Non-Insulin Dependent (Type II Diabetes) in the Eastern Cherokee

Type II (Non-insulin dependent) diabetes is a serious problem for the Eastern Cherokee affecting 8% of the total population and 25% of the population over the age of 35 years. However, there have been no published epidemiological data on diabetes among the Eastern Cherokee since 1965. This study describes the current (1988) epidemiology of diabetes in the Eastern Cherokee population calculated from Indian Health Service Data, compares these rates to the U.S. general population, and examines demographic, cultural, and social factors that affect distribution of diabetes among the Cherokee.

Diabetes was determined to be most common in individuals ages forty-five years and older and among individuals whose degree of Indian inheritance is 75% or more. Although socioeconomic indicators were not available for individual persons, diabetes occurs most frequently in Indian populations residing in North Carolina counties having the greatest number of Indian families with incomes below poverty level.

Comparison of data from the 1924 Baker Roll to the present enrollment shows the current population to be older and have a higher average degree of Indian inheritance. Assortative mating by blood degree resulted in a bimodal pattern of blood degree among Baker enrollees that has been reinforced by social and historical circumstances. The age distribution of the current diabetic cases shows that most of the current diabetic individuals were born when the population was clearly divided according to blood degree. Similar processes may have contributed to diabetes in other tribes and need to be taken into account in comparing diabetes prevalence rates.

Implications of the epidemiological findings for the Eastern Cherokee are discussed, as are other studies that would further enhance understanding of diabetes in this and other Native American populations.