community, the Salt River Pima-Maricopa Indian Community, the Urban Phoenix Indian community, Navajo Nation, the Zuni Indian Pueblo, the National Institutes of Health, the Indian Health Service (IHS), and the U.S. Department of Health and Human Services.

More information about the Diabetes Prevention Program and the results of the study are available on the web at www.bsc.gwu.edu/dpp/.

A video tape program describing the results of the Diabetes Prevention Program is available by calling IHS National Diabetes Program at 505-248-4182 or send an email to diabetesprogram@ihs.gov.

Picture of Patricia Hibbeler, DPP Participant.

Patricia Hibbeler, DPP Participant: “For me the Diabetes Prevention Program is a message of Hope. We have the power to prevent or delay the onset of diabetes.”

Picture of Glenda Thomas Fifer, DPP Participant.

Glenda Thomas Fifer, DPP Participant: “I know everybody can do it once they make up their mind. A lot of people out there know it runs in their family and they think ‘Okay, I’m going to get it’. No, it’s not so. You can prevent it. If I can do it, they can do it.”

Picture of Malcolm Bowekaty, Governor, Zuni Indian Pueblo.

Malcolm Bowekaty, Governor, Zuni Indian Pueblo: “As tribal leaders we owe it to our people to say prevention is where we need to make the most impact. For the people of other tribes, make sure your kids get a healthy start. Make sure that you will be around for the next generation so we can have all the tribes prosper.”